5 ms·

I'm in my 40s with genetic predisposition for Alzheimer's. Been seriously considering the past year or two paying out of pocket for Shingrix. I think it would b

I'm in my 40s with genetic predisposition for Alzheimer's. Been seriously considering the past year or two paying out of pocket for Shingrix. I think it would be ~$500 total for two doses. Sure, I could wait 7 or 8 years until I qualify via insurance, but is that really worth the risk for what is an easily absorbed cost to me? Especially when I have a friend in her late 30s who just went through a very rough bout of shingles? It makes sense to have targets like age 50 for population-wide public health recommendations. But it can and does infect people of much earlier ages. Recent articles like this make me think I'll go ahead.

cyanydeez 3mo ago
aside from age ranges being the tested population, your just gambling no other interference pattern is involved.
- deleted 3mo ago
  [deleted]
copperx 3mo ago
Shingles terrifies me because it can cause hearing loss. I spoke to my GP and he wouldn't give me a script for it even though I'm 3 years away from qualifying. He mentioned side effects.
- jyounker 3mo ago
  That seems like being penny wise and pound foolish.
  - tptacek 3mo ago
    I think the bigger thing is that the vaccine has a peak response window, and the current medical guidance lines that up with when you're epidemiologically most likely to experience a shingles outbreak (for most people, that's very unlikely when you're young, because your immune system is so jumpy, but that wanes with age). If you get the vaccine early, its effect can be attenuated right when you need it most. (I don't like this logic and if I had the option of just going to Walgreens and getting vaccinated, I'd do that this afternoon. I'm just saying, there's a logic to it.)
  - subscribed 3mo ago
    Looks like the GP is in the UK. I tried to go private (also not 50), but everyone just refused. Pharmacy, GP, private GP. Currently I'm arranging it in the third country because WTAF. (UK becoming the dirtiest and sickest country of Europe one more time)
    - monkey_monkey 3mo ago
      > (UK becoming the dirtiest and sickest country of Europe one more time) Big Yawn
      - subscribed 3mo ago
        Don't let the facts to discourage you from yawning. > [1] Of the reported 22,289 bathing waters across Europe (EU-27, Albania and Switzerland) in 2025, 84% were rated excellent quality. This share reached 85% at the EU level. [1] https://www.eea.europa.eu/en/analysis/publications/european-bathing-water-quality-in-2025 https://www.eea.europa.eu/en/analysis/publications/european-... > [2] In 2025, 297 bathing waters in England (66.1 per cent) met the Excellent standard Note the sharply increasing amount of "Poor" waters. And that's despite the methodology allowing to presence of untreated sewage and human faeces in the "excellent" waters: https://www.theferret.scot/scottish-beaches-excellent-polluted-sewage/ https://www.theferret.scot/scottish-beaches-excellent-pollut... [2] https://www.gov.uk/government/statistics/bathing-water-quality-statistics/2025-statistics-on-english-coastal-and-inland-bathing-waters-a-summary-of-compliance-with-the-bathing-water-amendment-england-and-wales-regulatio https://www.gov.uk/government/statistics/bathing-water-quali... With treatment waiting times, dental treatment availability and deaths while waiting for the ambulance I don't think I need to get into gory details.
    - pasc1878 3mo ago
      The age for shingles vaccine in the UK under the NHS (so free) is 65. Of course I got shingles when I was 64. Caught early and got anti-virals and had no lasting effects.
      - subscribed 3mo ago
- bitwize 3mo ago
  My A1C popped high, so I could get Shingrix 2 years before the nominal minimum age, paid for by insurance, on the technicality of having a T2D diagnosis. My blood sugar is much more under control now, but that's a nice little side benefit I won't hesitate to take advantage of. The most severe side effect for me was long term muscle pain near the injection site (even now 10 months after I got the shot). But it's totally worth it because the pain of shingles is far, far worse as I understand it.
- dr_kiszonka 3mo ago
  "An increased risk of Guillain-Barré syndrome (severe muscle weakness) was observed after vaccination with SHINGRIX" https://www.shingrix.com/side-effects/ https://www.shingrix.com/side-effects/
  - throwaway2037 3mo ago
    For the record, annual flu vaccines also have this risk, but it doesn't stop 450 million people from getting them.
andy99 3mo ago
