When the vaccine came out in the UK, they included a hard age cutoff: Above a certain age, you weren't eligible. Below that age, you were eligible.
They looked at the probability of a dementia diagnosis over the 7 years after the vaccine was introduced.
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 cut and dry. The researchers didn't separate out the people who actually got the vaccine.
It's one of those studies where you don't even need to look at the p-value to see the difference between the cohorts.
It's not even dementia, it's shingles itself. Two friends of mine had shingles in the last year or two, one of whom has a pain threshold at a level where I'm not entirely sure he's human ("I pulled the flesh back and you could see the bare bone, it was interesting, I've never seen my insides like that before"). After hearing their description of the pain levels involved I got a shot the next week.
My older neighbour also had it a few years ago, but in her case wasn't aware it was shingles, just some rash on her face. Doctors said if they hadn't stopped it within the next few days she'd have lost her sight.
Get the shot. You probably won't need it, but if you do then you'll really need it.
So much of neurodegeneration has turned out to be the effects of latent viruses in the body. HSV-1 is correlated with developing dementia along with many respiratory viruses.
Why on earth wouldn't you need to look at the P value? You give good arguments for the soundness is the methodology, but you still need to look at the results and their statistical significance.
Their P value is 0.02, which is good but certainly not definitive. Also the effect is kind of small, 3.5% reduction in diagnoses.
I think I'm failing to understand your subtext. Obviously older people have higher rates of dementia. A study reporting that doesn't tell us anything about the effect of the vaccine.
Sorry - the older group has higher rates of dementia than the younger group when they reach the same age - so when they reach 75, they're more likely to have dementia.
I see what you mean, there's a clear gap in the fitted (regression) lines, suggesting the trend of dementia with age is different in the two groups.
But I wonder if that's just a statistical artifact. The overall trend looks the same in both groups if you ignore a couple points (ages) on either side of introducing the vaccine.
A single line appears to fit all the points well, except two points on either side of the divide.
The normalization of the age variable still looks problematic, as it requires that there is a linear dependency between age and incidence.
Both the scatter plot and also the probability graph seem to be curving upwards w.r.t age, i.e. the incidence of dementia cases seems to accelerate with age. Which at least makes a lot of intuitive sense, and would forbid just plotting in a regression line.
Having a more or less circumstantial point to arbitrarily cut your regression line in half also just begs for introducing Simpson's Paradox.
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.
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.
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.
Thanks very much for linking that substack, very informative.
But in your summary:
> 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.
I would change "people" to "women". I thought it was very interesting that the benefit of the Shingles vaccine eligibility for Alzheimer's was largely confined to women - men showed no such benefit per the graph in that substack article.
The video explains why the analysis is wrong and gives a very clear graph of how when you look at the proper data, there’s no benefit from the shingles vaccine for dementia. The signal is clear as day.
FWIW Eric Topol is an extremely unreliable source. He has “fame” but most of his stories end up being wrong because of his poor analysis like the review above. I subscribed to him during the pandemic when he migrated to substack but ended my subscription after countless bad articles.
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.
So you have a 30 person RCT, half the treatment bails midway through, you include the assigned but not treated (ITT) in the analysis. That’s going to give you the power to make a definitive statement while a large scale longitudinal with n=50,000 will not?
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).
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.
> 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.
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.
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
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.
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.
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.
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.
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.
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.
My primary care suggested I hold off to mid-late 50s instead of right at 50 for this reason. Between not wanting shingles, and some of the newer research into neuroprotective angles I'm not sure I'm going to do this however.
You absolutely can get it twice. It's currently not officially recommended, but that's probably just because Shingrix is relatively new, so booster shots aren't that relevant yet.
Hmm but as I understand it, dementia begins in your 30s. It's just that we don't see the signs of it until much later. So if it is protective, waiting doesn't seem wise (on the dementia side of it).
I've had two shingles shots: Zostavax and Shingrix. There's no reason you couldn't take either shot again. You might have to pay but no big deal.
I know people who've had shingles and it is not only a major PITA but can be life-threatening, can blind you, etc., just bad stuff. Don't delay taking advised precautions, including injections.
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.
I doubt you need a prescription for most vaccines. Typically there's some sort of guidelines that might say normally given to over 55 years old, but there will be some wiggle room due to other hard to prove preconditions such as family history of xxx or sensitivity to yyy. You say you have one of those things and Costco or the public health dept. will give you the vaccine no questions asked. For example when the COVID-19 vaccine was rolled out it was supposed to be for older people, but also people with various other (not easy to test for) preconditions such as asthma. So everyone who wasn't an anti-vaxxer developed asthma.
Medications are different. Need prescription for that, although $$ and a zoom call can solve that problem.
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.
Some countries are even more open. You can walk up to pharmacies in some countries and ask for most medications without a prescription. Up until 10-20 years ago you could walk into pharmacies in some countries and get abusable drugs, too, but that became enough of a problem that they cracked down on it.
The unique thing about the US is that we have access to almost everything first, and you can find a doctor willing to prescribe it to you if you look hard enough. In many other countries doctors don't want to stray far from the government prescribing guidelines. You may also not be allowed certain treatments unless your doctor can prove you meet the government requirements.
In the US, the enforcement is on the backend, if at all. There have been many cases of doctors getting the bright idea of turning their prescription pad into a money printer and writing prescriptions for scheduled medications to anyone willing to pay cash. Some of them make millions before the DEA catches up and goes after them. The smarter ones have moved into spaces where the enforcement brings less attention. Prescribing opioids is out, but I can't even turn on the radio without getting ads for doctors who will write me a prescription for testosterone to "get an edge in the gym".
Not exactly. My doctor wanted to start me on a medicine that would make me more likely to develop shingles so he asked me to get the vaccine series before he'd prescribe the medicine. I guess there's no such thing as a prescription for a vaccine, so I just went to my local pharmacy. I made the mistake of writing on the form that I had no health issues. The pharmacist came out and said because I wasn't 50 and had no health issues they weren't allowed to administer the vaccine. Even after I explained my condition and the doctor's request they still refused. They wouldn't even let me fill out a new form. I had to go to a different pharmacy which conveniently didn't ask about my current health status.
It's stupid too, because the question I answered "wrong" wasn't clear. It basically sounded like they were asking me if I currently had a cold or covid.
I'm in my 40s and asked my GP for it since I similar had a bad experience with it a few years ago. After warning me 3 times that it might not get covered by insurance, they gave it to me. I tried to get the second dose at a pharmacy, and they would not do it since I'm under 50. I got the second dose at my GP again a few months later.
You can just ask for vaccines at the pharmacy. I got a potentially missed childhood vaccination as an adult and they asked a few questions about why I wanted it, but were happy to give it to me. If it’s something odd you might need to go to a travel clinic.
I got mine at a tiny off-chain pharmacy. I just lied about my age. They didn't even check my ID. I did it in my early 30s, definitely did not look 50. Very happy I did so, have seen a few younger friends go through shingles and it _sucks_.
Most age recommendations do not prevent you from access, but determine whether the insurance will pay. I got both the shingles and HPV vaccines despite being outside the age bracket.
