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. 2022 Apr 13;8(1):e12293.
doi: 10.1002/trc2.12293. eCollection 2022.

Reduced dementia incidence after varicella zoster vaccination in Wales 2013-2020

Christian Schnier  1 , Janet Janbek  2 , Richard Lathe  1 , Jürgen Haas  1
Affiliations

Reduced dementia incidence after varicella zoster vaccination in Wales 2013-2020

Christian Schnier et al. Alzheimers Dement (N Y). .

Abstract

Introduction: Chronic infection with herpes viruses is a potential contributing factor to the development of dementia. The introduction of nationwide shingles (varicella zoster) vaccination in Wales might therefore be associated with reduced incident dementia.

Methods: We analyzed the association of shingles vaccination with incident dementia in Wales between 2013 and 2020 using retrospectively collected national health data.

Results: Vaccinated individuals were at reduced risk of dementia (adjusted hazard ratio: 0.72; 95% confidence interval: 0.69 to 0.75). The association was not modified by a reduction in shingles diagnosis and was stronger for vascular dementia than for Alzheimer's disease. Vaccination was also associated with a reduction in several other diseases and all-cause mortality.

Discussion: Our study shows a clear association of shingles vaccination with reduced dementia, consistent with other observational cohort studies. The association may reflect selection bias with people choosing to be vaccinated having a higher healthy life expectancy.

Keywords: Alzheimer's disease; shingles; vaccine; vascular dementia.

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Conflict of interest statement

The authors declare no conflicts of interest. CS: received funding from the Benter Foundation (to the University of Edinburgh) for research and visits to AAIC and EAN conferences. JJ: no funding to declare. RL: received funding from the Benter Foundation (to the University of Edinburgh) for research; consulting fees to himself from Life Science Capital and the University of Edinburgh; funding to attend meetings to himself from Prevention Alzheimer International Foundation (International Conference of Chronic Inflammatory Disorders – Alzheimer's Disease), Associazione Autonoma Aderent alla SIN per le Demenze (SINDem; 7th Winter Seminar in Clinical and Experimental Research on Dementia and Neurodegenerative Disorders), Societa Italiana de Neurologia (Sin; 7th Winter Seminar in Clinical and Experimental Research on Dementia and Neurodegenerative Disorders), Deutsche Forschungs Gemeinschaft and the Pesl‐Alzheimer‐Stiftung (2nd International Conference on Cognitive Reserve in Dementia). JH: received funding from the Benter Foundation, BBSRC, MRC, and Wellcome Trust (to the University of Edinburgh) for research and consulting fees (to the University of Edinburgh) from Pneumagen Ltd.

Figures

FIGURE 1
FIGURE 1
Results (adjusted hazard ratio [HR] and 95% confidence interval [CI]) from the multivariable Cox proportional hazard model of the association between exposure to shingles vaccination and dementia. A, Classified by type of dementia (Alzheimer's disease; and vascular dementia). The comparison group (HR = 1.0) was not vaccinated. B, Classified by exposure (S+V−: shingles, not vaccinated; S−V+: no shingles, vaccinated; S+V+: first shingles, then vaccinated; V+S+: first vaccinated, then shingles). The comparison group is no shingles, not vaccinated. Full results of both models are given in the supporting information
FIGURE 2
FIGURE 2
Results (adjusted hazard ratio [HR]; and 95% confidence interval [CI]) from the multivariable Cox proportional hazard models of the association between exposure to shingles vaccination and shingles, all‐cause mortality, stroke, myocardial infarction, hip fracture, and cancer. The comparison group (HR = 1.0) was not vaccinated. MI, myocardial infarction
See this image and copyright information in PMC

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