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A no-brainer for protecting your brain

67 points3 hourseconomist.com
robot_jesus2 hours ago

I'm in my 40s with genetic predisposition for Alzheimer's. Been seriously considering the past year or two paying out of pocket for Shingrix. I think it would be ~$500 total for two doses.

Sure, I could wait 7 or 8 years until I qualify via insurance, but is that really worth the risk for what is an easily absorbed cost to me? Especially when I have a friend in her late 30s who just went through a very rough bout of shingles?

It makes sense to have targets like age 50 for population-wide public health recommendations. But it can and does infect people of much earlier ages.

Recent articles like this make me think I'll go ahead.

andy991 hour ago

I read before that iirc because of waning protection it’s better not to get it too early. It’s not clear to me why you can’t get it twice, but what I read (and it was some online discussion so could be wrong) was that someone had been specifically told by their doctor to wait to 50 as the best spot to get it. I’d like to know more, I’m in my 40s and would be happy to get it now too but not if it was going to be worse overall for some reason.

anonym291 hour ago

The antibodies you develop to fight the virus fade over time. I just had it fairly recently (young 30s, vaccinated with the attenuated chickenpox virus, never had chickenpox, so this was likely the vaccine strain¹). Did a lot of reading and research during and after. The antibodies seem to offer good protection for 5-10 years following either vaccination or infection according to the literature I was reading.

¹ The vaccine strain tends to be much more mild than the wild strain, and indeed it was quite unpleasant, but not extremely painful for me. The wild strain is considerably more painful and linked to a greater incidence rate of complications. Please do not skip chickenpox vaccinations for your kids, the minor risk of latent infection from attenuated vaccine is far less harmful than the consequences of not vaccinating. Most important of all, if you have a cluster of blisters or rash on one side of your body that keep popping up, make sure to see a doctor and get on antivirals within the first 72 hours for best results.

tptacek1 hour ago

Wait, you can just pay for the shingles vaccine, before you're 50? Where do I do that?

I had shingles in my 30s. It was the sickest I've ever been.

Aurornis48 minutes ago

You can get basically any medication or vaccination you want in the US as long as you can find a doctor to write the prescription.

We even have anabolic steroids that were approved for muscle wasting in cancer patients, but if you can find a doctor willing to write the prescription and a pharmacy that won’t question it, anyone can have pharmacy grade Anavar for the gym, completely legal. In theory the doctor writing the prescription is putting their license at risk, but enforcement is so lax that there are “anti-aging” clinics all over that will prescribe testosterone and Anavar to anyone with a credit card.

So with a documented history of shingles you should have no problem getting a prescription written. It would be worth a quick check with your insurance company because it might even be covered if your doctor will fill out the form and attach evidence of the past diagnosis.

mlyle1 hour ago

I got shingles at 45 and it was -not fun-. My arm is slightly disfigured.

I think the age 50 target is dated. With reduced childhood incidence of chicken pox, we're all exposed to varicella zoster less, and it seems like the ages of incidence of shingles is falling. Public health recommendations are slow to catch up with research (especially for vaccinations, these days).

zahlman25 minutes ago

> Japan was among the first countries to vaccinate for chickenpox. The vaccine developed by Hilleman was first licensed in the United States in 1995.[17][60]

People (well, Americans and Canadians at least) in their 40s now generally didn't get vaccinated as children, as their parents didn't have the option. It will be different for the next generation.

jyounker29 minutes ago

Yeah, I came here to say the same thing. I got it around 46. The horrible looking stuff on the outside is also on the inside, and it weakens your internal tissues. I know this because I tore one of the muscles in my lower back, and it still causes problems.

copperx1 hour ago

Shingles terrifies me because it can cause hearing loss. I spoke to my GP and he wouldn't give me a script for it even though I'm 3 years away from qualifying. He mentioned side effects.

jyounker28 minutes ago

That seems like being penny wise and pound foolish.

tptacek17 minutes ago

I think the bigger thing is that the vaccine has a peak response window, and the current medical guidance lines that up with when you're epidemiologically most likely to experience a shingles outbreak (for most people, that's very unlikely when you're young, because your immune system is so jumpy, but that wanes with age). If you get the vaccine early, its effect can be attenuated right when you need it most.

(I don't like this logic and if I had the option of just going to Walgreens and getting vaccinated, I'd do that this afternoon. I'm just saying, there's a logic to it.)

cyanydeez2 hours ago

aside from age ranges being the tested population, your just gambling no other interference pattern is involved.

robot_jesus2 hours ago
sowbug2 hours ago

Shingles vaccine, if you don't feel like clicking through.

blooalien2 hours ago

Thank you.

hereme8881 hour ago

Replicated association, which is strong, but not proof. Initial study saw a 3.5% absolute reduction in dementia diagnoses over seven years with a very wide confidence interval. In Australia the study was replicated with 1.8% absolute reduction over 7.4 yrs. Canadian replication: 2% over 5.5 yrs.

Infections generally increase the risk of future dementia. Like the more colds you have throughout life.

gruez1 hour ago

>Replicated association [...]

