Q&A: Can a routine shingles shot lower risk of dementia?

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Research has found the shingles vaccine not only prevents the painful, blistering rash in older people, but also protects the brain.

Scientists led by Stanford University found, over seven years, the vaccine cut the risk of developing dementia by 20%. In December, a follow-up study by a team led by Heidelberg University Hospital reported that shingles vaccination may also lower risks across different stages of dementia, even among those already diagnosed.

Dr. Costi Sifi, director of hospital epidemiology at UVA Health, talks about the studies and their significance.

Q. Can you explain what shingles is and who should be vaccinated?

A. Shingles is due to the chickenpox virus. Before we were vaccinating for it, you’d get it once, usually in childhood. (It causes) a localized rash on one side of the body or another, often on the chest, occasionally on the face. It can be pretty severe, causing a lot of pain and some itchiness. In a subset of individuals, it can cause post-infectious pain. (When) we reach 50, 60, 70 years of age, it’s more likely to occur and can be quite debilitating. Often it takes weeks or months to resolve.

In general, if you’re over the age of 50 or are immunocompromised, you’re eligible for (the FDA-approved vaccine) Shingrex.

Q. Is it true that if you had chicken pox, you need a shingles vaccine, but if you didn’t, you don’t need the vaccine?

A. So, the first thing is, most people who don’t know or don’t think that they’ve ever had chickenpox actually have had chickenpox. They just didn’t realize that. They were too young to remember it, or their parents never told them. Or maybe their case was so mild … they didn’t recognize (it) as having chickenpox.

If you meet the criteria for Shingrix—you’re 50 years of age or older, but you don’t remember that you had chicken pox, or your mom never told you, or she didn’t know, or you were adopted—the recommendation is just to get the Shingrix vaccine.

Q. How would you characterize these studies? What is your professional view?

A. I’m not a neurologist, but I think that a 20% reduction in dementia or death due to dementia (is) a remarkable finding. So, I do think that it’s a landmark and that it maybe helps us think freshly about some of the things that can lead to neurologic decline and ways to mitigate them.

Q. What should people also be doing to reduce their risk of dementia?

A. Exercise and excellent diet, keeping yourself cardiovascularly healthy … maintaining your weight, avoiding smoking and alcohol, having a well-balanced diet, are all things that we’re familiar with as ways to protect ourselves from Alzheimer’s and other causes of neurologic decline as we get older.

Those are all critically important. There’s (also) been a lot of focus recently on things like your connectedness to communities. So, having loved ones and spouses (and) a community that cares for you and that you care for are important.

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