If you just want to pay out of pocket or with an HSA, etc. you can get many vaccines at a pharmacy. Might need to check if there are limited hours for that service or appointments needed. Not sure if Shingrix is one of them.
If you have already had shingles as an adult, aren’t you fairly well protected for the next ten years or so, at least? I’d wager that you are one of the people least at risk since your immune system is already primed and readying suppress the virus that’s latently infecting you.
Usually just most, except some in your organs where your immune response is different, out of necessity.
Then, if your immune functionality drops below a certain threshold that they can replicate inhibited, and leave the fort, you’re dealing with a systemic infection again.
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.
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.
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?
> 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.
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/
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.
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.
I'm glad you got lucky. I got it identified and treated with antivirals early (first 12 hours), a friend of mine turned out to be a research dermatologist who took over treatment in the first 36 hours, and still I ended up with long term effects. (Apparently if I'd gone another 12 hours without significant response, he would have put me on intravenous antivirals.)
I wanted to pay the full price, but pharmacies (Boots, Lloyds, couple of small ones) refused citing NICE guidance, GP and private GP refused to "prescribe" it.
Weird, I went to a travel vaccination clinic in London and got it no questions asked (the nurse was even familiar with the dementia research).
Try calling privatemedicalclinic.com ?
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.
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.)
The mechanism is that people with the shingles vaccine are less likely to visit the hospital (because they don't get shingles). Because they have fewer hospital visits they are less likely to receive an incidental diagnosis of dementia from a hospital.
There's countless treatments and countless diseases. It is very much worth combing data to find treatments with potential off-label uses, but with that many combinations of treatments and diseases, much more care needs to go into eliminating not just non-causative correlations, but straight-up random correlations that have a very small probability of happening on their own, but are likely to happen in a large enough group of comparisons.
I got shingles in my early 50s and did not know there were antivirals that could help mitigate its effects. I now have postherpetic neuralgia and the pain is not quite enough to off myself but the fact that I have to live with this for the rest of my life weighs me down.
It turns out that "pain management" is more art than science and almost all the pharma options out there come with significant risks and concerns. I ended up turning to kratom to manage the pain, which it does, but it's come at significant cost as well (addiction being one of them). I'm now going to try peptides (ARA-290 and BPC-157) to see if maybe that can help but it's all a crap shoot.
I share this as a warning/advice: get the vaccine if you can, even if insurance resists, push back. It may be worth it out of pocket IMHO. If you can't, remember to get access to antivirals immediately if you can.
The antiviral treatments for shingles are not very practical in that by the time you decide to visit the doctor it may already be too late for them to work.
Replicated association, which is strong, but not proof. Initial study saw a 3.5% absolute reduction in dementia diagnoses over seven years with a very wide confidence interval. In Australia the study was replicated with 1.8% absolute reduction over 7.4 yrs. Canadian replication: 2% over 5.5 yrs.
Infections generally increase the risk of future dementia. Like the more colds you have throughout life.
"association" undersells it a bit, because the data is better than the typical cohort study, which has issues like "what if people who got the vaccine are also richer and care about their health more?". There's quasi-randomization going on. From the more in depth article that's linked:
>Research is also revealing unexpected interventions that help to keep ageing minds sharp. One of the most promising derives from an analysis by Pascal Geldsetzer of Stanford University and his team of a natural experiment in Wales. In 2013 the British region started offering people aged 70-79 free vaccinations through the public-health system. This change resembled an RCT, in that a large number of people were separated almost at random into two groups: those who had already turned 80 in the weeks before the programme started, and so were not eligible to be jabbed; and those who turned 80 in the weeks after, roughly half of whom were duly vaccinated.
The shingles virus hides in the nervous system and can come back out when immune control weakens. It causes inflammation and nerve injury, sometimes severe enough to leave people with chronic pain. From there, it’s reasonable to theorize that it could also affect the brain and even its glymphatic system over time.
I'm one of those people (knock on wood) who never gets sick. I never get colds or seasonal flu, and I don't get routine flu vaccines. Never got COVID either, even when several people in the house had it (I did get the J&J vaccine for that, however).
I did have chicken pox as a kid, but have not had shingles nor the vaccine (yet). A co-worker was laid up for a week after his shingles vaccine, but that's obviously just one data point.
But, I've been considering getting the Shingrix series even if I have to pay for it. I turn 60 this year. Shingles doesn't sound fun.
This isn't common knowledge. This is something people (non-experts) are starting to infer, because we're seeing it with Long COVID - https://news.ycombinator.com/item?id=48877214 - but there's no reason to think this is something special about SARS-CoV-2 - it could just as well happen with all viral infections but we weren't looking.
It reminds me that we didn't look at vaccine efficacy at the individual level until SARS-CoV-2. People were getting upset that SARS-CoV-2 vaccines only have a moderate chance to stop you getting the virus, and usually lessen its impact if you do get it, and calling this an ineffective vaccine. But the truth is, we have no idea whether every previous vaccine was also like that, because we only ever looked at the population level: when lots of people get the vaccine, the virus dies out.
From a legal perspective, if the injection does not provide 100% immunity (when used as directed), then it cannot be called a vaccine, instead it is a therapeutic treatment.
Because courts of law have recognized covid mRNA injections as therapeutic treatments, they cannot be mandated.
'The plaintiffs alleged that the vaccines do not prevent someone from becoming infected with COVID-19 and characterized it as a treatment rather than a “traditional vaccine.”'
Not common knowledge, but should be in this day and age.
For example, someone who worked in daycare and often got sick with the flu or similar, has a higher risk of dementia (statistically-speaking).
When I learned it, it was in the context of the influenza and similar common viruses.
As far as I know you're overstating what is known.
There was a study that showed that people who had severe influenza (they were hospitalized) were 3 times more likely to develop dementia. And there are mouse models that show that frequency respiratory virus infections can increase may contribute to brain aging (in mice).
>someone who worked in daycare and often got sick with the flu or similar, has a higher risk of dementia (statistically-speaking).
I can't find any evidence of this being true. I can find evidence that primary school teachers have lower rates of dementia. Pediatricians also have lower rates of dementia, so I find this highly doubtful.
You’re taking a mouse study, and a study that says that people hospitalized with influenza are more likely to get dementia, and stating confidently that daycare workers are more likely to get dementia.
That’s not “extrapolating some.” That’s just making stuff up.
The study you cited is from Taiwan and merely states that
“Physicians who were older, specialized in pediatrics and worked at local hospitals and clinics had a higher prevalence for dementia than their counterparts did.”
“physicians who are older are more likely to have dementia”
But beyond that, pediatricians or doctors who work in hospitals or clinics covers most doctors who aren’t work from home radiologists.
Wrong. Physicians (which includes pediatricians), who are in general less likely to get dementia, experience its signs at an older age in general due to protective effects of their high education. Among physicians, pediatricians seemed to have higher rates.
The discussion is very low-yield though, since infections are already a minor point re: dementia, and none of the evidence is conclusive.
>Among physicians, pediatricians seemed to have higher rates.
Not just pediatricians, but physicians that work at hospitals and clinics.
