Lower risk of dementia with AS01-adjuvanted vaccination against shingles and respiratory syncytial virus infections

Abstract

AS01-adjuvanted shingles (herpes zoster) vaccination is associated with a lower risk of dementia, but the underlying mechanisms are unclear. In propensity-score matched cohort studies with 436,788 individuals, both the AS01-adjuvanted shingles and respiratory syncytial virus (RSV) vaccines, individually or combined, were associated with reduced 18-month risk of dementia. No difference was observed between the two AS01-adjuvanted vaccines, suggesting that the AS01 adjuvant itself plays a direct role in lowering dementia risk.

Fig. 1. Associations between AS01 vaccines and dementia, negative control outcome and zoster infection in the primary and secondary analyses.

A Association between AS01-adjuvanted vaccines and risk of dementia, negative control outcome and zoster infection. Each dot and bold number represent the ratio of restricted mean time lost (RMTL) for the comparison between two cohorts, while horizontal lines and numbers in brackets are 95% confidence intervals. RMTL ratios below 1 indicate that the risk is lower in the first cohort (e.g. recipients of the RSV vaccine on the first line) than in the second (e.g. recipients of the flu vaccine). B Associations between AS01-adjuvanted vaccines (compared to flu vaccine) and risk of dementia in females, males and in the cohorts including people who developed dementia within the first 3 months post-vaccination.

Fig. 2. Kaplan–Meier estimates of the cumulative incidence of dementia in the comparison between cohorts.

Shaded areas represent 95% CI. The RMTL ratio, the P value for the association, and the additional time that affected people lived diagnosis-free are reported above each figure.