I read before that iirc because of waning protection it’s better not to get it too early. It’s not clear to me why you can’t get it twice, but what I read (and it was some online discussion so could be wrong) was that someone had been specifically told by their doctor to wait to 50 as the best spot to get it. I’d like to know more, I’m in my 40s and would be happy to get it now too but not if it was going to be worse overall for some reason.
- anonym29 3mo ago
  The antibodies you develop to fight the virus fade over time. I just had it fairly recently (young 30s, vaccinated with the attenuated chickenpox virus, never had chickenpox, so this was likely the vaccine strain¹). Did a lot of reading and research during and after. The antibodies seem to offer good protection for 5-10 years following either vaccination or infection according to the literature I was reading. ¹ The vaccine strain tends to be much more mild than the wild strain, and indeed it was quite unpleasant, but not extremely painful for me. The wild strain is considerably more painful and linked to a greater incidence rate of complications. Please do not skip chickenpox vaccinations for your kids, the minor risk of latent infection from attenuated vaccine is far less harmful than the consequences of not vaccinating. Most important of all, if you have a cluster of blisters or rash on one side of your body that keep popping up, make sure to see a doctor and get on antivirals within the first 72 hours for best results.
  - jimbob45 3mo ago
    You had Shingles after never having chicken pox except the vaccine?
    - anonym29 3mo ago
      Yes. In my case, the virus became active after severe and chronic sleep deprivation one summer where I tried experimenting with going from a 16/8 sleep schedule to a 24/12 sleep schedule, on a now-resoundingly-disproven hypothesis that the ratio of waking hours to sleeping hours was more important than the absolute number of each for healthy functioning. Stress and sleep deprivation are known triggers for the virus, which lies dormant in the nervous system for life after initial infection, and can be dormant for decades at a time between reactivations.
mlyle 3mo ago
I got shingles at 45 and it was -not fun-. My arm is slightly disfigured. I think the age 50 target is dated. With reduced childhood incidence of chicken pox, we're all exposed to varicella zoster less, and it seems like the ages of incidence of shingles is falling. Public health recommendations are slow to catch up with research (especially for vaccinations, these days).
- jyounker 3mo ago
  Yeah, I came here to say the same thing. I got it around 46. The horrible looking stuff on the outside is also on the inside, and it weakens your internal tissues. I know this because I tore one of the muscles in my lower back, and it still causes problems.
- zahlman 3mo ago
  > Japan was among the first countries to vaccinate for chickenpox. The vaccine developed by Hilleman was first licensed in the United States in 1995.[17][60] People (well, Americans and Canadians at least) in their 40s now generally didn't get vaccinated as children, as their parents didn't have the option. It will be different for the next generation.
  - pkaye 3mo ago
    Interestingly UK took a different approach and only started offering chicken pox vaccines for children this year. https://www.gov.uk/government/news/free-chickenpox-vaccination-offered-for-first-time-to-children https://www.gov.uk/government/news/free-chickenpox-vaccinati...
    - mlyle 3mo ago
      Which, if chickenpox is really the cause of a lot of dementia (as this article implies) might have been a pretty grave mistake.
- iambenm 3mo ago
  I got it around 36, and coincidentally a friend 5-6 years younger than me in a different part of the country got it at the same time. My research at the time led me to the same conclusion: Since we've basically eradicated chickenpox, we're not exposed to the varicella zoster virus as much as previous generations (via children that have chickenpox). Without exposure our antibodies / resistance fade out. Since we had chickenpox, the virus is already in us and dormant. When it wakes up and decides to do its thing, our bodies have forgotten how to fight it effectively compared to previous generations - and as a result, the incidence of shingles is increasing in younger populations compared to previous generations. My doctor said vaccination for under 50 is only indicated after multiple occurrences of shingles... so here's to hoping I'm good til the guidelines change.
tptacek 3mo ago
Wait, you can just pay for the shingles vaccine, before you're 50? Where do I do that? I had shingles in my 30s. It was the sickest I've ever been.
- Aurornis 3mo ago