Which is nearly all of them.
I think what you’re dealing with is a low quality, low effort survey study from Taiwan, which was poorly written, so there is no point trying to figure out what they meant.
It's not a strong study, and the demographic group was very particular, but it involved 30k physicians, which is something. I would have no problem conceding that I misread the study, but ChatGPT, which is obviously never wrong (joking of course), agreed with me: https://chatgpt.com/share/6a550f00-d174-83ea-b111-0369a8e4db...
I was wrong calling it a survey study, because I didn’t realize Taiwan had such detailed information on every citizen.
But looking at the specific data the naive ratio for pediatricians is lower than several other specialities. It was only higher when they adjusted for confounding factors. But the list of confounders was limited by the data available.
In addition they found that for some reason working at a large hospital was protective, but they didn’t adjust for hospital size when comparing specialities. In general pediatricians are less likely to work at large hospitals than the average specialty (wife is a pediatrician).
The result is essentially a cherry picked result that only adjust for some confounders. Add to that only 19 cases of dementia among pediatricians. Then the CI for pedestrians overlaps every other listed speciality. The study is essentially meaningless for your purposes.
Also the paper is actually saying that older doctors are more likely to have dementia than younger doctors, not that doctors develop dementia later than the general population.
Academic and ongoing challenging education results in greater number of connections between nerves. In normal population, as plaque accumulates, it causes loss of transmission and deterioration of nerve connections.
In physicians, because they have more "density" and more pathways in which nerves are connected than the general population, dementias like Alzheimer's show no symptoms until there's even more plaque accumulated, because they can compensate with extra pathways, similar to the study on nuns who showed no signs of alzheimer's at an old age because they kept so active, even though post-mortem they had horrible alzheimer's on biopsy. At the late stage physicians finally manifest the dementia, it's stronger and progresses quicker. It's like "catching it late" for doctors.
Plaque is the end-cause. What's debatable is why it accumulates and what pharmaceuticals and interventions we doctors should prescribe for our patients, not whether it's present or not.
Isn't cholesterol released into the bloodstream to protect arteries when it gets acidic, and over time turning into plaque buildup? Also, going the other way doesn't help either because if you got a spike in acid your arteries wouldn't cope with the overload
> Most of the evidence of its anti-dementia effect relates to an earlier version of the vaccine, which used a weakened form of the live virus. It has since been largely replaced by a new one, Shingrix, which contains just a sprinkling of proteins from the virus and is seen as safer because it cannot cause an infection.
Unfortunately the apparent anti-dementia effect of this old vaccine (Zostavax) recently turned out to be a statistical illusion: https://youtube.com/watch?v=qlTnnQytOJ0
It is not clear whether the effect from Shingrix (the new one) is real or not. We currently don't have a case-control study which could prove causation.
I recall seeing a few discussions on HN comments hypothesizing that immune system stimulation via the vaccine might be the root cause. Now that the Amyloid hypothesis is on the wane, hopefully we'll explore other paths.
I think the short version is that people have developed a lot of things to substantially reduce the levels in human brains, but in practice is doesn't seem to be yielding clearly-good results.
Dementia might have dozens of risk factors, each adding up a little. Physical and emotional stress, insomnia, head microinjuries, arteriovascular risk factors, infections and there lies herpes zoster. Only the latter has a causal treatment and is only single stone on the wall of disease.
The article says that one possible reason the vaccine protects against dementia is incidental protection from other diseases. Getting chickenpox as a kid might protect you against shingles, but maybe not against those other diseases.
No! The opposite thing is true. Getting chickenpox as a kid drastically increases your likelihood of getting shingles as an adult. The initial chickenpox infection is the mechanism by which you're set up for shingles: you get it, fight it back, and it remains dormant in your nerves. Shingles is not simply chickenpox; it's the secondary infection you get from a resurgent zoster outbreak based in your nerves.
I got chickenpox and shingles as a kid. I was young enough to not remember the chicken pox (which I I think I got from one of my older siblings), and then in second grade I got the shingles, which I had never even heard of at the time. As a late millennial (of parents who were not antivax by any means) I imagine if I were even a few years younger I probably would have gotten the chickenpox vaccine and been able to skip both.
Getting chicken pox as a kid means you already have the H. zoster virus in your system, and when you get older as your immune system weakens, it may come out for a second go around, manifesting as shingles. Having had chicken pox as a kid is one of the reasons why I got my Shingrix as soon as I was able.
We don’t really define infection well (especially in a context where you’re waiting 2-6 weeks for an appointment to get bloodwork ordered, by which point the blood is often irrelevant to the complaint 2-6 weeks prior).
I got shingles after the covid vaccine, which is a rare but statistically highly significant risk: https://pubmed.ncbi.nlm.nih.gov/35470920/ . Both covid and shingles sucked, luckily it was years ago now.
I know quite a few people who got shingles in their early 20s. One of their doctors didn’t believe she had shingles until the blisters formed. The vaccine can definitely help those younger than 50, dementia benefits or not. Some of them have permanent nerve damage after getting shingles.
Watching my mum's descent into dementia, if (when?) I ever go down the same route, I plan to have, "You have dementia, be calm," tattooed on one arm, and pictures of my loved ones tattooed on the other.
> Another is that the vaccination gives the immune system a firm kick up its B-cells, activating it against other bugs that might contribute to dementia.
It's weird that they kinda gloss over the very real and open questions here, because the idea that the AS01 adjuvant is involved in the dementia protection is very much alive and an ongoing topic. A paper from last year[1] looked into it and found that the Shingrix shingles vaccine and the RSV vaccine are about the same in their risk reduction for dementia (with a bunch of caveats).
I believe the current evidence point to the shingles vaccine helping, but also a protective effect happening from the AS01 adjuvant on its own.
I'm not a researcher but my layman's take is that the Economist whiffed it here, and there's a more interesting and complicated story to be told beyond this clickbait-adjacent science journalism.
Good guess. The actual mechanism is that people who don't get the vaccination are more likely to need to visit the hospital to treat their shingles, and because they visit the hospital more they have more chances to get a diagnosis of dementia in a hospital. See this presentation: https://youtu.be/qlTnnQytOJ0
The lesson is to be extremely suspicious of findings of causation based on observational studies.
Yeah I got this last week and I felt like I got hit by a bus 12 hours later. The pharmacist claimed the second dose is worse. But getting the disease is no picnic at all. I had it in my 20s and it was like someone kept stabbing me in the eye, all day long for a week.
TL;DR Shingles vaccines reduces chances of dementia by 20%. Yet, most countries health systems only look at the upfront cost of ~$300 and don’t recommend for all who could benefit.
In a separate article the other factors are quoted with similar impact (listed in order of max potential magnitude)
- anti depression treatment
- education increases
- hearing improvement
- obesity reduction
- low alcohol
That may be the case in other countries, but in the US we're generally fee-for-service, so the incentives are reversed, and we still don't give it until you're 50 (which, as someone who has had it and is under 50, annoys me to no end).
most people can't really get a worthwhile quality of life like that. maybe life is worthwhile to you walking around in an N95 respirator, but not to me, at least not... indefinitely. I'd rather be dead TBH. IMO it makes sense to wait to die to be dead. Why be dead while you're still technically alive? What are you trying to optimize for? Days you woke up?
