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Medscape
2 days ago
- Health
- Medscape
How the Shingles Vaccine Guards Against Dementia: New Clues
How do vaccines reduce dementia risk? A new study suggested that immune-boosting adjuvants contained in some vaccines may offer one explanation. Adults who received the recombinant shingles vaccine Shingrix or the respiratory syncytial virus (RSV) vaccine Arexvy — both of which contain the AS01 adjuvant — had a lower risk for dementia in the 18 months after vaccination than peers who received the flu vaccine, which does not contain the AS01 adjuvant, investigators found. 'The findings are striking. We need studies to confirm whether the adjuvant present in some vaccines contributes to the reduced dementia risk and to understand how it does so,' senior author Paul Harrison, PhD, with the University of Oxford, Oxford, England, said in a statement. The study was published online on June 25 in the journal npj Vaccines . Vaccine or the Adjuvant? For this study, investigators built on a prior analysis of the US patient database TriNetX that showed that adults who received the AS01 shingles vaccine had a lower risk for dementia than peers who received the older shingles vaccine (Zostavax), which does not contain the AS01 adjuvant. To test the hypothesis that the AS01 adjuvant could be the key driver of the dementia-protective effect, researchers turned again to the TriNetX database and identified 103,798 people who received the AS01 shingles vaccine only, 35,938 who received the AS01 RSV vaccine only, and 78,658 who received both. These cohorts were propensity score matched to an equal number of people who received the flu vaccine and neither the shingles nor the RSV vaccine. In the 18 months following vaccination, compared to those who received the flu vaccine, the risk for dementia diagnosis was 29% lower in those who received the AS01 RSV vaccine (restricted mean time lost [RMTL] ratio, 0.71) and 18% lower in those who received the AS01 shingles vaccine (RMTL, 0.82). Individuals receiving both AS01 vaccines had a 37% reduced risk for dementia diagnosis (RMTL, 0.63). These effects were consistent in men and women and were not explained by reductions in RSV or shingles infections alone. And no difference was observed between the two AS01 adjuvant vaccines, 'suggesting that the AS01 adjuvant itself plays a direct role in lowering dementia risk,' the investigators said. 'Our data provide support for the hypothesis that, besides protection against their target infection, these vaccines could well protect against dementia via the action of the AS01 components through specific immunological pathways,' they wrote. In particular, the AS01 adjuvant includes monophosphoryl lipid A (MPL), which activates immune cells, and QS-21, a plant-derived extract that amplifies the immune response. Animal studies have shown that MPL can improve Alzheimer-related pathology, and other work suggests it triggers immune activity that might reduce the formation of amyloid plaques, a hallmark of Alzheimer's disease. Caveats and Cautionary Notes Several experts not involved in the study offered perspective on this research in a statement from the UK nonprofit Science Media Centre. Julia Dudley, head of Research at Alzheimer's Research UK, said a strength of the study is that it adjusted for factors that could influence risk, such as underlying health conditions and some lifestyle and environmental factors. 'However, as the study is observational and examined past health data, the researchers cannot conclude how the Shingrix and Arexvy vaccines may protect against dementia. We also cannot rule out that the link between vaccine and dementia risk is due to other factors not captured in this study, such as social and lifestyle factors,' Dudley said. A limitation of the study, highlighted by the authors, is that people could be living with dementia without having a formal diagnosis, 'which could skew the findings,' Dudley commented. In addition, 'we do not know if the adjuvant is reducing the risk of dementia or delaying its onset. The follow-up period was only 18 months, so more research is needed to determine the potential long-term effects of the vaccines,' Dudley said. Kevin McConway, PhD, emeritus professor of applied statistics, The Open University, Milton Keynes, England, said the study is 'an interesting, worthwhile, and statistically competent piece of work, but a lot more research needs to be done to make good sense of its possible implications for healthcare.' 'Previous research has provided pretty convincing evidence that vaccination against shingles, in older people, can reduce dementia risk [but] exactly how AS01 might be involved in reducing dementia risk' is unclear, McConway said, and 'we're not yet anywhere near the stage of using the results of the new study to change clinical practice.' Andrew Pollard, FMedSci, director of the Oxford Vaccine Group, University of Oxford, agreed. 'It is premature to be too certain about the mechanism by which vaccines might reduce dementia risk, but these observations provide further incentive for those eligible to turn up for their scheduled vaccination visits to prevent the unpleasant and potentially serious and life-threatening infections for which they were designed, but with the added possible benefit of a longer dementia-free lifespan. What's not to like?' Pollard commented.
