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The shingles vaccine may reduce the risk of dementia

economist.com

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Re: The shingles vaccine may reduce the risk of dementia

#201

Post by MrDresden »

tptacek wrote: post #50
dymk wrote: post #46

Earlier quoted context omitted.

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…

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.

Re: The shingles vaccine may reduce the risk of dementia

#202

Post by InsideOutSanta »

tptacek wrote: post #24
robot_jesus wrote: post #5

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…

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.

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.

Re: The shingles vaccine may reduce the risk of dementia

#203

Post by InsideOutSanta »

dataflow wrote: post #107
Aurornis wrote: post #40

Earlier quoted context omitted.

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…

> 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?

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.

Re: The shingles vaccine may reduce the risk of dementia

#204

Post by InsideOutSanta »

andy99 wrote: post #18
robot_jesus wrote: post #5

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…

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…

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.

Re: The shingles vaccine may reduce the risk of dementia

#207

Post by yayachiken »

leereeves wrote: post #177
gdudeman wrote: post #175

Earlier quoted context omitted.

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 d…

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.

Re: The shingles vaccine may reduce the risk of dementia

#208

Post by warshinder »

reenorap wrote: post #194
warshinder wrote: post #164

Earlier quoted context omitted.

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?

Re: The shingles vaccine may reduce the risk of dementia

#209

Post by reenorap »

warshinder wrote: post #208
reenorap wrote: post #194

Earlier quoted context omitted.

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?

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Re: The shingles vaccine may reduce the risk of dementia

#210

Post by pineapplepizza6 »

chasil wrote: post #199
duk3luk3 wrote: post #190

Earlier quoted context omitted.

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...

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