And for transparency, I am triple vaccinated (maybe more, I lost count), have had 0 covid infections as far as I know, masked for a long time while it seemed to make sense.
Your comment is completely unfair. You are entirely dismissive of those who are not ignorant of long Covid and of those who have experienced the hell that Covid could be.
And you'd rather be dead? Careful what you wish for.
I wear a P95, not for Covid, but because I simply don't like getting sick even with a cold. Also, it blocks pollution which is independently important for the brain.
But what if those unstudied accessible "natural" remedies have even more problems? Should we choose to do nothing, only study nothing, or just redefine what "natural" is?
I mean, you conformed to the norms and customs of horsepaste quackery, and in that sense you "did it right". However, the science here is a little off-point. Ivermectin had observable benefits in some localities during the pandemic. In all likelihood, everyone who walks into a hospital for any reason in those countries should be given Ivermectin, because they all have undiagnosed parasites.
If you haven't seen the chart from the UK study, I highly recommend checking it out: https://erictopol.substack.com/p/the-shingles-vaccine-and-re...
When the vaccine came out in the UK, they included a hard age cutoff: Above a certain age, you weren't eligible. Below that age, you were eligible.
They looked at the probability of a dementia diagnosis over the 7 years after the vaccine was introduced.
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 cut and dry. The researchers didn't separate out the people who actually got the vaccine.
It's one of those studies where you don't even need to look at the p-value to see the difference between the cohorts.
It's not even dementia, it's shingles itself. Two friends of mine had shingles in the last year or two, one of whom has a pain threshold at a level where I'm not entirely sure he's human ("I pulled the flesh back and you could see the bare bone, it was interesting, I've never seen my insides like that before"). After hearing their description of the pain levels involved I got a shot the next week.
My older neighbour also had it a few years ago, but in her case wasn't aware it was shingles, just some rash on her face. Doctors said if they hadn't stopped it within the next few days she'd have lost her sight.
Get the shot. You probably won't need it, but if you do then you'll really need it.
So much of neurodegeneration has turned out to be the effects of latent viruses in the body. HSV-1 is correlated with developing dementia along with many respiratory viruses.
I can’t wait to see what happens when we have an Epstein-Barr virus vaccine.
Looks like there's no difference in men, but a huge difference in women? What a weird situation.
Why on earth wouldn't you need to look at the P value? You give good arguments for the soundness is the methodology, but you still need to look at the results and their statistical significance.
Their P value is 0.02, which is good but certainly not definitive. Also the effect is kind of small, 3.5% reduction in diagnoses.
I think I'm failing to understand your subtext. Obviously older people have higher rates of dementia. A study reporting that doesn't tell us anything about the effect of the vaccine.
Sorry - the older group has higher rates of dementia than the younger group when they reach the same age - so when they reach 75, they're more likely to have dementia.
I see what you mean, there's a clear gap in the fitted (regression) lines, suggesting the trend of dementia with age is different in the two groups.
But I wonder if that's just a statistical artifact. The overall trend looks the same in both groups if you ignore a couple points (ages) on either side of introducing the vaccine.
A single line appears to fit all the points well, except two points on either side of the divide.
The normalization of the age variable still looks problematic, as it requires that there is a linear dependency between age and incidence.
Both the scatter plot and also the probability graph seem to be curving upwards w.r.t age, i.e. the incidence of dementia cases seems to accelerate with age. Which at least makes a lot of intuitive sense, and would forbid just plotting in a regression line.
Having a more or less circumstantial point to arbitrarily cut your regression line in half also just begs for introducing Simpson's Paradox.
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.
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
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.
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-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!
Thanks very much for linking that substack, very informative.
But in your summary:
> 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.
I would change "people" to "women". I thought it was very interesting that the benefit of the Shingles vaccine eligibility for Alzheimer's was largely confined to women - men showed no such benefit per the graph in that substack article.
The video explains why the analysis is wrong and gives a very clear graph of how when you look at the proper data, there’s no benefit from the shingles vaccine for dementia. The signal is clear as day.
FWIW Eric Topol is an extremely unreliable source. He has “fame” but most of his stories end up being wrong because of his poor analysis like the review above. I subscribed to him during the pandemic when he migrated to substack but ended my subscription after countless bad articles.
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.
It’s the opposite. Observational studies are very biased by the selection process and the only way to get signal from them is rct.
So you have a 30 person RCT, half the treatment bails midway through, you include the assigned but not treated (ITT) in the analysis. That’s going to give you the power to make a definitive statement while a large scale longitudinal with n=50,000 will not?
[dead]
Great video, thanks for the link.
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).
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.
> 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.
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-vaccinati...
Which, if chickenpox is really the cause of a lot of dementia (as this article implies) might have been a pretty grave mistake.
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.
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)
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
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.
https://www.neurology.org/doi/10.1212/WNL.0000000000214782
edit: Sorry this is the follow up study but the 40% study is linked within
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-...
If you were vaccinated on the normal schedule, what year would you generally be born to be vaccinated with the single dose?
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.
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.
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.
As I understand it, antibodies only last a month within the blood before they degrade.
It is the memory B cells that produce them that last years.
https://en.wikipedia.org/wiki/Memory_B_cell
https://www.quora.com/What-is-the-lifespan-of-an-antibody-in...
You had Shingles after never having chicken pox except the vaccine?
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.
My primary care suggested I hold off to mid-late 50s instead of right at 50 for this reason. Between not wanting shingles, and some of the newer research into neuroprotective angles I'm not sure I'm going to do this however.
You absolutely can get it twice. It's currently not officially recommended, but that's probably just because Shingrix is relatively new, so booster shots aren't that relevant yet.
Hmm but as I understand it, dementia begins in your 30s. It's just that we don't see the signs of it until much later. So if it is protective, waiting doesn't seem wise (on the dementia side of it).
Yeah
And you can absolutely get Shingles before 50 (in some cases)
But surely you can do a booster shot?
I've had two shingles shots: Zostavax and Shingrix. There's no reason you couldn't take either shot again. You might have to pay but no big deal.
I know people who've had shingles and it is not only a major PITA but can be life-threatening, can blind you, etc., just bad stuff. Don't delay taking advised precautions, including injections.
So far as I know there's no standard booster protocol for Shingrix.
That just tells you it hasn’t been fully researched, not that it wouldn’t be useful.
You could just get one more dose, right?
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.
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.
> 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?
I doubt you need a prescription for most vaccines. Typically there's some sort of guidelines that might say normally given to over 55 years old, but there will be some wiggle room due to other hard to prove preconditions such as family history of xxx or sensitivity to yyy. You say you have one of those things and Costco or the public health dept. will give you the vaccine no questions asked. For example when the COVID-19 vaccine was rolled out it was supposed to be for older people, but also people with various other (not easy to test for) preconditions such as asthma. So everyone who wasn't an anti-vaxxer developed asthma.
Medications are different. Need prescription for that, although $$ and a zoom call can solve that problem.
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.
That's it.
