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The most interesting thing that I saw was: "We find strong protective effects of the vaccine for women but none for men, and that this diff is driven by Alzheim

The most interesting thing that I saw was: "We find strong protective effects of the vaccine for women but none for men, and that this diff is driven by Alzheimer’s (not vascular) dementia." I've been meaning to get around to getting the shingles vaccine. I was all set to head out the the pharmacy to get it immediately until I read that..

teraflop 3y ago
You have to be careful how you read that. The researchers did not find that the shingles vaccine does not protect men (from dementia caused by Alzheimer's). They failed to find statistically significant evidence, in their studied population, that the vaccine protects men. As the preceding sentence says, this can be plausibly explained by the fact that shingles is more common in women, so whatever protective effect the vaccine has is larger and more measurable.
- A_D_E_P_T 3y ago
  The paper found absolutely no effect in men. That is to say: No trend nor indication that it might protect men. Sometimes trends seem suggestive of a real effect, but don't rise to statistical significance. That is not the case here. This is in Figure 4 of the preprint.
  - regularfry 3y ago
    It could also be that there is a potential effect that this study would have been underpowered to detect, and by chance no trend was visible in this population. That's not inconsistent, or even particularly unlikely, if I'm understanding it right.
    - A_D_E_P_T 3y ago
      (A) To suggest that the lack of effect in men is a statistical anomaly, and that there IS an effect we're not seeing. (B) To suggest that the effect in women is a statistical anomaly, and that there's nothing there but a fluke. These things, from the data, are approximately equally likely. Because there was zero effect in men -- in fact, men who took the vaccine were apparently more likely to be diagnosed with Alzheimer's, though this trend was extremely slight.
      - adgjlsfhk1 3y ago
        this isn't necessarily true. if the study had 1000 women and 100 men, it would be a lot more likely that the result in men was wrong. similarly, if the effect was 20x weaker in men than women, but still existed you would be much more likely to see no effect in men even though effects existed for both.
        A_D_E_P_T 3y ago
        Not necessarily true in a theoretical sense, sure. But there's absolutely no indication that they enrolled 10x (or even 2x) more women than men. Nor is there any indication of any effect in men, 20x weaker or otherwise. (If we're charitable, it's pretty much a flat zero.)
        sbierwagen 3y ago
        Total study size was 282,541 people, 128,322 men and 154,218 women. From supplementary material 1, page 27: https://www.medrxiv.org/content/10.1101/2023.05.23.23290253v1.supplementary-material https://www.medrxiv.org/content/10.1101/2023.05.23.23290253v...
      - shkkmo 3y ago
        > These things, from the data, are approximately equally likely. They aren't. The paper states that 95% confidence interval for men includes a maximum protective effect of up to -1.9 while the 95% confidence for women include a minimum effect of -1.3. Thus it is far more likely that there is a protective effect for man than no protective effect for women.
        A_D_E_P_T 3y ago
        Are you ignoring the fact that it might have a negative effect, rather than a protective effect? The range for men is -1.9 to +2.1 -- which averages out to +0.2 -- which indeed makes it seem as though the vaccine's trend is to make one slightly more susceptible to Alzheimer's, rather than less susceptible, which is itself borne out in the figure's trend line. (Fig 4.) For women it's -5.3 to -1.3.
bigbillheck 3y ago
Get it anyway, you don't want shingles.
- throwaway173738 3y ago
  Yeah Shingles is awful.
  - phkahler 3y ago
    Even a mild case sucks a lot.
- deleted 3y ago
  [deleted]
WillPostForFood 3y ago
Also, the study was based on the Zostavax, the live virus shingles vaccine. It was discontinued in 2020 (at least in the US) in favor of Shingrix which doesn't have live virus. Unclear whether Shingrix will have the same effects, though seems reasonable to think it might.
loeg 3y ago
You should get the vaccine. Shingles is awful.
theonething 3y ago
So you're hesitating to get the shingles vaccine because you found out it might not protect you against dementia? Don't you want to be protected against shingles?

teraflop 3y ago

You have to be careful how you read that. The researchers did not find that the shingles vaccine does not protect men (from dementia caused by Alzheimer's). They failed to find statistically significant evidence, in their studied population, that the vaccine protects men. As the preceding sentence says, this can be plausibly explained by the fact that shingles is more common in women, so whatever protective effect the vaccine has is larger and more measurable.

A_D_E_P_T 3y ago
The paper found absolutely no effect in men. That is to say: No trend nor indication that it might protect men. Sometimes trends seem suggestive of a real effect, but don't rise to statistical significance. That is not the case here. This is in Figure 4 of the preprint.
- regularfry 3y ago
  It could also be that there is a potential effect that this study would have been underpowered to detect, and by chance no trend was visible in this population. That's not inconsistent, or even particularly unlikely, if I'm understanding it right.
  - A_D_E_P_T 3y ago
    (A) To suggest that the lack of effect in men is a statistical anomaly, and that there IS an effect we're not seeing. (B) To suggest that the effect in women is a statistical anomaly, and that there's nothing there but a fluke. These things, from the data, are approximately equally likely. Because there was zero effect in men -- in fact, men who took the vaccine were apparently more likely to be diagnosed with Alzheimer's, though this trend was extremely slight.
    - adgjlsfhk1 3y ago
      this isn't necessarily true. if the study had 1000 women and 100 men, it would be a lot more likely that the result in men was wrong. similarly, if the effect was 20x weaker in men than women, but still existed you would be much more likely to see no effect in men even though effects existed for both.
      - A_D_E_P_T 3y ago
        Not necessarily true in a theoretical sense, sure. But there's absolutely no indication that they enrolled 10x (or even 2x) more women than men. Nor is there any indication of any effect in men, 20x weaker or otherwise. (If we're charitable, it's pretty much a flat zero.)
      - sbierwagen 3y ago
        Total study size was 282,541 people, 128,322 men and 154,218 women. From supplementary material 1, page 27: https://www.medrxiv.org/content/10.1101/2023.05.23.23290253v1.supplementary-material https://www.medrxiv.org/content/10.1101/2023.05.23.23290253v...
    - shkkmo 3y ago
      > These things, from the data, are approximately equally likely. They aren't. The paper states that 95% confidence interval for men includes a maximum protective effect of up to -1.9 while the 95% confidence for women include a minimum effect of -1.3. Thus it is far more likely that there is a protective effect for man than no protective effect for women.
      - A_D_E_P_T 3y ago
        Are you ignoring the fact that it might have a negative effect, rather than a protective effect? The range for men is -1.9 to +2.1 -- which averages out to +0.2 -- which indeed makes it seem as though the vaccine's trend is to make one slightly more susceptible to Alzheimer's, rather than less susceptible, which is itself borne out in the figure's trend line. (Fig 4.) For women it's -5.3 to -1.3.

bigbillheck 3y ago

Get it anyway, you don't want shingles.

throwaway173738 3y ago
Yeah Shingles is awful.
- phkahler 3y ago
  Even a mild case sucks a lot.
deleted 3y ago
[deleted]

WillPostForFood 3y ago

Also, the study was based on the Zostavax, the live virus shingles vaccine. It was discontinued in 2020 (at least in the US) in favor of Shingrix which doesn't have live virus. Unclear whether Shingrix will have the same effects, though seems reasonable to think it might.

loeg 3y ago

You should get the vaccine. Shingles is awful.

theonething 3y ago

So you're hesitating to get the shingles vaccine because you found out it might not protect you against dementia? Don't you want to be protected against shingles?