Let’s be clear. The main reason for receiving the shingles (infection caused by the shingles virus) vaccination is the two-dose vaccination. 90% protection It combats a painful, blistering condition that can cause persistent nerve pain and other serious long-term complications. And it will affect one-third of Americans in their lifetime.
The most important reasons older adults get vaccinated against respiratory syncytial virus (RSV) include: There is a risk of hospitalization due to this respiratory infection. There is a nearly 70% decline in the year of vaccination, and a nearly 60% decline two years later.
And the main reason to get the flu vaccine every year is that although it does not always prevent infection, it certainly reduces the severity of the disease. But its effectiveness depends on how well scientists predict what the dominant flu strain will be that year.
However, reasons are also emerging for older people to get vaccinated. In medical terms, this is called an “indirect benefit.” This means that these vaccines have positive effects beyond preventing the diseases for which they are designed.
“As research has accumulated and accelerated over the past decade, the list of these indirect benefits continues to grow,” explained Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center.
Some of these protective effects are supported by decades of data. Others are from more recent studies and their benefits are not yet fully clear. For example, the RSV vaccine was only released in 2023.
Nonetheless, the findings are “really very consistent,” said Dr. Stefania Maggi, a geriatrician and senior researcher at the National Research Council’s Institute of Neuroscience in Padua, Italy.
Maggi is the main author of: Recent analysis of several studies Published in a British magazine age and agingThe risk of dementia has been shown to be reduced after vaccination against a variety of diseases. Given these types of “cascade side effects, vaccines are a key tool to promote healthy aging and prevent physical and cognitive decline,” Maggi said.
But too many older people are unvaccinated, despite weakened immune systems and a higher prevalence of chronic diseases, which puts them at higher risk for infectious diseases.
In mid-December, Centers for Disease Control and Prevention (CDC) reports that approximately 37% of older adults have not yet received the flu vaccine. Only 42% of people have been vaccinated against RSV, and less than a third have received the most recent Covid vaccine.
CDC recommends one dose of pneumococcal vaccine for adults age 50 and older. however analyze published in American Journal of Preventive Medicine From 2022 to 2024, when the recommendations were updated, it is estimated that only 12% of people aged 67 to 74 years have received recommendations, and only 8% of people aged 75 years and older have received recommendations.
The strongest evidence for an indirect benefit dates back 25 years, showing a reduction in cardiovascular risk after flu vaccination.
Healthy older adults who have been vaccinated against flu have a significantly lower risk of being hospitalized due to the flu. heart failurePneumonia and other respiratory infections. The flu vaccine is also linked to: reduced risk of heart attack And stroke.
Additionally, many of these studies were conducted before the availability of the more potent flu vaccine currently recommended for older adults.
Could RSV vaccines that prevent other respiratory diseases provide similar cardiovascular benefits?
A recent study targeting older adults Denmark On a larger scale, cardiopulmonary hospitalizations (heart and lung related) were found to be reduced by almost 10% in vaccinated people compared to the control group. significant reduction.
However, the reduction in hospitalization rates for cardiovascular disease and stroke was not statistically significant. This may be because the follow-up period was too short or the diagnostic tests were inadequate, said study co-author Dr. Helen Chu, an infectious disease expert at the University of Washington. Editorial with study of Zama.
“I don’t think RSV behaves much differently than the flu,” Chu said. “It’s still too early to know everything about RSV, but we think it will show the same effect, maybe even greater effect.”
Getting vaccinated against Covid-19, another dangerous respiratory disease, has also been linked to lowering the risk of: Long-term COVID-19 outbreakThe effects are damaging to both physical and mental health.
Perhaps the most provocative discovery has to do with the shingles vaccine. Researchers made headlines last year when they showed a link between the vaccine and reduced rates of dementia, even in an older, less effective version of the vaccine that had already been replaced by Shingrix, which was approved in 2017.
Almost all studies of indirect benefits are observation-based. Because scientists cannot, for ethical reasons, refuse a safe and effective vaccine to control groups who may eventually develop the disease.
This means the results may be influenced by “healthy volunteer bias” because vaccinated people tend to have different healthy habits that set them apart from those who have not been vaccinated.
Although the researchers try to adjust the data to take into account age, gender, health and education level, “we can only confirm that there is a clear association between the vaccine and a reduction in dementia, not a causal relationship,” Maggi explained.
Stanford researchers took advantage of the following: A natural experiment has occurred in Wales. In 2013, the first shingles vaccine, Zostavax, became available to older adults who were not yet 80 years old. Anyone already over 80 is not eligible.
Over a seven-year period, the incidence of dementia among people eligible for vaccination fell by 20% compared to people excluded for just a few days, even though only half of those actually received the vaccine.
“There is no reason to think that people born a week ago are any different from people born a few days later,” said Maggie.
research australia why USA They also found that getting the shingles vaccine reduced the likelihood of developing dementia.
If we actually examine the research results, Published by Maggi and his teamSome childhood and adult vaccines appear to have similar effects. “We now know that many infections, whether Alzheimer’s disease or the vascular type, are associated with the development of dementia,” he explained.
In 21 studies involving more than 104 million participants across Europe, Asia, and North America, shingles vaccination was associated with a 24% reduced risk of developing dementia. In the case of the flu vaccine, the decrease was 13%. People who were vaccinated against pneumococcal infection had a 36% lower risk of developing Alzheimer’s disease.
The Tdap vaccine against tetanus, diphtheria, and whooping cough was associated with a one-third reduction in the risk of dementia. For adults, it is recommended to apply once every 10 years. Many people decide to get their grandchildren vaccinated when they are born. This is because newborns cannot receive a full range of vaccines in the first month of life.
Other researchers say the vaccine shingles It also reduces the risk of heart attack and stroke, and when the coronavirus vaccine improves, survival of cancer patients.
What causes these additional benefits of the vaccine?
Most hypotheses focus on the inflammation that occurs when the immune system is activated to fight infection. Mr. Chu explained, “There is damage to the environment around the body’s cells, and it takes time for it to return to normal.”
The effects of inflammation can last much longer than the initial disease. This can make other infections more susceptible, and blood clots can form in narrowed blood vessels, which can lead to heart attacks and strokes. “Preventing infection also prevents other harm,” Chu added.
Hospitalization, where elderly patients may lose strength and mobility or develop delirium, is itself a risk factor for dementia and other health problems. So a vaccine that helps prevent this may delay or even prevent cognitive decline.
Trump administration health officials asked more questions. Vaccines for children more than vaccines for adultsBut their vocal opposition may have prevented many older people from getting vaccinated.
Not only will many people miss out on the indirect benefits that are being discovered, but they will still be vulnerable to the diseases that the vaccines prevent or alleviate.
“The current national policy on vaccinations is vague at best and in some ways appears anti-vaccine,” said Schaffner, a former member of the CDC’s Advisory Committee on Immunization Practices. “All of us in public health are really worried.”
new era Produced in collaboration with. new york times.