Some countries are even more open. You can walk up to pharmacies in some countries and ask for most medications without a prescription. Up until 10-20 years ago you could walk into pharmacies in some countries and get abusable drugs, too, but that became enough of a problem that they cracked down on it.
The unique thing about the US is that we have access to almost everything first, and you can find a doctor willing to prescribe it to you if you look hard enough. In many other countries doctors don't want to stray far from the government prescribing guidelines. You may also not be allowed certain treatments unless your doctor can prove you meet the government requirements.
In the US, the enforcement is on the backend, if at all. There have been many cases of doctors getting the bright idea of turning their prescription pad into a money printer and writing prescriptions for scheduled medications to anyone willing to pay cash. Some of them make millions before the DEA catches up and goes after them. The smarter ones have moved into spaces where the enforcement brings less attention. Prescribing opioids is out, but I can't even turn on the radio without getting ads for doctors who will write me a prescription for testosterone to "get an edge in the gym".
Yes, it is. In my experience, in most cases, your regular doctor will prescribe things if they are not dangerous even if they aren't recommended.
In some countries, getting that prescription is much harder (unless you have the medical condition the medicine is intended/licensed for)
Not exactly. My doctor wanted to start me on a medicine that would make me more likely to develop shingles so he asked me to get the vaccine series before he'd prescribe the medicine. I guess there's no such thing as a prescription for a vaccine, so I just went to my local pharmacy. I made the mistake of writing on the form that I had no health issues. The pharmacist came out and said because I wasn't 50 and had no health issues they weren't allowed to administer the vaccine. Even after I explained my condition and the doctor's request they still refused. They wouldn't even let me fill out a new form. I had to go to a different pharmacy which conveniently didn't ask about my current health status.
It's stupid too, because the question I answered "wrong" wasn't clear. It basically sounded like they were asking me if I currently had a cold or covid.
I'm in my 40s and asked my GP for it since I similar had a bad experience with it a few years ago. After warning me 3 times that it might not get covered by insurance, they gave it to me. I tried to get the second dose at a pharmacy, and they would not do it since I'm under 50. I got the second dose at my GP again a few months later.
You can just ask for vaccines at the pharmacy. I got a potentially missed childhood vaccination as an adult and they asked a few questions about why I wanted it, but were happy to give it to me. If it’s something odd you might need to go to a travel clinic.
Not this one you can't.
I told my local Walgreens I am immunocompromised and they did not ask for proof (early 40s).
https://www.cdc.gov/shingles/hcp/vaccine-considerations/inde...
See this is the information I'm looking for. :)
Happy to help!
Safeway pharmacy staff dgaf about anything from my personal experience.
I got mine at a tiny off-chain pharmacy. I just lied about my age. They didn't even check my ID. I did it in my early 30s, definitely did not look 50. Very happy I did so, have seen a few younger friends go through shingles and it _sucks_.
Sorry Tom, but you definitely look older than your age!8-))
Most age recommendations do not prevent you from access, but determine whether the insurance will pay. I got both the shingles and HPV vaccines despite being outside the age bracket.
If you just want to pay out of pocket or with an HSA, etc. you can get many vaccines at a pharmacy. Might need to check if there are limited hours for that service or appointments needed. Not sure if Shingrix is one of them.
I've tried to get the shingles vaccine at Walgreens before and been turned down because I wasn't old enough.
Huh. Well maybe not then. Did you make it clear you'd pay out of pocket and not insurance?
Yes. I really want this vaccine.
Have you tried asking your PCP?
I'm pretty confident I could talk my PCP into it! I'm just wondering if there is some easier retail way to do it.
If you DM your provider through their health portal it's likely they'll write an order without requiring an office visit.
If you have already had shingles as an adult, aren’t you fairly well protected for the next ten years or so, at least? I’d wager that you are one of the people least at risk since your immune system is already primed and readying suppress the virus that’s latently infecting you.
You are more likely to have a recurrence of shingles after once having it before. At any rate, I had mine more than 10 years ago.
Yep! You rarely kill off all of the bugs.
Usually just most, except some in your organs where your immune response is different, out of necessity.
Then, if your immune functionality drops below a certain threshold that they can replicate inhibited, and leave the fort, you’re dealing with a systemic infection again.
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.
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.
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?
They have donanimab now, and apoe4 testing may qualify you if you have any prodromal (easily faked frankly) symptoms and a decent insurer.
> 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.
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/
People who are immune compromised qualify for this. I'm not sure how much your insurance company would push back on that though.
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.
Got the shingrix vaccine for free at my county health center, even though it was not covered by my insurance. Worth checking.
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.
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.
"An increased risk of Guillain-Barré syndrome (severe muscle weakness) was observed after vaccination with SHINGRIX"
https://www.shingrix.com/side-effects/
For the record, annual flu vaccines also have this risk, but it doesn't stop 450 million people from getting them.
That seems like being penny wise and pound foolish.
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)
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.
I'm glad you got lucky. I got it identified and treated with antivirals early (first 12 hours), a friend of mine turned out to be a research dermatologist who took over treatment in the first 36 hours, and still I ended up with long term effects. (Apparently if I'd gone another 12 hours without significant response, he would have put me on intravenous antivirals.)
I'm glad you didn't have any lasting effects.
I wanted to pay the full price, but pharmacies (Boots, Lloyds, couple of small ones) refused citing NICE guidance, GP and private GP refused to "prescribe" it.
Weird, I went to a travel vaccination clinic in London and got it no questions asked (the nurse was even familiar with the dementia research). Try calling privatemedicalclinic.com ?
Thanks a lot!
Close, I'm in the US. I don't need a script to get it, only if I want the insurance to pay for it.
But if I couldn't I could still go to Mexico and buy brand name Shingrix.
> (UK becoming the dirtiest and sickest country of Europe one more time)
Big Yawn
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-...
> [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-pollut...
[2] 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.
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.)
When covid struck, I went and got revaccinated for the usual - MMR, Polio, etc.
aside from age ranges being the tested population, your just gambling no other interference pattern is involved.
Unfortunately this is a spurious finding. See this presentation: https://youtu.be/qlTnnQytOJ0
The mechanism is that people with the shingles vaccine are less likely to visit the hospital (because they don't get shingles). Because they have fewer hospital visits they are less likely to receive an incidental diagnosis of dementia from a hospital.
There's also this whole thing: https://xkcd.com/882/
There's countless treatments and countless diseases. It is very much worth combing data to find treatments with potential off-label uses, but with that many combinations of treatments and diseases, much more care needs to go into eliminating not just non-causative correlations, but straight-up random correlations that have a very small probability of happening on their own, but are likely to happen in a large enough group of comparisons.
Yes, though the above only addresses studies based on Zostavax. Shingrix might still offer some protection from dementia.
are there that many instances of mild dementia where a lack of diagnosis remains a lack?
Well it does tend to happen late in life where other health issues could take you out before the dementia gets noticeable beyond usual senility.
I got shingles in my early 50s and did not know there were antivirals that could help mitigate its effects. I now have postherpetic neuralgia and the pain is not quite enough to off myself but the fact that I have to live with this for the rest of my life weighs me down.