"association" undersells it a bit, because the data is better than the typical cohort study, which has issues like "what if people who got the vaccine are also richer and care about their health more?". There's quasi-randomization going on. From the more in depth article that's linked:

>Research is also revealing unexpected interventions that help to keep ageing minds sharp. One of the most promising derives from an analysis by Pascal Geldsetzer of Stanford University and his team of a natural experiment in Wales. In 2013 the British region started offering people aged 70-79 free vaccinations through the public-health system. This change resembled an RCT, in that a large number of people were separated almost at random into two groups: those who had already turned 80 in the weeks before the programme started, and so were not eligible to be jabbed; and those who turned 80 in the weeks after, roughly half of whom were duly vaccinated.

alfiedotwtf49 minutes ago

> like the more colds you have in life

Whoa wait what? This is the first time I’ve heard of this - is this actually common knowledge?

antaviana40 minutes ago

So if you had shingles in your youth then you are better protected against dementia?

tptacek33 minutes ago

No, the opposite. If you've had shingles before, you're more likely to get it again later, not less.

dymk34 minutes ago

The article says that one possible reason the vaccine protects against dementia is incidental protection from other diseases. Getting chickenpox as a kid might protect you against shingles, but maybe not against those other diseases.

tptacek32 minutes ago

No! The opposite thing is true. Getting chickenpox as a kid drastically increases your likelihood of getting shingles as an adult. The initial chickenpox infection is the mechanism by which you're set up for shingles: you get it, fight it back, and it remains dormant in your nerves. Shingles is not simply chickenpox; it's the secondary infection you get from a resurgent zoster outbreak based in your nerves.

Don't get chickenpox.

therein32 minutes ago

Not really, shingles is a lifetime infection. You'd be more likely.

khriss36 minutes ago

Recently, even the TDAP (Tetanus) vaccine was correlated with lower incidence of dementia https://news.ycombinator.com/item?id=26919881

I recall seeing a few discussions on HN comments hypothesizing that immune system stimulation via the vaccine might be the root cause. Now that the Amyloid hypothesis is on the wane, hopefully we'll explore other paths.

zahlman35 minutes ago

> the Amyloid hypothesis is on the wane

Oh? What did I miss?

khriss12 minutes ago

https://news.ycombinator.com/item?id=32183302

TL;DR A lot of evidence supporting the Amyloid hypothesis is suspect.

Terr_14 minutes ago

[delayed]

syntaxing1 hour ago

I know quite a few people who got shingles in their early 20s. One of their doctors didn’t believe she had shingles until the blisters formed. The vaccine can definitely help those younger than 50, dementia benefits or not. Some of them have permanent nerve damage after getting shingles.

satya712 hours ago

TL;DR Shingles vaccines reduces chances of dementia by 20%. Yet, most countries health systems only look at the upfront cost of ~$300 and don’t recommend for all who could benefit.

MASNeo1 hour ago

In a separate article the other factors are quoted with similar impact (listed in order of max potential magnitude) - anti depression treatment - education increases - hearing improvement - obesity reduction - low alcohol

The earlier you start the better.

rsyring53 minutes ago

Can you share the article you reference?

WalterGR59 minutes ago

> hearing improvement

This means addressing hearing loss, e.g. via hearing aids.

gruez1 hour ago

>anti depression treatment - regular exercise - obesity reduction - education - less/no alcohol

Injecting people with a shingles vaccine is far easier than the others you listed, which is why it stands out.

tptacek48 minutes ago

That may be the case in other countries, but in the US we're generally fee-for-service, so the incentives are reversed, and we still don't give it until you're 50 (which, as someone who has had it and is under 50, annoys me to no end).

hatsunearu1 hour ago

Should I get the shingles vaccine at a young age? I've had chickenpox earlier in my life.

jyounker33 minutes ago

As someone who got shingles at about 46, yes.

SoftTalker1 hour ago

20% of what?

swed4201 hour ago

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timcobb1 hour ago

most people can't really get a worthwhile quality of life like that. maybe life is worthwhile to you walking around in an N95 respirator, but not to me, at least not... indefinitely. I'd rather be dead TBH. IMO it makes sense to wait to die to be dead. Why be dead while you're still technically alive? What are you trying to optimize for? Days you woke up?

And for transparency, I am triple vaccinated (maybe more, I lost count), have had 0 covid infections as far as I know, masked for a long time while it seemed to make sense.

OutOfHere1 hour ago

Your comment is completely unfair. You are entirely dismissive of those who are not ignorant of long Covid and of those who have experienced the hell that Covid could be.

And you'd rather be dead? Careful what you wish for.

timcobb57 minutes ago

I didn't wish for anything, I stated my calculus, and I'm pretty comfortable with it.

Not sure what's unfair about my comment, let alone completely.

OutOfHere44 minutes ago

Your calculus doesn't relate to anyone else. It is like a billionaire saying that poverty doesn't exist.

swed42057 minutes ago

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timcobb24 minutes ago

Why are you insulting the people you're seemingly trying to convince of something? What's going on there? What are you doing here?

OutOfHere1 hour ago

I wear a P95, not for Covid, but because I simply don't like getting sick even with a cold. Also, it blocks pollution which is independently important for the brain.

xyzsparetimexyz1 hour ago

Lmao

swed4201 hour ago

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gruez1 hour ago

What are either of those links supposed to imply?

swed42059 minutes ago

The levels that capital interests stooped to, and it worked. Nobody was given an alternative, nor the facts that would motivate searching for one.

mecdu921 hour ago

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mecdu921 hour ago

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gruez1 hour ago

" Please don't post shallow dismissals, especially of other people's work. A good critical comment teaches us something. "

https://news.ycombinator.com/newsguidelines.html

zyralab1 hour ago

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