  You can get basically any medication or vaccination you want in the US as long as you can find a doctor to write the prescription. We even have anabolic steroids that were approved for muscle wasting in cancer patients, but if you can find a doctor willing to write the prescription and a pharmacy that won’t question it, anyone can have pharmacy grade Anavar for the gym, completely legal. In theory the doctor writing the prescription is putting their license at risk, but enforcement is so lax that there are “anti-aging” clinics all over that will prescribe testosterone and Anavar to anyone with a credit card. So with a documented history of shingles you should have no problem getting a prescription written. It would be worth a quick check with your insurance company because it might even be covered if your doctor will fill out the form and attach evidence of the past diagnosis.
  - dataflow 3mo ago
    > You can get basically any medication or vaccination you want in the US as long as you can find a doctor to write the prescription. Is that not usually true in other countries?
    - jandrewrogers 3mo ago
      There is a large industry in the US that specializes in catering to people that want medications, vaccines, diagnostics, and treatments that are outside the recommended standard of care that medical insurance or public health systems cover. You have to pay for these services directly but the market is competitive so the cost is quite reasonable. A doctor must sign off on these but that step is mostly performative outside of some narrow exceptions. My impression is that this type of medical care is much more accessible in the US than most other developed countries.
scrollop 3mo ago
There were a few studies around 2022 showing the influenza vaccines and pneumoccocal vaccines reduce alzheimers (influenza by up to a whopping 40%!). I tell me patients this to increase uptake, so we can reduce alzheimer's prevalence. (I'm a doctor)
- hn_throwaway_99 3mo ago
  Do you have a link to these studies? I ask because, as another commenter mentioned, I think it would be very difficult to tease out cause and effect and I think the "healthy vaccinee" hypothesis could easily explain why so often you see the association between any vaccine (just here we have shingles, influenza and pneumococcal) and Alzheimer's risk reduction. To be clear, I would get those vaccines regardless for their stated effectiveness, it just feels like so many observational conclusions ("moderate red wine is good for you!") have been proven to be non-causitive correlations when examined more closely. Edit: Actually, the youtube link posted above talks about tons of vaccines where observational studies show reduced Alzheimer's risk: https://youtu.be/qlTnnQytOJ0?t=340 https://youtu.be/qlTnnQytOJ0?t=340
  - gdudeman 3mo ago
    I believe that there are studies that show that merely getting very sick increases your chance of dementia - essentially it ages you faster or brings chronic disease forward. If that's the case, vaccines for things like the flu - a disease you're likely to get - are probably good overall. They also activate the immune system in generaly, which could probably go either way in terms of longevity. In general I don't think vaccines are preventing so much as delaying dementia, but if they stop chronic infection they might be.
  - emceestork 3mo ago
    https://www.neurology.org/doi/10.1212/WNL.0000000000214782 https://www.neurology.org/doi/10.1212/WNL.0000000000214782 edit: Sorry this is the follow up study but the 40% study is linked within
js2 3mo ago
On the topic of vaccines, if you were vaccinated against measles before it switched to the two-dose schedule (1989 in the US), you might want to have your titers measured. I was vaccinated in the early 70s when it was a single dose. With measles in the news recently, I asked my doc to add a measles antibodies test to my blood draw. Came back negative. No immunity. I went to the local pharmacy and got an MMR booster the next day. https://www.health.harvard.edu/diseases-and-conditions/some-adults-may-need-a-measles-booster-shot-who-should-get-one-and-why https://www.health.harvard.edu/diseases-and-conditions/some-...
- daft_pink 3mo ago
  If you were vaccinated on the normal schedule, what year would you generally be born to be vaccinated with the single dose?
  - js2 3mo ago
    In the U.S., the second dose was added in 1989 so around then. You might've also gotten a booster in the U.S. if you were born earlier but lived in a college dormitory. If you're not sure, get tested. It's a simple blood draw.
zeckalpha 3mo ago