Irish Times
25-06-2025
- Health
- Irish Times
Vaccines may offer double protection against dementia, study suggests
Some vaccines may reduce the risk of dementia through a double effect in which the jabs help protect the brain through their added 'adjuvant' chemicals as well as by suppressing viruses, according to a study by Oxford university. The analysis of health records of 430,000 people in the US, published on Wednesday, found that vaccination against respiratory syncytial virus (RSV) with GlaxoSmithKline's Arexvy was associated with a 29 per cent decrease in diagnoses of Alzheimer's and other forms of dementia during the following 18 months. The findings add to growing evidence of a link between viral infections and dementia, but the Oxford scientists were most excited about their conclusion that a significant part of the dementia reduction might be due to the AS01 adjuvant – a mixture of fatty molecules that are added to enhance the vaccine's effectiveness by priming the recipient's immune system. That could open the way for a new approach to dementia prevention, said Paul Harrison, Oxford professor of psychiatry. 'The findings are striking,' he said. 'We need more studies to confirm whether the adjuvant ... contributes to the reduced dementia risk, and to understand how it does so.' READ MORE Previous studies showed that Shingrix, GSK's most recent vaccine against shingles – which is caused by the Herpes zoster virus – cut the risk of dementia by 27 per cent. Shingrix contains the same AS01 adjuvant, unlike its predecessor Zostavax, which showed a much smaller reduction. Shingrix and Arexvy decreased dementia by similar proportions, though they target very different viruses, contributing to the Oxford team's argument that the adjuvant played an important role. Bobby Healy on why Manna drone delivery could be the 'biggest technology company in the world for its space' Listen | 67:08 Another boost to their argument 'is the fact that a protective effect is seen within a few months of vaccination, as it seems unlikely that enough infections would be prevented during such a short time frame to explain the magnitude of the protection', Harrison said. How long the protection lasts is unknown. The scientists are not sure how AS01 might lower the risk of dementia, though the effect is likely to involve the immune system in the brain, which has been shown in recent research to play an important role in Alzheimer's disease. The study, published in the journal npj Vaccines, compared the health of people in the TriNetX data network who had received Shingrix and Arexvy, singly or in combination, with a control group that only received a flu vaccine. 'One of the strengths of the study is that it adjusted for factors that could influence risk, such as underlying health conditions and some lifestyle and environmental factors,' said Julia Dudley, head of research at the charity Alzheimer's Research UK. 'But we cannot rule out that the link between vaccine and dementia risk is due to other factors not captured in this study ... As we understand more about the biological mechanisms behind any protective effects seen with vaccines, we may be able to investigate new treatment approaches.' To maintain independence, the researchers excluded GSK from any involvement in the analysis. The company said: 'This is an interesting independent study. We are collaborating with UK Dementia Research Institute and Health Data Research UK to investigate the potential links between shingles vaccination and reduced dementia risk. We look forward to assessing these new findings.' – Copyright The Financial Times Limited 2025
The Guardian
10-05-2025
- Politics
- The Guardian
Reform UK councillors face allegations of sharing far-right and Islamophobic content
Up to 12 newly elected Reform UK councillors are facing allegations of sharing social media content ranging from support for the far right to explicitly Islamophobic comments. They include councillors at three different county councils who have shared social media content from Britain First, a far-right party known for staging provocative marches and stunts. A week after Reform's local elections breakthrough, in which it won 677 of more than 1,600 seats contested, the backgrounds of its winning councillors are under scrutiny after the party largely sought to deflect allegations during the campaign. The councillors accused of retweeting Britain First content include Paul Harrison, who was elected to Leicestershire county council. He retweeted and said 'yes' to a question posed on X by Britain First's chair who asked if followers supported mass deportations and posted an AI-generated picture of Muslim men with Pakistani flags. Russell Cherry, elected as a councillor in Thurrock, allegedly retweeted Paul Golding, who is Britain First's leader and has a conviction for religiously aggravated harassment. Ivan Dabbs, a Reform councillor in West Northamptonshire, also allegedly shared a Britain First tweet and material by Golding calling for a street demonstration. The off-the-shelf vetting software used by Reform UK before the elections was from Ferretly, a US social media startup founded in 2019, the Guardian has learned. The platform assesses digital red flags, including hate speech, disparaging