It turns out that "pain management" is more art than science and almost all the pharma options out there come with significant risks and concerns. I ended up turning to kratom to manage the pain, which it does, but it's come at significant cost as well (addiction being one of them). I'm now going to try peptides (ARA-290 and BPC-157) to see if maybe that can help but it's all a crap shoot.
I share this as a warning/advice: get the vaccine if you can, even if insurance resists, push back. It may be worth it out of pocket IMHO. If you can't, remember to get access to antivirals immediately if you can.
The antiviral treatments for shingles are not very practical in that by the time you decide to visit the doctor it may already be too late for them to work.
That’s why pharmacies are allowed to give them out directly here for shingles (Ontario Canada and possibly other provinces)
This may be the case, I haven't researched it deeply enough because it was already a day late and a dollar short.
I just asked The Goog and it said the answer is effectively "possibly, but nuanced". So you may be right but not completely ;-).
I'd still suggest doing it as its likely to have a positive risk/reward ratio. But better still is to get the vaccine.
Replicated association, which is strong, but not proof. Initial study saw a 3.5% absolute reduction in dementia diagnoses over seven years with a very wide confidence interval. In Australia the study was replicated with 1.8% absolute reduction over 7.4 yrs. Canadian replication: 2% over 5.5 yrs.
Infections generally increase the risk of future dementia. Like the more colds you have throughout life.
>Replicated association [...]
"association" undersells it a bit, because the data is better than the typical cohort study, which has issues like "what if people who got the vaccine are also richer and care about their health more?". There's quasi-randomization going on. From the more in depth article that's linked:
>Research is also revealing unexpected interventions that help to keep ageing minds sharp. One of the most promising derives from an analysis by Pascal Geldsetzer of Stanford University and his team of a natural experiment in Wales. In 2013 the British region started offering people aged 70-79 free vaccinations through the public-health system. This change resembled an RCT, in that a large number of people were separated almost at random into two groups: those who had already turned 80 in the weeks before the programme started, and so were not eligible to be jabbed; and those who turned 80 in the weeks after, roughly half of whom were duly vaccinated.
I wonder if infections do not cause more dementia, but are simply correlated with more. A weaker immune system may trigger many many things.
And similar questions about obesity "causing" many diseases, sunburns causing skin cancer (although that sounds somewhat plausible) etc.
There isn't a causal mechanistic link between shingles and Alzheimers. We don't know why the Shingrix vaccine reduces incidence of Alzheimers.
(You should very much want to avoid any chance of getting shingles, though; it's a nightmare.)
Probably other, possibly even unknown viruses that the vaccine has efficacy for.
The shingles virus hides in the nervous system and can come back out when immune control weakens. It causes inflammation and nerve injury, sometimes severe enough to leave people with chronic pain. From there, it’s reasonable to theorize that it could also affect the brain and even its glymphatic system over time.
I'm one of those people (knock on wood) who never gets sick. I never get colds or seasonal flu, and I don't get routine flu vaccines. Never got COVID either, even when several people in the house had it (I did get the J&J vaccine for that, however).
I did have chicken pox as a kid, but have not had shingles nor the vaccine (yet). A co-worker was laid up for a week after his shingles vaccine, but that's obviously just one data point.
But, I've been considering getting the Shingrix series even if I have to pay for it. I turn 60 this year. Shingles doesn't sound fun.
Your thymus shuts down in your 80s, and you will make no more new T cells.
I also understand that a third of the elderly will have shingles by their 80s if unvaccinated.
Just curious, do you have children? Do you socialize pretty freely during all seasons indoors?
> like the more colds you have in life
Whoa wait what? This is the first time I’ve heard of this - is this actually common knowledge?
This isn't common knowledge. This is something people (non-experts) are starting to infer, because we're seeing it with Long COVID - https://news.ycombinator.com/item?id=48877214 - but there's no reason to think this is something special about SARS-CoV-2 - it could just as well happen with all viral infections but we weren't looking.
It reminds me that we didn't look at vaccine efficacy at the individual level until SARS-CoV-2. People were getting upset that SARS-CoV-2 vaccines only have a moderate chance to stop you getting the virus, and usually lessen its impact if you do get it, and calling this an ineffective vaccine. But the truth is, we have no idea whether every previous vaccine was also like that, because we only ever looked at the population level: when lots of people get the vaccine, the virus dies out.
From a legal perspective, if the injection does not provide 100% immunity (when used as directed), then it cannot be called a vaccine, instead it is a therapeutic treatment.
Because courts of law have recognized covid mRNA injections as therapeutic treatments, they cannot be mandated.
From a legal perspective, right and wrong are decided by a coin flip most of the time.
That sounds like nonsense. Most vaccines do not provide 100% immunity.
Not to the union, it's not.
'The plaintiffs alleged that the vaccines do not prevent someone from becoming infected with COVID-19 and characterized it as a treatment rather than a “traditional vaccine.”'
https://calmatters.org/education/2024/06/covid-vaccine-manda...
You're aware that the article you posted is full of sovcit antivaxers?
The reason the case was dismissed was because the requirement was removed.
The case was reopened on appeal due to the rules being temporarily re-established.
Anything else is nonsense. This is spelled out in the article but wrapped with a bunch of whatifs and maybes and possiblies.
If your hypothesis was correct, then NOTHING is a vaccine.
Do I care?
Well you're the one making the claim that a vaccine needs to block infections permanently, so I guess you do?
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Not common knowledge, but should be in this day and age. For example, someone who worked in daycare and often got sick with the flu or similar, has a higher risk of dementia (statistically-speaking).
When I learned it, it was in the context of the influenza and similar common viruses.
It's actually more nuanced than that. If you want to read more: https://www.openevidence.com/ask/bccc3cc2-e15d-4fb0-a0c5-16f...
As far as I know you're overstating what is known.
There was a study that showed that people who had severe influenza (they were hospitalized) were 3 times more likely to develop dementia. And there are mouse models that show that frequency respiratory virus infections can increase may contribute to brain aging (in mice).
>someone who worked in daycare and often got sick with the flu or similar, has a higher risk of dementia (statistically-speaking).
I can't find any evidence of this being true. I can find evidence that primary school teachers have lower rates of dementia. Pediatricians also have lower rates of dementia, so I find this highly doubtful.
I'm extrapolating some. But pediatricians have higher rates of dementia compared to their counterparts (physicians have lower dementia in general): https://link.springer.com/article/10.1007/s40520-019-01278-4
You’re taking a mouse study, and a study that says that people hospitalized with influenza are more likely to get dementia, and stating confidently that daycare workers are more likely to get dementia.
That’s not “extrapolating some.” That’s just making stuff up.
The study you cited is from Taiwan and merely states that “Physicians who were older, specialized in pediatrics and worked at local hospitals and clinics had a higher prevalence for dementia than their counterparts did.”
“physicians who are older are more likely to have dementia”
But beyond that, pediatricians or doctors who work in hospitals or clinics covers most doctors who aren’t work from home radiologists.