My understanding is that they're not sure if the vaccine will last in your system for more than 30 years, and that subsequent doses may be less effective, so getting it early may weaken you later. But I am with you. My personal bet is we'll know more about this by the time that becomes an issue. The earliest cohorts of vaccinated children are approaching their 30s, so we should learn about long term efficacy this decade.
- dualvariable 3mo ago
  > they're not sure if the vaccine will last in your system for more than 30 years Vaccines don't really last in your system more than a few days (although some cells get dragged off to the lymph nodes and get harshly interrogated for longer than that). It is the T-cell and B-cell responses that are persistent for years. > and that subsequent doses may be less effective They should activate B cells that you already have and produce high-affinity mature antibodies.
- robot_jesus 3mo ago
  It's a fair callout, but for me (and increased propensity for Alzheimer's) the calculus is a bit different. Making to to my mid-70s with full mental faculties would easily be worth the tradeoff of an increasing likelihood of shingles at that point. And besides, I would presume I would be able take the vaccine again?
  - warshinder 3mo ago
    They have donanimab now, and apoe4 testing may qualify you if you have any prodromal (easily faked frankly) symptoms and a decent insurer.
anarticle 3mo ago
I feel like we've probably spent more for less! Any interaction with the medical industry for less than 1k feels like a steal to me.
reenorap 3mo ago
This finding of shingles and dementia is likely due to “healthy vaccinee” bias as per the link someone else posted below: https://youtu.be/qlTnnQytOJ0?is=XJ0c5pWVV6Lg0IMs https://youtu.be/qlTnnQytOJ0?is=XJ0c5pWVV6Lg0IMs As per one of the slides around 7 minutes in, there are many vaccines that show a 20-40% reduction in mortality and dementia. The talk above basically says that “observational studies” may show great results, like the so-called protective action of the shingles vaccine against dementia. However when brought to a well designed RCT all those benefits don’t actually show up. And the speaker shows later on that the shingles vaccines shows a marked benefit for shingles but nothing for dementia.
- gdudeman 3mo ago
  This really isn't the case in the Shingles vaccine unless the UK study is flawed a way that isn't clear to me. The study looked at the effect of being eligible for a vaccine and the results were clear. (see chart below the fold here: https://erictopol.substack.com/p/the-shingles-vaccine-and-reduction https://erictopol.substack.com/p/the-shingles-vaccine-and-re...) There was a hard age cutoff in the UK study. Above a certain age, you weren't eligible. Below it, you were. People who were born in the "can get the vaccine" group have markedly lower rates of dementia. People in the "too old" group have higher rates. It's one of those studies where you don't even need to look at the p-value to see the difference. I'm very open to being wrong about this!
  - warshinder 3mo ago
    Right. And RCTs not showing things than can be seen in larger observational studies seems plausibly related to the problems with RCTs, for instance statistical power being generally lower because n sizes are lower, attrition is an issue, etc… I want to believe the research though, especially since I like most smart people are going to get the Shingrix shot anyway.
    - reenorap 3mo ago
      It’s the opposite. Observational studies are very biased by the selection process and the only way to get signal from them is rct.
OutOfHere 3mo ago
Most people, especially those under the vaccination age of 50, with a weak immune system don't supplement a correct dose of basic immune boosting supplements like vitamin D3 (4-6 KIU), zinc (15-25 mg), selenium (200 mcg), and beta glucan, which typically is why they have a weak immune system in the first place. Safely boosting your immune system's baseline will protect you not just against opportunistic shingles but various other things too.
WalterBright 3mo ago
When covid struck, I went and got revaccinated for the usual - MMR, Polio, etc.
gdudeman 3mo ago
People who are immune compromised qualify for this. I'm not sure how much your insurance company would push back on that though.
greg7mdp 3mo ago
Got the shingrix vaccine for free at my county health center, even though it was not covered by my insurance. Worth checking.
deleted 3mo ago
[deleted]
throwaway2037 3mo ago
If you have any developing countries nearby (holiday, etc.), you can usually get it cheaper at a clinic. I get my vaccines (when on holiday) in Thailand here: https://www.thaitravelclinic.com/vaccine-price-list/ https://www.thaitravelclinic.com/vaccine-price-list/

