Herpes zoster vaccination and the risk of dementia: A systematic review and meta-analysis

doi:10.1002/brb3.3415

Meta-Analysis

. 2024 Feb;14(2):e3415.

doi: 10.1002/brb3.3415.

Herpes zoster vaccination and the risk of dementia: A systematic review and meta-analysis

Sangam Shah¹, Krishna Dahal¹, Sangharsha Thapa², Prativa Subedi³, Basanta Sharma Paudel¹, Swati Chand², Amr Salem², Markus Lammle⁴, Ranjit Sah^{5

6

7}, Martin Krsak⁸

Affiliations

¹ Institute of Medicine, Tribhuvan University, Maharajgunj, Nepal.
² Westchester Medical Center, Valhalla, New York, USA.
³ Kist Medical College and Teaching Hospital, Imadole, Lalitpur, Nepal.
⁴ SUNY Upstate Medical University, Syracuse, New York, USA.
⁵ Department of Microbiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal.
⁶ Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India.
⁷ Datta Meghe Institute of Higher Education and Research, Jawaharlal Nehru Medical College, Wardha, India.
⁸ Division of Infectious Diseases, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.

PMID: 38687552
PMCID: PMC10839537
DOI: 10.1002/brb3.3415

Meta-Analysis

Herpes zoster vaccination and the risk of dementia: A systematic review and meta-analysis

Sangam Shah et al. Brain Behav. 2024 Feb.

. 2024 Feb;14(2):e3415.

doi: 10.1002/brb3.3415.

Authors

Sangam Shah¹, Krishna Dahal¹, Sangharsha Thapa², Prativa Subedi³, Basanta Sharma Paudel¹, Swati Chand², Amr Salem², Markus Lammle⁴, Ranjit Sah^{5

6

7}, Martin Krsak⁸

Affiliations

¹ Institute of Medicine, Tribhuvan University, Maharajgunj, Nepal.
² Westchester Medical Center, Valhalla, New York, USA.
³ Kist Medical College and Teaching Hospital, Imadole, Lalitpur, Nepal.
⁴ SUNY Upstate Medical University, Syracuse, New York, USA.
⁵ Department of Microbiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal.
⁶ Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India.
⁷ Datta Meghe Institute of Higher Education and Research, Jawaharlal Nehru Medical College, Wardha, India.
⁸ Division of Infectious Diseases, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.

PMID: 38687552
PMCID: PMC10839537
DOI: 10.1002/brb3.3415

Abstract

Introduction: Previous studies have reported a decreased risk of dementia with herpes zoster vaccination. Given this background, this systematic review and meta-analysis aimed to investigate the association between herpes zoster vaccination and the risk of dementia.

Methods: We searched five databases until November 2023 for case-control, cross-sectional, or cohort studies investigating the association of herpes zoster vaccination and dementia. Odds ratios and 95% confidence intervals (95% CIs) were pooled in the meta-analysis. Meta-regression, subgroup, and sensitivity analysis were also conducted.

Results: We evaluated a total of five studies (one cross-sectional, one case-control, and four cohort studies) that included a total number of 103,615 patients who were vaccinated with herpes zoster vaccine. All the studies were of high quality, ranging from 7 to 9. Due to the high heterogeneity (I² = 100%, p < .00001) observed in our study, a random effect model was used for the analysis. The pooled odds ratio was 0.84 (95% CI: 0.50, 1.43), p (overall effect) = .53), indicating that herpes zoster vaccination reduces the risk of dementia.

Conclusion: Herpes zoster vaccination is associated with a reduction of the risk of dementia. More epidemiological studies are needed to confirm the association.

Keywords: dementia; herpes zoster; shingles; vaccination.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

**FIGURE 1**
Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) flowchart of the included studies.

**FIGURE 2**
Forest plot showing risk of dementia after herpes zoster vaccination.

**FIGURE 3**
Funnel plot showing publication bias among included studies. OR, odds ratio.

See this image and copyright information in PMC

Cited by

Bibliometric analysis and visualization mapping of herpes zoster vaccine publications from 1999 to 2024.
Gao W, Gao D, Li L, Li J, Yao X, Zhang J. Gao W, et al. Front Med (Lausanne). 2025 Jul 10;12:1516450. doi: 10.3389/fmed.2025.1516450. eCollection 2025. Front Med (Lausanne). 2025. PMID: 40708637 Free PMC article.
Computational design of prefusion-stabilized Herpesvirus gB trimers.
McCallum M, Veesler D. McCallum M, et al. bioRxiv [Preprint]. 2024 Oct 24:2024.10.23.619923. doi: 10.1101/2024.10.23.619923. bioRxiv. 2024. PMID: 39484573 Free PMC article. Preprint.
Infectious Disease as a Modifiable Risk Factor for Dementia: A Narrative Review.
Farrer TJ, Moore JD, Chase M, Gale SD, Hedges DW. Farrer TJ, et al. Pathogens. 2024 Nov 7;13(11):974. doi: 10.3390/pathogens13110974. Pathogens. 2024. PMID: 39599527 Free PMC article. Review.