or bullying behaviour and inflammatory rhetoric, along with connections to extremist groups or individuals. However, Reform has drawn criticism for its reliance on the platform after its leadership claimed to have the 'most in-depth vetting procedure' of any party. In an interview with Times Radio on 30 April, Nigel Farage said vetting was done internally using 'AI techniques and other things' to 'give us a bit of a shortcut'. Neither the Conservatives nor Labour rely on AI software to the same degree. In the case of the Tories, a 30-strong group was involved in vetting each of its general election candidates. By Thursday, Reform was known to have lost at least three of its elected councillors. They included Donna Edmunds, a councillor in Shropshire who was suspended on Wednesday after she said that she planned to defect from the party. Edmunds, a supporter of Rupert Lowe who was kicked out of Reform and has been engaged in a bitter row with Farage, accused the Reform leader of treating members with contempt and described the party as a cult. Luke Shingler, who was elected in Warwickshire, said he would be an independent councillor for the 'next 18 months' because his work meant he was unable to serve under a political organisation. Shingler is understood to work for the RAF. A third councillor, Desmond Clarke, has resigned from Nottinghamshire county council, triggering a byelection. Many of the alleged social media posts by Reform councillors were unearthed by the counter-extremism campaign group Hope Not Hate. Georgie Laming, Hope Not Hate's director of campaigns, said: 'Nigel Farage has claimed that Reform UK have the 'most in-depth vetting procedure' of any party. Our investigation shows that their processes leave much to be desired. 'Not only have they admitted using 'AI techniques and other things' to do the vetting, but Reform UK continue to shirk responsibility for their candidates' online behaviour. They have yet to drop any of the candidates that have been exposed,' she said. Hope Not Hate uncovered Reform candidates – some now elected – who posted anti-Muslim hate, pushed far-right conspiracies including calling the climate crisis a 'globalist hysterical climate hoax', praising extremists such as Tommy Robinson and sharing content from David Irving, the UK's best known Holocaust denier. Reform has been approached for comment.
Boston Globe
02-04-2025
- Health
- Boston Globe
Shingles vaccine can decrease risk of dementia, study finds
'If you're reducing the risk of dementia by 20 percent, that's quite important in a public health context, given that we don't really have much else at the moment that slows down the onset of dementia,' said Dr. Paul Harrison, a professor of psychiatry at the University of Oxford. Harrison was not involved in the new study, but has done other research indicating that shingles vaccines lower dementia risk. Advertisement Whether the protection can last beyond seven years can only be determined with further research. But with few currently effective treatments or preventions, Harrison said, shingles vaccines appear to have 'some of the strongest potential protective effects against dementia that we know of that are potentially usable in practice.' Get Starting Point A guide through the most important stories of the morning, delivered Monday through Friday. Enter Email Sign Up Shingles cases stem from the virus that causes childhood chickenpox, varicella-zoster, which typically remains dormant in nerve cells for decades. As people age and their immune systems weaken, the virus can reactivate and cause shingles, with symptoms of burning, tingling, painful blisters, and numbness. The nerve pain can become chronic and disabling. In the United States, about one in three people develop at least one case of shingles, also called herpes zoster, in their lifetime, the Centers for Disease Control and Prevention estimates. About a third of eligible adults have received the vaccine in recent years, according to the CDC. Advertisement Several previous studies have suggested that shingles vaccinations might reduce dementia risk, but most could not exclude the possibility that people who get vaccinated might have other dementia-protective characteristics, like healthier lifestyles, better diets, or more years of education. The new study ruled out many of those factors. 'It's pretty strong evidence,' said Dr. Anupam Jena, a health economist and physician at Harvard Medical School, who was not involved in the study, but reviewed it for Nature. The study emerged from an unusual aspect of a shingles vaccine rollout in Wales on Sept. 1, 2013. Welsh officials established a strict age requirement: people who were 79 on that date were eligible for the vaccine for one year, but those 80 and older, were ineligible. As younger people turned 79, they became eligible for the vaccine for one year. The age cutoff — imposed because of a limited supply and because the vaccine was then considered less effective for people over 80 — set up a 'natural experiment,' said Dr. Pascal Geldsetzer, an assistant professor of medicine at Stanford University and the study's senior author. It allowed scientists to compare relatively equal groups: people eligible for the vaccine with people just slightly older who could not get it. 