cyanydeez 3mo ago

aside from age ranges being the tested population, your just gambling no other interference pattern is involved.

deleted 3mo ago
[deleted]

copperx 3mo ago

Shingles terrifies me because it can cause hearing loss. I spoke to my GP and he wouldn't give me a script for it even though I'm 3 years away from qualifying. He mentioned side effects.

jyounker 3mo ago
That seems like being penny wise and pound foolish.
- tptacek 3mo ago
  I think the bigger thing is that the vaccine has a peak response window, and the current medical guidance lines that up with when you're epidemiologically most likely to experience a shingles outbreak (for most people, that's very unlikely when you're young, because your immune system is so jumpy, but that wanes with age). If you get the vaccine early, its effect can be attenuated right when you need it most. (I don't like this logic and if I had the option of just going to Walgreens and getting vaccinated, I'd do that this afternoon. I'm just saying, there's a logic to it.)
- subscribed 3mo ago
  Looks like the GP is in the UK. I tried to go private (also not 50), but everyone just refused. Pharmacy, GP, private GP. Currently I'm arranging it in the third country because WTAF. (UK becoming the dirtiest and sickest country of Europe one more time)
  - monkey_monkey 3mo ago
    > (UK becoming the dirtiest and sickest country of Europe one more time) Big Yawn
    - subscribed 3mo ago
      Don't let the facts to discourage you from yawning. > [1] Of the reported 22,289 bathing waters across Europe (EU-27, Albania and Switzerland) in 2025, 84% were rated excellent quality. This share reached 85% at the EU level. [1] https://www.eea.europa.eu/en/analysis/publications/european-bathing-water-quality-in-2025 https://www.eea.europa.eu/en/analysis/publications/european-... > [2] In 2025, 297 bathing waters in England (66.1 per cent) met the Excellent standard Note the sharply increasing amount of "Poor" waters. And that's despite the methodology allowing to presence of untreated sewage and human faeces in the "excellent" waters: https://www.theferret.scot/scottish-beaches-excellent-polluted-sewage/ https://www.theferret.scot/scottish-beaches-excellent-pollut... [2] https://www.gov.uk/government/statistics/bathing-water-quality-statistics/2025-statistics-on-english-coastal-and-inland-bathing-waters-a-summary-of-compliance-with-the-bathing-water-amendment-england-and-wales-regulatio https://www.gov.uk/government/statistics/bathing-water-quali... With treatment waiting times, dental treatment availability and deaths while waiting for the ambulance I don't think I need to get into gory details.
  - pasc1878 3mo ago
    The age for shingles vaccine in the UK under the NHS (so free) is 65. Of course I got shingles when I was 64. Caught early and got anti-virals and had no lasting effects.
    - subscribed 3mo ago
bitwize 3mo ago
My A1C popped high, so I could get Shingrix 2 years before the nominal minimum age, paid for by insurance, on the technicality of having a T2D diagnosis. My blood sugar is much more under control now, but that's a nice little side benefit I won't hesitate to take advantage of. The most severe side effect for me was long term muscle pain near the injection site (even now 10 months after I got the shot). But it's totally worth it because the pain of shingles is far, far worse as I understand it.
dr_kiszonka 3mo ago
"An increased risk of Guillain-Barré syndrome (severe muscle weakness) was observed after vaccination with SHINGRIX" https://www.shingrix.com/side-effects/ https://www.shingrix.com/side-effects/
- throwaway2037 3mo ago
  For the record, annual flu vaccines also have this risk, but it doesn't stop 450 million people from getting them.