Wrong. Physicians (which includes pediatricians), who are in general less likely to get dementia, experience its signs at an older age in general due to protective effects of their high education. Among physicians, pediatricians seemed to have higher rates.
The discussion is very low-yield though, since infections are already a minor point re: dementia, and none of the evidence is conclusive.
That’s not what that sentence says though.
>Among physicians, pediatricians seemed to have higher rates.
Not just pediatricians, but physicians that work at hospitals and clinics.
Which is nearly all of them.
I think what you’re dealing with is a low quality, low effort survey study from Taiwan, which was poorly written, so there is no point trying to figure out what they meant.
It's not a strong study, and the demographic group was very particular, but it involved 30k physicians, which is something. I would have no problem conceding that I misread the study, but ChatGPT, which is obviously never wrong (joking of course), agreed with me: https://chatgpt.com/share/6a550f00-d174-83ea-b111-0369a8e4db...
I was wrong calling it a survey study, because I didn’t realize Taiwan had such detailed information on every citizen.
But looking at the specific data the naive ratio for pediatricians is lower than several other specialities. It was only higher when they adjusted for confounding factors. But the list of confounders was limited by the data available.
In addition they found that for some reason working at a large hospital was protective, but they didn’t adjust for hospital size when comparing specialities. In general pediatricians are less likely to work at large hospitals than the average specialty (wife is a pediatrician).
The result is essentially a cherry picked result that only adjust for some confounders. Add to that only 19 cases of dementia among pediatricians. Then the CI for pedestrians overlaps every other listed speciality. The study is essentially meaningless for your purposes.
Also the paper is actually saying that older doctors are more likely to have dementia than younger doctors, not that doctors develop dementia later than the general population.
Let me try to paint a picture:
Academic and ongoing challenging education results in greater number of connections between nerves. In normal population, as plaque accumulates, it causes loss of transmission and deterioration of nerve connections.
In physicians, because they have more "density" and more pathways in which nerves are connected than the general population, dementias like Alzheimer's show no symptoms until there's even more plaque accumulated, because they can compensate with extra pathways, similar to the study on nuns who showed no signs of alzheimer's at an old age because they kept so active, even though post-mortem they had horrible alzheimer's on biopsy. At the late stage physicians finally manifest the dementia, it's stronger and progresses quicker. It's like "catching it late" for doctors.
That’s possible (although the plaque hypothesis as the sole cause is looking less plausible).
But that’s not what the study is saying. It’s literally just saying that older doctors are more likely than younger doctors to have dementia.
Also that study only looks at dementia and Alzheimer’s only accounts for ~2/3 of cases.
Plaque is the end-cause. What's debatable is why it accumulates and what pharmaceuticals and interventions we doctors should prescribe for our patients, not whether it's present or not.
Isn't cholesterol released into the bloodstream to protect arteries when it gets acidic, and over time turning into plaque buildup? Also, going the other way doesn't help either because if you got a spike in acid your arteries wouldn't cope with the overload
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> Most of the evidence of its anti-dementia effect relates to an earlier version of the vaccine, which used a weakened form of the live virus. It has since been largely replaced by a new one, Shingrix, which contains just a sprinkling of proteins from the virus and is seen as safer because it cannot cause an infection.
Unfortunately the apparent anti-dementia effect of this old vaccine (Zostavax) recently turned out to be a statistical illusion: https://youtube.com/watch?v=qlTnnQytOJ0
It is not clear whether the effect from Shingrix (the new one) is real or not. We currently don't have a case-control study which could prove causation.
Recently, even the TDAP (Tetanus) vaccine was correlated with lower incidence of dementia https://news.ycombinator.com/item?id=26919881
I recall seeing a few discussions on HN comments hypothesizing that immune system stimulation via the vaccine might be the root cause. Now that the Amyloid hypothesis is on the wane, hopefully we'll explore other paths.
> the Amyloid hypothesis is on the wane
Oh? What did I miss?
I think the short version is that people have developed a lot of things to substantially reduce the levels in human brains, but in practice is doesn't seem to be yielding clearly-good results.
https://news.ycombinator.com/item?id=32183302
TL;DR A lot of evidence supporting the Amyloid hypothesis is suspect.
Dementia might have dozens of risk factors, each adding up a little. Physical and emotional stress, insomnia, head microinjuries, arteriovascular risk factors, infections and there lies herpes zoster. Only the latter has a causal treatment and is only single stone on the wall of disease.
So if you had shingles in your youth then you are better protected against dementia?
The article says that one possible reason the vaccine protects against dementia is incidental protection from other diseases. Getting chickenpox as a kid might protect you against shingles, but maybe not against those other diseases.
No! The opposite thing is true. Getting chickenpox as a kid drastically increases your likelihood of getting shingles as an adult. The initial chickenpox infection is the mechanism by which you're set up for shingles: you get it, fight it back, and it remains dormant in your nerves. Shingles is not simply chickenpox; it's the secondary infection you get from a resurgent zoster outbreak based in your nerves.
Don't get chickenpox.
I got chickenpox and shingles as a kid. I was young enough to not remember the chicken pox (which I I think I got from one of my older siblings), and then in second grade I got the shingles, which I had never even heard of at the time. As a late millennial (of parents who were not antivax by any means) I imagine if I were even a few years younger I probably would have gotten the chickenpox vaccine and been able to skip both.
I just recently got a blood test to confirm if I ever had gotten chickenpox as a child (my mother didn't remember if I had).
Sadly it came back positive for antibodies. I was really hoping I had somehow evaded it, and could get the vaccine as an adult.
The original question had nothing to do with getting Chickenpox or Shingles.
Well, now… I can tell you second hand that catching chicken pox as an adult is no picnic either.
No it is not. Ranked list of outcomes:
1. Not getting chickenpox at all. Highly desirable.
2. Getting chickenpox as a kid.
3. Getting chickenpox as an adult.
And last of all, DNSSEC.
Getting chicken pox as a kid means you already have the H. zoster virus in your system, and when you get older as your immune system weakens, it may come out for a second go around, manifesting as shingles. Having had chicken pox as a kid is one of the reasons why I got my Shingrix as soon as I was able.
> it may come out for a second go around
or third. fifteenth.
We don’t track reinfection well.
We don’t really define infection well (especially in a context where you’re waiting 2-6 weeks for an appointment to get bloodwork ordered, by which point the blood is often irrelevant to the complaint 2-6 weeks prior).
Not in practice, anyway.
Chickenpox vaccination does increase shingles cases, but mainly in young adults https://www.sciencedaily.com/releases/2015/08/150811103555.h...
No, the opposite. If you've had shingles before, you're more likely to get it again later, not less.
They asked about dimentia
Not really, shingles is a lifetime infection. You'd be more likely.
RIF
I got shingles after the covid vaccine, which is a rare but statistically highly significant risk: https://pubmed.ncbi.nlm.nih.gov/35470920/ . Both covid and shingles sucked, luckily it was years ago now.
Not only shingles vaccine: https://www.gavi.org/vaccineswork/eight-vaccines-linked-lowe...
Some of these correlations could be merely due to the "healthy vaccinee effect": https://www.science.org/content/blog-post/healthy-vaccinee-e...
