The study will analyze data from electronic health records of approximately 3.5 million nursing home residents who were admitted between 2017 and 2022 across the United States. The researchers will examine the data to ascertain whether there is a variance in the risk of dementia between patients who complete the two-dose series of the shingles vaccine and patients who are unvaccinated.
“If a precursor to incident dementia is neuroinflammation and stroke, if you have a stroke, it’s a strong predictor for vascular dementia,” stated Dr. Harris. “If that can be prevented in a healthy brain, it can arguably prevent a new dementia case later in life.”
Dr. Harris posed the question, “For those who show early neurological changes of dementia but are asymptomatic, could a shingles infection accelerate dementia progression through increased neuroinflammation and potential other adverse events like stroke?” He added, “Preventing shingles through vaccination may, therefore, be one strategy to slow dementia progression in those exhibiting underlying neuropathology of dementia.”
“GSK’s scientific division is very interested in getting the right answer—the truth,” Dr. Harris stated. “They are invested in this vaccine. Additionally, there’s a lot of regulatory pressure on them, so they must make supported claims.”
Dr. Harris’ colleagues at Brown University in Providence, Rhode Island, are conducting a parallel study using 60,000 Veterans Administration health records. Dr. Harris stated, “They have even more comprehensive data. If a person enlists in the military at age 18 or in their twenties, their health record is longitudinal and includes all lab records and outpatient visits.” He also cautioned, “It has limitations. Veterans and service members are predominantly male, and it’s a generally less healthy cohort on average.” Estimates from both studies will be merged through meta-analysis.
Dr. Harris noted that within the nursing home cohort of this study, he predicts a decrease in stroke and a reduction in more severe neurologic adverse events in residents vaccinated with the Shingrix vaccine versus those unvaccinated residents and anticipated a modest reduction in incident dementia risk.
He stated, “I’m optimistic and believe Shingrix will also be effective at reducing shingles and its sequelae, especially with how effective the vaccine has shown to be in other settings.” Dr. Harris hopes the findings from this study highlight the clinical benefits of obtaining the shingles vaccination, particularly for patients in nursing homes who are at augmented risk for stroke and other complications from a shingles infection.
Finally, Dr. Harris added, “Vaccines have the potential to do more than just prevent the infection they’re designed to prevent. If we prevent the infection, then we can also avoid the devastating downstream effects of that infection.” The researchers project that the study will take over a year to complete, but they anticipate having preliminary data available in the next few months.
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