andy99 3mo ago

I read before that iirc because of waning protection it’s better not to get it too early. It’s not clear to me why you can’t get it twice, but what I read (and it was some online discussion so could be wrong) was that someone had been specifically told by their doctor to wait to 50 as the best spot to get it. I’d like to know more, I’m in my 40s and would be happy to get it now too but not if it was going to be worse overall for some reason.

anonym29 3mo ago
The antibodies you develop to fight the virus fade over time. I just had it fairly recently (young 30s, vaccinated with the attenuated chickenpox virus, never had chickenpox, so this was likely the vaccine strain¹). Did a lot of reading and research during and after. The antibodies seem to offer good protection for 5-10 years following either vaccination or infection according to the literature I was reading. ¹ The vaccine strain tends to be much more mild than the wild strain, and indeed it was quite unpleasant, but not extremely painful for me. The wild strain is considerably more painful and linked to a greater incidence rate of complications. Please do not skip chickenpox vaccinations for your kids, the minor risk of latent infection from attenuated vaccine is far less harmful than the consequences of not vaccinating. Most important of all, if you have a cluster of blisters or rash on one side of your body that keep popping up, make sure to see a doctor and get on antivirals within the first 72 hours for best results.
- jimbob45 3mo ago
  You had Shingles after never having chicken pox except the vaccine?
  - anonym29 3mo ago
    Yes. In my case, the virus became active after severe and chronic sleep deprivation one summer where I tried experimenting with going from a 16/8 sleep schedule to a 24/12 sleep schedule, on a now-resoundingly-disproven hypothesis that the ratio of waking hours to sleeping hours was more important than the absolute number of each for healthy functioning. Stress and sleep deprivation are known triggers for the virus, which lies dormant in the nervous system for life after initial infection, and can be dormant for decades at a time between reactivations.

mlyle 3mo ago

I got shingles at 45 and it was -not fun-. My arm is slightly disfigured. I think the age 50 target is dated. With reduced childhood incidence of chicken pox, we're all exposed to varicella zoster less, and it seems like the ages of incidence of shingles is falling. Public health recommendations are slow to catch up with research (especially for vaccinations, these days).

jyounker 3mo ago
Yeah, I came here to say the same thing. I got it around 46. The horrible looking stuff on the outside is also on the inside, and it weakens your internal tissues. I know this because I tore one of the muscles in my lower back, and it still causes problems.
zahlman 3mo ago
> Japan was among the first countries to vaccinate for chickenpox. The vaccine developed by Hilleman was first licensed in the United States in 1995.[17][60] People (well, Americans and Canadians at least) in their 40s now generally didn't get vaccinated as children, as their parents didn't have the option. It will be different for the next generation.
- pkaye 3mo ago
  Interestingly UK took a different approach and only started offering chicken pox vaccines for children this year. https://www.gov.uk/government/news/free-chickenpox-vaccination-offered-for-first-time-to-children https://www.gov.uk/government/news/free-chickenpox-vaccinati...
  - mlyle 3mo ago
    Which, if chickenpox is really the cause of a lot of dementia (as this article implies) might have been a pretty grave mistake.
iambenm 3mo ago
I got it around 36, and coincidentally a friend 5-6 years younger than me in a different part of the country got it at the same time. My research at the time led me to the same conclusion: Since we've basically eradicated chickenpox, we're not exposed to the varicella zoster virus as much as previous generations (via children that have chickenpox). Without exposure our antibodies / resistance fade out. Since we had chickenpox, the virus is already in us and dormant. When it wakes up and decides to do its thing, our bodies have forgotten how to fight it effectively compared to previous generations - and as a result, the incidence of shingles is increasing in younger populations compared to previous generations. My doctor said vaccination for under 50 is only indicated after multiple occurrences of shingles... so here's to hoping I'm good til the guidelines change.

tptacek 3mo ago

Wait, you can just pay for the shingles vaccine, before you're 50? Where do I do that? I had shingles in my 30s. It was the sickest I've ever been.

