There Might Be an Unexpected Benefit to the Shingles Vaccine. It Was Enough for Me to Go Ahead and Get It.

Medical Examiner The Shingles Vaccine Isn’t Just for “Old” People I’m in my 30s, but it felt worth it for a few reasons—including some exciting new research. pocketlight/Getty Images Plus. Sign up for the Slatest to get the most insightful analysis, criticism, and advice out there, delivered to your inbox daily. Bushra Tbakhi was in med school when she developed an unattractive, “creepy” itchy patch above one of her eyes. Even though she was on her way to becoming a physician herself, and even though she was exhausted and stressed, and stress is a possible agitator for shingles, her doctors didn’t immediately find a diagnosis. Tbakhi was 23 at the time, and even in the medical field, shingles is viewed as something that, well, old people get. Despite a round of antivirals, the flare turned into the painful condition Bell’s palsy, a complication that causes muscle weakness and drooping, often in one side of the face. Reactivation of the varicella-zoster virus, aka chickenpox, into herpes zoster, aka shingles, does typically happen in later life. Yet, younger and younger seemingly healthy people are reporting flare-ups. (Celebrities Justin Bieber, Ed Sheeran, and NBA All-Star Tyrese Haliburton have all made headlines with the disease, and Slate’s editor in chief wrote about getting shingles when she was only 48.) Recent data bears this out—though it’s not clear why younger people might be having shingles flares, it’s possible that it’s related to high levels of stress. If you’ve had chickenpox, you have the potential to have shingles. “If you’ve had chickenpox naturally, that will go away, but it will live dormant. It’ll hang out within your nerves,” Tbakhi, now an allergy and immunology fellow at the University of Cincinnati, explained. That means a lot of people (95 percent of American adults), for a very long time, have been playing host to a virus that can cause a rash and nasty pustules. There is, as Tbakhi experienced, a potential for continued complications—as well as long-term neuralgic pain called postherpetic neuralgia, blindness, and encephalitis. After my dad had a flare-up of shingles, I started to wonder if I should look into getting the vaccine for myself. (It was actually that article in Slate that tipped me off that it might be a good idea to mention shingles to his doctors, although by that time it was too late for him to take the antiviral drugs—which are most effective when taken within 72 hours of onset.) Both the initial shingles vaccine, which was approved in 2006, and the newer vaccine, approved in 2017, have been rolled out to those who are over 50 or immunocompromised, as these demographics are most likely to experience the harsher effects of the disease. While I’m only in my 30s, I do fall into the immunocompromised camp. There’s another reason I was interested in looking into getting the vaccine, beyond its ability to help prevent a flare-up. A bunch of new research shows that both the discontinued live-attenuated vaccine and the new recombinant version (Shingrix) that replaced it allegedly offer an array of dramatic off-label benefits: reduced dementia diagnoses, protection against cardiovascular disease, and even slowed biological aging. “This will have huge, huge consequences for population health,” said Pascal Geldsetzer, who is an assistant professor of medicine at Stanford University and a member of the team who first found the connection between the shingles vaccine and dementia prevention. That first study, which his team has been able to repeat in multiple locations around the world, piggybacked off the rollout of the live-attenuated shingles vaccine in Wales in 2013. Those born before Sept. 2, 1933 were not eligible to receive the vaccine. Those born after that date were. The conditions created the perfect situation to observe effects of the shot. “Researchers always have this problem that those who are more health-motivated and have better preventive behaviors are the ones who go get their vaccines,” Geldsetzer explained. But, outside of being born just a week or so apart before or after the 1933 deadline, little separated the Welsh pensioners his team analyzed. And what researchers saw was astounding. Those who received the vaccine displayed what Geldsetzer described as “large preventive effects,” correlating to a 20 percent reduction in dementia diagnoses. It’s unknown whether it’s something in the vaccine itself that’s offering this bonus benefit or it’s simply the effects of reduced flare-ups of the virus within us. Geldsetzer said research points toward the latter. It seems, he said, that sans vaccine, minor reactivations throughout our lives boost immunity to the virus. And it seems that these undetected flares may contribute to several of the hallmark diseases of old age. This is all just a working theory, of course. But I have a family history of both dementia and heart failure, and have seen firsthand how painful shingles can be. My reaction was simple: Sign me up for that vaccine! After scrolling through the shingles subreddit and reading about other immunocompromised millennials struggling to get the shot, I didn’t think I’d easily qualify. When a cheerful pharmacist told me my insurance would cover it while I waited for my husband to finish perusing the aisles of a big-box store one recent weekend, I felt like I was getting away with something. A slight jab and a vaguely sore arm later, I’m now halfway to being significantly more protected against a shingles outbreak than I was before. (I’ll have to get a second shot in a few months to seal the deal.) To be clear, I’m not sitting here rubbing my hands with glee, thinking I’m immune to dementia or a heart attack and I’ll stay young forever. First, we don’t know yet how long the vaccine offers immunity against shingles, nor is it clear whether the protective qualities it seems to offer older folks apply when it’s given to younger populations. Nor does it even 100 percent protect me against shingles—I could still get an outbreak, albeit a much less severe case. But evidence is exciting researchers, and they’re keen to learn more. “We’ve got so few tools for dementia,” Geldsetzer said. “Here you’d have a one-off, inexpensive, readily scalable, safe intervention that people don’t even have to take every day, let alone a lifestyle regimen you have to adhere to for decades.” As I type, two studies and a clinical trial are ongoing to affirm how Shingrix may impact dementia, cardiovascular disorders, and major adverse cardiac events. For now, while exploration is ongoing into whether approving the vaccine to younger populations is warranted, doctors recommend paying close attention to any itchy patches, even areas of skin with no visible rash. For most outbreaks in healthy individuals, “We take an antiviral, and it should be fine,” Tbakhi said. Experts like Tbakhi and Geldsetzer are loath to say that younger adults should all get the shingles vaccine—both affirmed that recommendations should be left to committees such as those at the Food and Drug Administration. But evidence is piling up, and, if you’re immunocompromised like me, there’s no downside to getting it sooner than later. Health Health Care Medicine Research Vaccines