References

1. Bae, S. , Yun, S. C. , Kim, M. C. , Yoon, W. , Lim, J. S. , Lee, S. O. , Choi, S. H. , Kim, Y. S. , Woo, J. H. , Kim, S. Y. , & Kim, S. H. (2021). Association of herpes zoster with dementia and effect of antiviral therapy on dementia: A population‐based cohort study. European Archives of Psychiatry and Clinical Neuroscience, 271(5), 987–997. 10.1007/s00406-020-01157-4 - DOI - PubMed
1. Benn, C. S. , Netea, M. G. , Selin, L. K. , & Aaby, P. (2013). A small jab—A big effect: Nonspecific immunomodulation by vaccines. Trends in Immunology, 34(9), 431–439. 10.1016/j.it.2013.04.004 - DOI - PubMed
1. Chen, V. C. H. , Wu, S. I. , Huang, K. Y. , Yang, Y. H. , Kuo, T. Y. , Liang, H. Y. , Huang, K. L. , & Gossop, M. (2018). Herpes zoster and dementia: A nationwide population‐based cohort study. Journal of Clinical Psychiatry, 79(1), 16m11312. 10.4088/JCP.16m11312 - DOI - PubMed
1. Choi, H. G. , Park, B. J. , Lim, J. S. , Sim, S. Y. , Jung, Y. J. , & Lee, S. W. (2021). Herpes zoster does not increase the risk of neurodegenerative Dementia: A case‐control study. American Journal of Alzheimers Disease and Other Dementias, 36, 15333175211006504. 10.1177/15333175211006504 - DOI - PMC - PubMed
1. Centers for Disease Control and Prevention . (2023a). Clinical overview . https://www.cdc.gov/shingles/hcp/clinical‐overview.html

Publication types

Actions
Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions

Substances

Actions

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Health Information

[1] Bae, S. , Yun, S. C. , Kim, M. C. , Yoon, W. , Lim, J. S. , Lee, S. O. , Choi, S. H. , Kim, Y. S. , Woo, J. H. , Kim, S. Y. , & Kim, S. H. (2021). Association of herpes zoster with dementia and effect of antiviral therapy on dementia: A population‐based cohort study. European Archives of Psychiatry and Clinical Neuroscience, 271(5), 987–997. 10.1007/s00406-020-01157-4 - DOI - PubMed

[2] Bae, S. , Yun, S. C. , Kim, M. C. , Yoon, W. , Lim, J. S. , Lee, S. O. , Choi, S. H. , Kim, Y. S. , Woo, J. H. , Kim, S. Y. , & Kim, S. H. (2021). Association of herpes zoster with dementia and effect of antiviral therapy on dementia: A population‐based cohort study. European Archives of Psychiatry and Clinical Neuroscience, 271(5), 987–997. 10.1007/s00406-020-01157-4 - DOI - PubMed

[3] Benn, C. S. , Netea, M. G. , Selin, L. K. , & Aaby, P. (2013). A small jab—A big effect: Nonspecific immunomodulation by vaccines. Trends in Immunology, 34(9), 431–439. 10.1016/j.it.2013.04.004 - DOI - PubMed

[4] Benn, C. S. , Netea, M. G. , Selin, L. K. , & Aaby, P. (2013). A small jab—A big effect: Nonspecific immunomodulation by vaccines. Trends in Immunology, 34(9), 431–439. 10.1016/j.it.2013.04.004 - DOI - PubMed

[5] Chen, V. C. H. , Wu, S. I. , Huang, K. Y. , Yang, Y. H. , Kuo, T. Y. , Liang, H. Y. , Huang, K. L. , & Gossop, M. (2018). Herpes zoster and dementia: A nationwide population‐based cohort study. Journal of Clinical Psychiatry, 79(1), 16m11312. 10.4088/JCP.16m11312 - DOI - PubMed

[6] Chen, V. C. H. , Wu, S. I. , Huang, K. Y. , Yang, Y. H. , Kuo, T. Y. , Liang, H. Y. , Huang, K. L. , & Gossop, M. (2018). Herpes zoster and dementia: A nationwide population‐based cohort study. Journal of Clinical Psychiatry, 79(1), 16m11312. 10.4088/JCP.16m11312 - DOI - PubMed

[7] Choi, H. G. , Park, B. J. , Lim, J. S. , Sim, S. Y. , Jung, Y. J. , & Lee, S. W. (2021). Herpes zoster does not increase the risk of neurodegenerative Dementia: A case‐control study. American Journal of Alzheimers Disease and Other Dementias, 36, 15333175211006504. 10.1177/15333175211006504 - DOI - PMC - PubMed

[8] Choi, H. G. , Park, B. J. , Lim, J. S. , Sim, S. Y. , Jung, Y. J. , & Lee, S. W. (2021). Herpes zoster does not increase the risk of neurodegenerative Dementia: A case‐control study. American Journal of Alzheimers Disease and Other Dementias, 36, 15333175211006504. 10.1177/15333175211006504 - DOI - PMC - PubMed

[9] Centers for Disease Control and Prevention . (2023a). Clinical overview . https://www.cdc.gov/shingles/hcp/clinical‐overview.html

[10] Centers for Disease Control and Prevention . (2023a). Clinical overview . https://www.cdc.gov/shingles/hcp/clinical‐overview.html

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Herpes zoster vaccination and the risk of dementia: A systematic review and meta-analysis

Affiliations

Herpes zoster vaccination and the risk of dementia: A systematic review and meta-analysis

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Medical

Abstract

Conflict of interest statement

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

Substances

Related information

LinkOut - more resources

Full Text Sources

Medical