I know quite a few people who got shingles in their early 20s. One of their doctors didn’t believe she had shingles until the blisters formed. The vaccine can definitely help those younger than 50, dementia benefits or not. Some of them have permanent nerve damage after getting shingles.
My brother had it when he was 17
I had it at 14
Watching my mum's descent into dementia, if (when?) I ever go down the same route, I plan to have, "You have dementia, be calm," tattooed on one arm, and pictures of my loved ones tattooed on the other.
> Another is that the vaccination gives the immune system a firm kick up its B-cells, activating it against other bugs that might contribute to dementia.
It's weird that they kinda gloss over the very real and open questions here, because the idea that the AS01 adjuvant is involved in the dementia protection is very much alive and an ongoing topic. A paper from last year[1] looked into it and found that the Shingrix shingles vaccine and the RSV vaccine are about the same in their risk reduction for dementia (with a bunch of caveats).
I believe the current evidence point to the shingles vaccine helping, but also a protective effect happening from the AS01 adjuvant on its own.
I'm not a researcher but my layman's take is that the Economist whiffed it here, and there's a more interesting and complicated story to be told beyond this clickbait-adjacent science journalism.
[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC12198376/
It appears my wife (Australian, 49) may be suffering from shingles. So this was an apt time for this article to appear.
She's seen her Dr and swabs are being processed. She's on antivirals and painkillers and has a nasty fever.
Now I am horrified about how awful it can be, after reading all the comments in here.
Is it also possible they're finding healthier people that are proactive in their treatment, maybe even exercise more, work longer, etc...
Good guess. The actual mechanism is that people who don't get the vaccination are more likely to need to visit the hospital to treat their shingles, and because they visit the hospital more they have more chances to get a diagnosis of dementia in a hospital. See this presentation: https://youtu.be/qlTnnQytOJ0
The lesson is to be extremely suspicious of findings of causation based on observational studies.
> Good guess. The actual mechanism [...]
Why couldn't both these factors contribute to the result of the study?
This would seem to be a good reason to attempt to create an 'all disease' vaccine.
You would go round the nation taking samples from every sick person you could find, then inactivate them with radiation, then inject it as a vaccine.
I had the vaccine, last year (but I’m 64).
Hoowee, it made me sick, but only for a day (twice, as you get a booster, six months later).
Had chickenpox (and measles, at the same time), when I was a kid. That was fun.
My mother used to get recurring bouts of the shingles. Definitely not fun.
Yeah I got this last week and I felt like I got hit by a bus 12 hours later. The pharmacist claimed the second dose is worse. But getting the disease is no picnic at all. I had it in my 20s and it was like someone kept stabbing me in the eye, all day long for a week.
PSA: For us uninsured, the shingles vaccine costs ~$500 out of pocket (>$250 x2).
I want folks to get it but - I feel "Just Get It" admonitions carry a vibe that the cost is negligible.
Wasn't this done with the previous shingles vacccine, not the current one ? If so this would need to be retested to be validated.
I actually contracted shingles as a teenager (at the same time as mono - fun times) should I still take the vaccine?
will we ever be free from the curse of believing correlation == causation
https://archive.ph/PzPop
Shingles vaccine, if you don't feel like clicking through.
Thanks! We've put shingles into the title above.
Thank you.
TL;DR Shingles vaccines reduces chances of dementia by 20%. Yet, most countries health systems only look at the upfront cost of ~$300 and don’t recommend for all who could benefit.
In a separate article the other factors are quoted with similar impact (listed in order of max potential magnitude) - anti depression treatment - education increases - hearing improvement - obesity reduction - low alcohol
The earlier you start the better.
>anti depression treatment - regular exercise - obesity reduction - education - less/no alcohol
Injecting people with a shingles vaccine is far easier than the others you listed, which is why it stands out.
Can you share the article you reference?
Its paywalled though: https://economist.com/briefing/2026/07/09/how-dementia-is-be...
> hearing improvement
This means addressing hearing loss, e.g. via hearing aids.
Should I get the shingles vaccine at a young age? I've had chickenpox earlier in my life.
As someone who got shingles at about 46, yes.
Dementia largely affects people on a pension, and not working adults contributing to the pyramid scheme.
This would be a good conspiracy theory if dementia was a short illness.
That may be the case in other countries, but in the US we're generally fee-for-service, so the incentives are reversed, and we still don't give it until you're 50 (which, as someone who has had it and is under 50, annoys me to no end).
20% of what?
Never marrying may reduce risk of dementia:
https://www.psychologytoday.com/us/blog/living-single/202504...
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" Please don't post shallow dismissals, especially of other people's work. A good critical comment teaches us something. "
https://news.ycombinator.com/newsguidelines.html
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most people can't really get a worthwhile quality of life like that. maybe life is worthwhile to you walking around in an N95 respirator, but not to me, at least not... indefinitely. I'd rather be dead TBH. IMO it makes sense to wait to die to be dead. Why be dead while you're still technically alive? What are you trying to optimize for? Days you woke up?
And for transparency, I am triple vaccinated (maybe more, I lost count), have had 0 covid infections as far as I know, masked for a long time while it seemed to make sense.
Your comment is completely unfair. You are entirely dismissive of those who are not ignorant of long Covid and of those who have experienced the hell that Covid could be.
And you'd rather be dead? Careful what you wish for.
I didn't wish for anything, I stated my calculus, and I'm pretty comfortable with it.
Not sure what's unfair about my comment, let alone completely.
Wearing masks while outdoors is very important for combating air pollution alone. If you don't know what air pollution does to people, see https://youtu.be/KwTR1FX-NPA and optionally https://youtu.be/51AFRAwu8-Y.
Your calculus doesn't relate to anyone else. It is like a billionaire saying that poverty doesn't exist.
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Why are you insulting the people you're seemingly trying to convince of something? What's going on there? What are you doing here?
Those are facts, not insults. HN isn't known for sugar-coating facts. If they offend you, consider asking yourself why.
I wear a P95, not for Covid, but because I simply don't like getting sick even with a cold. Also, it blocks pollution which is independently important for the brain.
Lmao
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What are either of those links supposed to imply?
The levels that capital interests stooped to, and it worked. Nobody was given an alternative, nor the facts that would motivate searching for one.
...and there may be damaging side effects
while there are probably lots of accessible "natural" demetia remedies
that you can do without having to resort to experimental drugs that may cause more problems and cost more
But what if those unstudied accessible "natural" remedies have even more problems? Should we choose to do nothing, only study nothing, or just redefine what "natural" is?
What is experimental about the Shingrix vaccine?
HORSE PASTE!!! NO!!! NO MEDICINE HAS TWO USES!!! HORSE PASTE!!!
Did I do it right?
https://c19early.org/i
Edit: I just learned all the dementia patients have undiagnosed shingles. Please ignore my comment now. :-|
I mean, you conformed to the norms and customs of horsepaste quackery, and in that sense you "did it right". However, the science here is a little off-point. Ivermectin had observable benefits in some localities during the pandemic. In all likelihood, everyone who walks into a hospital for any reason in those countries should be given Ivermectin, because they all have undiagnosed parasites.