Aurornis 3mo ago
You can get basically any medication or vaccination you want in the US as long as you can find a doctor to write the prescription. We even have anabolic steroids that were approved for muscle wasting in cancer patients, but if you can find a doctor willing to write the prescription and a pharmacy that won’t question it, anyone can have pharmacy grade Anavar for the gym, completely legal. In theory the doctor writing the prescription is putting their license at risk, but enforcement is so lax that there are “anti-aging” clinics all over that will prescribe testosterone and Anavar to anyone with a credit card. So with a documented history of shingles you should have no problem getting a prescription written. It would be worth a quick check with your insurance company because it might even be covered if your doctor will fill out the form and attach evidence of the past diagnosis.
- dataflow 3mo ago
  > You can get basically any medication or vaccination you want in the US as long as you can find a doctor to write the prescription. Is that not usually true in other countries?
  - jandrewrogers 3mo ago
    There is a large industry in the US that specializes in catering to people that want medications, vaccines, diagnostics, and treatments that are outside the recommended standard of care that medical insurance or public health systems cover. You have to pay for these services directly but the market is competitive so the cost is quite reasonable. A doctor must sign off on these but that step is mostly performative outside of some narrow exceptions. My impression is that this type of medical care is much more accessible in the US than most other developed countries.

scrollop 3mo ago

There were a few studies around 2022 showing the influenza vaccines and pneumoccocal vaccines reduce alzheimers (influenza by up to a whopping 40%!). I tell me patients this to increase uptake, so we can reduce alzheimer's prevalence. (I'm a doctor)

hn_throwaway_99 3mo ago
Do you have a link to these studies? I ask because, as another commenter mentioned, I think it would be very difficult to tease out cause and effect and I think the "healthy vaccinee" hypothesis could easily explain why so often you see the association between any vaccine (just here we have shingles, influenza and pneumococcal) and Alzheimer's risk reduction. To be clear, I would get those vaccines regardless for their stated effectiveness, it just feels like so many observational conclusions ("moderate red wine is good for you!") have been proven to be non-causitive correlations when examined more closely. Edit: Actually, the youtube link posted above talks about tons of vaccines where observational studies show reduced Alzheimer's risk: https://youtu.be/qlTnnQytOJ0?t=340 https://youtu.be/qlTnnQytOJ0?t=340
- gdudeman 3mo ago
  I believe that there are studies that show that merely getting very sick increases your chance of dementia - essentially it ages you faster or brings chronic disease forward. If that's the case, vaccines for things like the flu - a disease you're likely to get - are probably good overall. They also activate the immune system in generaly, which could probably go either way in terms of longevity. In general I don't think vaccines are preventing so much as delaying dementia, but if they stop chronic infection they might be.
- emceestork 3mo ago
  https://www.neurology.org/doi/10.1212/WNL.0000000000214782 https://www.neurology.org/doi/10.1212/WNL.0000000000214782 edit: Sorry this is the follow up study but the 40% study is linked within

js2 3mo ago

On the topic of vaccines, if you were vaccinated against measles before it switched to the two-dose schedule (1989 in the US), you might want to have your titers measured. I was vaccinated in the early 70s when it was a single dose. With measles in the news recently, I asked my doc to add a measles antibodies test to my blood draw. Came back negative. No immunity. I went to the local pharmacy and got an MMR booster the next day. https://www.health.harvard.edu/diseases-and-conditions/some-adults-may-need-a-measles-booster-shot-who-should-get-one-and-why https://www.health.harvard.edu/diseases-and-conditions/some-...

daft_pink 3mo ago
If you were vaccinated on the normal schedule, what year would you generally be born to be vaccinated with the single dose?
- js2 3mo ago
  In the U.S., the second dose was added in 1989 so around then. You might've also gotten a booster in the U.S. if you were born earlier but lived in a college dormitory. If you're not sure, get tested. It's a simple blood draw.

zeckalpha 3mo ago

My understanding is that they're not sure if the vaccine will last in your system for more than 30 years, and that subsequent doses may be less effective, so getting it early may weaken you later. But I am with you. My personal bet is we'll know more about this by the time that becomes an issue. The earliest cohorts of vaccinated children are approaching their 30s, so we should learn about long term efficacy this decade.