'If I take 1,000 people born one week and 1,000 people born one week later, there shouldn't be any difference between them, except for the large difference in the vaccination uptake,' Geldsetzer said. Researchers tracked health records of about 280,000 people ages 71 to 88 and without dementia when the rollout began. Over seven years, nearly half of those eligible for the vaccine received it, while only a tiny number from the ineligible group were vaccinated, providing a clear before-and-after distinction. Advertisement To limit the likelihood of differences between the groups, researchers used statistical analysis to more heavily weigh data from people just one week on either side of the cutoff: those who turned 80 in the week before rollout and those who turned 80 in the week after. They also examined medical records for possible differences between the vaccinated and unvaccinated. The study involved an older form of shingles vaccine, Zostavax, which contains a modified version of the live virus. It has since been discontinued in the United States and some other countries because its protection against shingles wanes over time. The new vaccine, Shingrix, which contains an inactivated portion of the virus, is more effective and lasting, research shows. A study last year by Harrison and colleagues suggested that Shingrix may be more protective against dementia than the older vaccine. Based on another 'natural experiment,' the 2017 shift in the United States from Zostavax to Shingrix found that over six years, people who had received the new vaccine had fewer dementia diagnoses than those who got the old one. Of the people diagnosed with dementia, those who received the new vaccine had nearly six months more time before developing the condition than people who received the old vaccine. There are different theories about why shingles vaccines might protect against dementia. One possibility is that by preventing shingles, vaccines reduce the neuroinflammation caused by reactivation of the virus, Geldsetzer said. "Inflammation is a bad thing for many chronic diseases, including dementia," he said, so "reducing these reactivations and the accompanying inflammation may have benefits for dementia." Advertisement Another possibility is that the vaccines rev up the immune system more broadly. This article originally appeared in
New York Times
02-04-2025
- Health
- New York Times
Shingles Vaccine Can Decrease Risk of Dementia, Study Finds
Getting vaccinated against shingles can reduce the risk of developing dementia, a large new study finds. The results provide some of the strongest evidence yet that some viral infections can have effects on brain function years later and that preventing them can help stave off cognitive decline. The study, published on Wednesday in the journal Nature, found that people who received the shingles vaccine were 20 percent less likely to develop dementia in the seven years afterward than those who were not vaccinated. 'If you're reducing the risk of dementia by 20 percent, that's quite important in a public health context, given that we don't really have much else at the moment that slows down the onset of dementia,' said Dr. Paul Harrison, a professor of psychiatry at Oxford. Dr. Harrison was not involved in the new study, but has done other research indicating that shingles vaccines lower dementia risk. Whether the protection can last beyond seven years can only be determined with further research. But with few currently effective treatments or preventions, Dr. Harrison said, shingles vaccines appear to have 'some of the strongest potential protective effects against dementia that we know of that are potentially usable in practice.' Shingles cases stem from the virus that causes childhood chickenpox, varicella-zoster, which typically remains dormant in nerve cells for decades. As people age and their immune systems weaken, the virus can reactivate and cause shingles, with symptoms like burning, tingling, painful blisters and numbness. The nerve pain can become chronic and disabling. In the United States, about one in three people develop at least one case of shingles, also called herpes zoster, in their lifetime, the Centers for Disease Control and Prevention estimates. About a third of eligible adults have received the vaccine in recent years, according to the C.D.C. Several previous studies have suggested that shingles vaccinations might reduce dementia risk, but most could not exclude the possibility that people who get vaccinated might have other dementia-protective characteristics, like healthier lifestyles, better diets or more years of education. The new study ruled out many of those factors. 'It's pretty strong evidence,' said Dr. Anupam Jena, a health economist and physician at Harvard Medical School, who was not involved in the study but reviewed it for Nature. The study emerged from an unusual aspect of a shingles vaccine rollout in Wales on Sept. 1, 2013. Welsh officials established a strict age requirement: people who were 79 on that date were eligible for the vaccine for one year, but those 80 and older, were ineligible. As younger people turned 79, they became eligible for the vaccine for one year. The age cutoff — imposed because of a limited supply and because the vaccine was then considered less effective for people over 80 — set up a 'natural experiment,' said Dr. Pascal Geldsetzer, an assistant professor of medicine at Stanford and the study's senior author. It allowed scientists to compare relatively equal groups: people eligible for the vaccine with people just slightly older who couldn't get it. 