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.
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.
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.
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.
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 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.
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.
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.)
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.
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.
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.
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 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, and it doesn't seem to be yielding clearly-good results.
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.
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).
Is it also possible they're finding healthier people that are proactive in their treatment, maybe even exercise more, work longer, etc...
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.
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.
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.
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.
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.
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 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.
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.
That seems like being penny wise and pound foolish.
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.)
aside from age ranges being the tested population, your just gambling no other interference pattern is involved.
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.
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.)
>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'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.
> 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?
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.
So if you had shingles in your youth then you are better protected against dementia?
No, the opposite. If you've had shingles before, you're more likely to get it again later, not less.
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.
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.
Not really, shingles is a lifetime infection. You'd be more likely.
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, and it 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.
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
https://archive.ph/PzPop
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.
Can you share the article you reference?
> hearing improvement
This means addressing hearing loss, e.g. via hearing aids.
>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.
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).
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.
20% of what?