dualvariable 3mo ago
> they're not sure if the vaccine will last in your system for more than 30 years Vaccines don't really last in your system more than a few days (although some cells get dragged off to the lymph nodes and get harshly interrogated for longer than that). It is the T-cell and B-cell responses that are persistent for years. > and that subsequent doses may be less effective They should activate B cells that you already have and produce high-affinity mature antibodies.
robot_jesus 3mo ago
It's a fair callout, but for me (and increased propensity for Alzheimer's) the calculus is a bit different. Making to to my mid-70s with full mental faculties would easily be worth the tradeoff of an increasing likelihood of shingles at that point. And besides, I would presume I would be able take the vaccine again?
- warshinder 3mo ago
  They have donanimab now, and apoe4 testing may qualify you if you have any prodromal (easily faked frankly) symptoms and a decent insurer.

anarticle 3mo ago

I feel like we've probably spent more for less! Any interaction with the medical industry for less than 1k feels like a steal to me.

reenorap 3mo ago

This finding of shingles and dementia is likely due to “healthy vaccinee” bias as per the link someone else posted below: https://youtu.be/qlTnnQytOJ0?is=XJ0c5pWVV6Lg0IMs https://youtu.be/qlTnnQytOJ0?is=XJ0c5pWVV6Lg0IMs As per one of the slides around 7 minutes in, there are many vaccines that show a 20-40% reduction in mortality and dementia. The talk above basically says that “observational studies” may show great results, like the so-called protective action of the shingles vaccine against dementia. However when brought to a well designed RCT all those benefits don’t actually show up. And the speaker shows later on that the shingles vaccines shows a marked benefit for shingles but nothing for dementia.

gdudeman 3mo ago
This really isn't the case in the Shingles vaccine unless the UK study is flawed a way that isn't clear to me. The study looked at the effect of being eligible for a vaccine and the results were clear. (see chart below the fold here: https://erictopol.substack.com/p/the-shingles-vaccine-and-reduction https://erictopol.substack.com/p/the-shingles-vaccine-and-re...) There was a hard age cutoff in the UK study. Above a certain age, you weren't eligible. Below it, you were. People who were born in the "can get the vaccine" group have markedly lower rates of dementia. People in the "too old" group have higher rates. It's one of those studies where you don't even need to look at the p-value to see the difference. I'm very open to being wrong about this!
- warshinder 3mo ago
  Right. And RCTs not showing things than can be seen in larger observational studies seems plausibly related to the problems with RCTs, for instance statistical power being generally lower because n sizes are lower, attrition is an issue, etc… I want to believe the research though, especially since I like most smart people are going to get the Shingrix shot anyway.
  - reenorap 3mo ago
    It’s the opposite. Observational studies are very biased by the selection process and the only way to get signal from them is rct.

OutOfHere 3mo ago

Most people, especially those under the vaccination age of 50, with a weak immune system don't supplement a correct dose of basic immune boosting supplements like vitamin D3 (4-6 KIU), zinc (15-25 mg), selenium (200 mcg), and beta glucan, which typically is why they have a weak immune system in the first place. Safely boosting your immune system's baseline will protect you not just against opportunistic shingles but various other things too.

WalterBright 3mo ago

When covid struck, I went and got revaccinated for the usual - MMR, Polio, etc.

gdudeman 3mo ago

People who are immune compromised qualify for this. I'm not sure how much your insurance company would push back on that though.

greg7mdp 3mo ago

Got the shingrix vaccine for free at my county health center, even though it was not covered by my insurance. Worth checking.

deleted 3mo ago

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throwaway2037 3mo ago

If you have any developing countries nearby (holiday, etc.), you can usually get it cheaper at a clinic. I get my vaccines (when on holiday) in Thailand here: https://www.thaitravelclinic.com/vaccine-price-list/ https://www.thaitravelclinic.com/vaccine-price-list/