Shingles Vaccines (Shingrix, Skyzoster) :: Does a Vaccine Prevent Dementia? A Specialist Fact-Checks It for You.

Hello, this is Merry Plastic Surgery Clinic, where it’s always a pleasure to meet you.

These days, my memory doesn’t seem as good as before… could it be a symptom of dementia?

This is a question I often hear from female patients in their 50s and 60s these days.

Surprisingly, according to a recent study, people who received the shingles vaccine may have a 20–25% lower risk of developing dementia than those who did not.

Source: https://www.nature.com/articles/s41586-025-08800-x?utm_source=chatgpt.com

A shingles vaccine not only prevents shingles but may also help brain health—doesn’t that make you curious?

Honestly, it’s a claim that makes you wonder about causation and is hard to believe, but I looked it up because it was published in the renowned journal NATURE. If it’s true, wouldn’t that be amazing? Really???

Does the shingles vaccine also prevent dementia?

Worrying about dementia is no longer someone else’s problem. In Korea, dementia is a common disease affecting about 10% of the population aged 65 and older. In particular, because women have a longer life expectancy, there are far more female dementia patients. Even so, prevention is still often approached cautiously.

Source: Announcement of the 2023 Dementia Epidemiology and Survey Results

Source: Announcement of the 2023 Dementia Epidemiology and Survey Results

The shingles vaccine was originally developed to prevent shingles, a painful skin disease that spreads along the nerves. But a recent study by Professor Pascal Geldsetzer’s team at Stanford University in the United States raised the possibility that this shingles vaccine may also be linked to dementia prevention.

In a study published in the scientific journal Nature in April 2025, hundreds of thousands of older adults in Wales, UK, around the age of 70, were followed for seven years. The results showed that people who received the shingles vaccine had a 20–25% lower incidence of dementia, with an even more pronounced reduction in vascular dementia.

This study was meaningful because it used a natural experiment design, comparing participants before and after a change in the vaccination policy, allowing for an indirect estimation of causality. But! It is still not a definitive conclusion.

There were also clear limitations to the study, which are the issues I personally thought about after reading the paper as a family medicine specialist.

1. The mechanism behind the vaccine’s effect is unclear

The process by which the vaccine may prevent dementia was not identified. It remains uncertain whether the vaccine actually reduced encephalitis/viral effects directly to prevent dementia, or whether there was an indirect effect through changes in health behavior or immune regulation.

2. Questions about the accuracy of the dementia diagnosis

This paper was based on CPRD (Clinical Practice Research Datalink, electronic medical records from primary care in the UK), HES (Hospital Episode Statistics, records of inpatient and outpatient hospital care), and ONS (Office for National Statistics, cause-of-death data). In the UK healthcare system, people visit primary care clinics due to memory decline, and if dementia is suspected, specialists in memory clinics, geriatrics, neurology, or psychiatry evaluate them and make the final dementia diagnosis. Therefore, if the diagnosis relies on GP records, the sensitivity may be low, and because some data were based on ONS, there was a limitation in that the exact timing of the dementia diagnosis was unclear.

3. Generalizability limits of Regression Discontinuity Design (RDD)

RDD can only generalize effects to participants near the cutoff (around age 70), so it is difficult to extend the results to other age groups. This means that estimates of the vaccine’s effect are limited outside the age range around 70.

4. Potential confounding variables

Other factors associated with vaccination status (for example, interest in health or frequency of hospital visits) could also affect the incidence of dementia. This means that factors other than vaccination may have caused differences in dementia rates. The study attempted to control for these factors, but it is uncertain whether they were completely controlled.

5. Limitations of long-term follow-up

Because the current paper uses only seven years of follow-up data, it is unclear whether the vaccine effect continues beyond seven years. Dementia is a long-term disease, so longer follow-up may be needed.

6. The difference in vaccination rates is not very large

Although the policy change increased the likelihood of vaccination, the actual difference in vaccination rates was only about 47%, which was not as large as expected and could affect the statistical precision of the effect estimate. In the paper, the researchers used the point in 2013 when the UK changed its policy to offer the shingles vaccine (Zostavax) free of charge to older adults aged 70 and over as an opportunity for a natural experiment. The difference in vaccination rates before and after the policy change was about 47%, so the policy target group did not automatically receive the vaccine. That is why the researchers did not conclude the effect definitively and emphasized that “further research is needed.” In other words, for now, it is only at the level of a possibility that there may be a dementia-prevention effect.

Currently available shingles vaccines in Korea

Zostavax has been discontinued.

The previously used Zostavax and Skyzoster, as well as the newly introduced Shingrix around 2022, are available. You probably recognize the one from the commercial with Ma Dong-seok that makes it seem like something terrible will happen if you don’t get vaccinated?

Currently, both the Korean Society of Infectious Diseases and the CDC recommend the newly introduced Shingrix first. The reason is that the preventive effect of Shingrix in people in their 60s is much greater, there is no age-related decline in prevention rate, and the protective duration is expected to be more than 10 years. (Longer-term follow-up studies are still needed.) Also, the prevention rates for postherpetic neuralgia (PHN), which I’m sure many of you have heard of at least once, show a large difference at 67% and 88.8%.

You may feel uneasy because it is a newly introduced vaccine, or feel burdened by the large price difference, but for shingles vaccination alone, I recommend getting the two-dose Shingrix series.

At our Slow Aging Clinic, we provide personalized vaccine counseling based on age, underlying conditions, and lifestyle habits.

If you have any further questions, please leave a comment or consult a specialist at a nearby hospital.

This has been Merry Plastic Surgery Clinic, where it’s always a pleasure to meet you.

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