I continue to write about the current state of the US vaccine system — it’s also essential to highlight the benefits of vaccines, including a recent study that provides evidence linking the shingles vaccine to lower rates of dementia-related deaths. For older individuals, this vaccine can literally be a lifesaver. Well, all vaccines save lives.

I have previously written that the shingles vaccine is linked to a lower risk of dementia, and this study provides further evidence of the value of the shingles vaccine for older adults beyond preventing shingles itself.

This article will review the newly published study, which links the shingles vaccine to a lower risk of dementia-related deaths.

Shingles and the vaccine

One of the complications of developing chickenpox, caused by the Varicella zoster virus (VZV), is that the body’s immune system does not destroy the virus. Once the symptoms of chickenpox disappear, the virus hides (it does not do this consciously; it’s a virus) in the dorsal root ganglion, a bundle of nerve fibers at the bottom of the spinal column. The virus stays there, hidden from the body’s immune system.

Even though the body generated an immune response to the original zoster virus infection, several years or decades after the initial infection, the adaptive immune response against the virus wanes or disappears. Due to other unknown factors, possibly stress or other infections like COVID-19, the Varicella zoster virus “moves” along the nerve bundles and begins a secondary infection with much more serious consequences to the individual.

This second infection, herpes zoster, is more commonly known as shingles. Shingles usually occurs in adults older than 50, although it can happen at any time, occasionally even in young adults. 

Even though the same virus causes chickenpox and shingles, shingles was given a different name, herpes zoster, probably because it was originally thought to be caused by a similar, but unrelated virus. However, herpes zoster is not a formal name based on biological binomial nomenclature. We now know that the virus Varicella zoster causes both chickenpox and shingles.

Shingles is an entirely unpredictable disease. It appears at random points in time in response to unknown causes. Once shingles appear, they can be painful, depending on the location of the outbreak. It can cause blindness (from herpes zoster ophthalmicus), disfigurement of the infected area, permanent pain (postherpetic neuralgia), and other conditions.

Shingles can be treated with antiviral drugs, but only if the infection is recognized and treated within 24-72 hours, which means the stricken individual must seek treatment quickly.

The initial symptoms appear as skin conditions, which many people might ignore. After 72 hours, the disease has to run its painful and dangerous course because the antiviral drugs have limited effectiveness. Post-herpetic neuralgia pain may last for weeks, months, or even years after the blisters have healed – this is not a trivial disease.

Furthermore, shingles is not a one-time event. Even if you develop shingles, it may return in months or years, so it is important to be vaccinated even if you have had shingles.

Almost all individuals in the US aged 50 years and older have been infected with VZV and are therefore at risk for shingles. There’s a growing body of evidence that herpes viruses, including VZV, may be linked to cognitive decline.

The only way to prevent a shingles infection is to boost the immune system with a vaccine against the zoster virus. The CDC recommends Shingrix (also known as the zoster vaccine, available in the USA), a relatively new, safe, and effective vaccine that prevents shingles. Shingrix has replaced the older shingles vaccine, Zostavax, because it is much more effective.

There is another way to prevent shingles — never get chickenpox in the first place. Of course, we have a vaccine for that, the chickenpox (or varicella) vaccine.

The CDC recommends the shingles vaccine for individuals 50 years or older. Additionally, the vaccine should also be given to individuals who are 19 years or older and have a compromised immune system. Other countries have different recommendations, so check your country’s public health authorities for recommendations.

So let’s be clear about a couple of things. First, you are only at risk for shingles if you have had chickenpox. Second, children who have received the chickenpox vaccine probably will not develop shingles as they age.

Shingles vaccine and dementia deaths study

In a paper published on 2 December 2025 in Cell, Pascal Geldsetzer, MD, PhD, Stanford University, and colleagues used data from the SAIL Databank and focused on two groups of adults in Wales born near the 1933 eligibility cutoff for shingles vaccination: 282,557 individuals with no record of cognitive impairment as of Sept. 1, 2013, and 14,350 individuals who already had dementia by that date.

Individuals born before Sept. 2, 1933, could not receive the vaccine and remained ineligible for the vaccine for life, while those born on or after that date were eligible to receive it after the vaccination program rolled out on Sept. 1, 2013.

Because this study used two groups — those born just before the cutoff date and those born just after — they should be similar in characteristics and behaviors. This study eliminated the selection bias inherent in most comparison studies of vaccinated and unvaccinated groups.

These are the key results:

• Dementia patients who received the Zostavax vaccine (the older shingles vaccine) had a 29.5% decrease in dementia-related deaths over 9 years.
• The vaccine was also linked to a 3.1% decrease in mild cognitive impairment cases during that period.

Summary

This is another study that supports the benefits of the shingles vaccine in aging, especially in reducing the rate of dementia-related deaths.

There are some limitations to this study. First, the researchers studied Zostavax, which is no longer available. The more effective Shingrix vaccine has also shown benefits, such as a reduction in the risk of dementia. We need new studies to confirm that Shingrix has the same benefits as Zostavax.

Second, this study used the 1933 threshold, and the benefits of the vaccine may not apply to younger age groups (although we do have studies that show a reduction in dementia risk in younger cohorts).

This study shows that the shingles vaccine benefits those with dementia by reducing their cognitive decline and risk of death.

If you are over 50 (and maybe younger), you should strongly consider getting the shingles vaccine. It will make aging a lot better.

Citations

• Xie M, Eyting M, Bommer C, Ahmed H, Geldsetzer P. The effect of shingles vaccination at different stages of the dementia disease course. Cell. 2025 Dec 2:S0092-8674(25)01256-5. doi: 10.1016/j.cell.2025.11.007. Epub ahead of print. PMID: 41338191.

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