'If I take 1,000 people born one week and 1,000 people born one week later, there shouldn't be any difference between them, except for the large difference in the vaccination uptake,' Dr. Geldsetzer said. Researchers tracked health records of about 280,000 people who were age 71 to 88 and without dementia when the rollout began. Over seven years, nearly half of those eligible for the vaccine received it, while only a tiny number from the ineligible group were vaccinated, providing a clear before-and-after distinction. To limit the likelihood of differences between the groups, researchers used statistical analysis to more heavily weigh data from people just one week on either side of the cutoff: those who turned 80 in the week before rollout and those who turned 80 in the week after. They also examined medical records for possible differences between the vaccinated and unvaccinated. They evaluated whether unvaccinated people received more diagnoses of dementia simply because they visited doctors more frequently, and whether they took more medications that could increase dementia risk. 'They do a pretty good job at that,' said Dr. Jena, who wrote a commentary about the study for Nature. 'They look at almost 200 medications that have been shown to be at least associated with elevated Alzheimer's risk.' He said, 'They go through a lot of effort to figure out whether or not there might be other things that are timed with that age cutoff, any other medical policy changes, and that doesn't seem to be it.' The study involved an older form of shingles vaccine, Zostavax, which contains a modified version of the live virus. It has since been discontinued in the United States and some other countries because its protection against shingles wanes over time. The new vaccine, Shingrix, which contains an inactivated portion of the virus, is more effective and lasting, research shows. A study last year by Dr. Harrison and colleagues suggested that Shingrix may be more protective against dementia than the older vaccine. Based on another 'natural experiment,' the 2017 shift in the United States from Zostavax to Shingrix, it found that over six years, people who had received the new vaccine had fewer dementia diagnoses than those who got the old one. Of the people diagnosed with dementia, those who received the new vaccine had nearly six months more time before developing the condition than people who received the old vaccine. There are different theories about why shingles vaccines might protect against dementia. One possibility is that by preventing shingles, vaccines reduce the neuroinflammation caused by reactivation of the virus, Dr. Geldsetzer said. 'Inflammation is a bad thing for many chronic diseases, including dementia,' he said, so 'reducing these reactivations and the accompanying inflammation may have benefits for dementia.' Both the new study and the Shingrix study provide support for that theory. Another possibility is that the vaccines rev up the immune system more broadly. The new study offers some evidence for that theory too. It found that women, who have more reactive immune systems and larger antibody responses to vaccination than men, experienced greater protection against dementia than men, Dr. Geldsetzer said. The vaccine also had a bigger protective effect against dementia among people with autoimmune conditions and allergies. Dr. Maria Nagel, a professor of neurology at University of Colorado School of Medicine, who was not involved in the study, said both theories could be true. 'There's evidence for a direct effect as well as an indirect effect,', said Dr. Nagel, who has consulted for the manufacturer of Shingrix, GSK. She said some studies have found that other vaccines, including those against flu, create a generalized neuroprotective effect, but that because the shingles virus hides in nerves, it makes sense that a shingles vaccine would be particularly protective against cognitive impairment. The study did not distinguish between types of dementia, but other research suggests that 'the effect of the shingles vaccine for Alzheimer's disease is much more pronounced than for another dementia,' said Svetlana Ukraintseva, a biologist at Duke who coauthored a recent study on Alzheimer's and other dementias and vaccines. She said that might be because some Alzheimer's cases are associated with compromised immunity. The Welsh population in the study was mostly white, Dr. Geldsetzer said, but the report also suggested similar protective effects by analyzing death certificates in England for deaths caused by dementia. His team has also replicated the results in Australia, New Zealand and Canada. Dr. Jena said the connection should be studied further and noted that reducing dementia risk is not the same as preventing all cases. Still, he said, the evidence suggests that 'something about the exposure or access to the vaccine has this effect on dementia risk years later.'
