Zoster vaccine recombinant, adjuvanted (GlaxoSmithKline)

GSK's Shingrix shingles vaccine was associated with a 9% reduction in cardiovascular (CV) disease burden among older adults, according to a study published Wednesday in Nature Medicine.The findings add to growing evidence that recombinant shingles vaccination may offer health benefits beyond preventing herpes zoster, although researchers stressed that the purported CV benefit needs to be confirmed in randomised trials."If confirmed in a [randomised controlled trial], the effect of Shingrix would be equivalent to antihypertensives," said Maxime Taquet, a clinical lecturer at the University of Oxford who led the study.The first vaccine against shingles, Merck & Co.'s Zostavax was a live attenuated vaccine made available in 2006. That was eventually superseded by Shingrix, a recombinant adjuvanted subunit vaccine that was FDA-approved in 2017. Researchers in Wednesday's study took advantage of the rapid transition from Zostavax to Shingrix in the US to conduct a natural experiment, comparing people vaccinated just before and after the switch.Specifically, the study compared 36,460 people vaccinated during April-September 2018, 93.5% of whom received Shingrix, with an equal number vaccinated during the same period in 2017, 98.6% of whom received Zostavax. By comparing people who had all chosen to be vaccinated, as opposed to vaccinated versus unvaccinated individuals, investigators said they sought to reduce "healthy-vaccinee" bias.'Hundreds of thousands' of casesThey found that over seven years, the predominantly Shingrix-vaccinated group showed a lower risk of CV events — a composite of ischaemic heart disease, heart failure and ischaemic stroke — than the predominantly Zostavax-vaccinated group, with a restricted mean time lost (RMTL) ratio of 0.91.The association was significant for ischaemic heart disease and heart failure, which were associated with 10% and 12% lower disease burden, respectively, for both men and women. Ischaemic stroke was associated with a 12% reduction in men. The protective association was found to be present in the first half of follow-up and attenuated over time."The observed reduction of risk is clinically meaningful," the authors wrote. "If confirmed in clinical trials, a 0.8% absolute difference in cumulative incidences of ischaemic heart disease and heart failure among adults over 60 years of age would translate into hundreds of thousands of cases prevented in the US alone."Researchers also found a 7% reduction in atrial fibrillation, but not other cardiac, peripheral and cerebrovascular outcomes.The findings add to earlier research by the same group with respect to dementia. In a Nature Medicine study two years ago, they used a similar natural-experiment approach around the switch from the live vaccine to Shingrix and found evidence that recombinant vaccination was associated with reduced dementia risk.In 2025, GSK started a four-year study using large-scale health data to explore potential links between vaccination with Shingrix and neurodegeneration. The "quasi-experimental" real-world analysis, called EPI-ZOSTER-110, takes advantage of a unique situation created when the UK expanded its national shingles immunisation programme.

Older adults who received the Shingrix shingles vaccine were 24% less likely to be diagnosed with dementia over four years in a study of more than 500,000 people. Researchers estimate the difference could amount to roughly one dementia case prevented for every 17 people vaccinated.Older adults who received a shingles vaccine after entering a skilled nursing facility were less likely to be diagnosed with dementia over the following four years, according to a new study. Researchers found that vaccinated adults had a 24% lower risk of dementia compared with those who did not receive the vaccine. The analysis drew on Medicare data and health records from more than 500,000 adults age 66 and older who were admitted to skilled nursing facilities for either short-term or long-term care. Researchers compared patients who received at least one dose of the recombinant shingles vaccine, known as RZV or Shingrix, with patients who remained unvaccinated. Shingrix was introduced in 2017 and is currently the only shingles vaccine available on the market. Studying the Newest Shingles Vaccine "A lot of previous studies with similar results focused on an older vaccine," said study author Kaley Hayes, an assistant professor at Brown University's School of Public Health. "This study looks at the newest vaccine only in an older, vulnerable adult population who were not up to date with shingles vaccination and are at a very clear clinical point in care: entering a skilled nursing facility." The results are consistent with several earlier studies involving a previous shingles vaccine that also found an association between shingles vaccination and a reduced risk of dementia. "It fits into this large puzzle that's just starting to come together that the vaccines are effective at preventing shingles and also appear to have neuroprotective benefits as well," said Hayes, who is also the associate director of pharmacoepidemiology for Brown's Center for Gerontology and Healthcare Research. Hayes led the study, published in Annals of Internal Medicine, with researchers from Brown, the University of Delaware, the Providence Veterans Affairs Medical Center and other institutions. More Than 500,000 Older Adults Analyzed The researchers used a technique called target trial emulation to analyze the data. This approach attempts to recreate some of the conditions of a randomized clinical trial in situations where conducting such a trial is not practical. The study included Medicare claims and electronic health records from patients admitted to more than 5,500 skilled nursing facilities nationwide between 2017 and 2022. Of the 509,926 people included in the analysis, just 8,843 received the shingles vaccine. Participants had to be eligible for shingles vaccination and could not have previously been diagnosed with dementia. After four years of follow-up, adults who had received at least one of the two Shingrix doses were substantially less likely to receive a dementia diagnosis. Dementia developed in 18.8% of vaccinated participants, compared with 24.6% of those who were not vaccinated. "This translates to about one in 17 dementia cases potentially being prevented," Hayes said. The Study Cannot Prove Cause and Effect One important limitation is that the researchers cannot determine with certainty whether Shingrix itself was responsible for the lower rate of dementia diagnoses. People who received the vaccine tended to be slightly younger and healthier than those who remained unvaccinated, differences that could also contribute to a lower dementia risk. The researchers adjusted their analysis to account for these factors and found that they did not fully explain the association. Additional research, including clinical trials, will be needed to establish whether shingles vaccination directly reduces the risk of developing dementia. The researchers say the findings suggest that an already widely accessible preventive measure could potentially benefit both physical and cognitive health. "Our cognition is so tied to our overall health and what happens to us physically," Hayes said. "It's really amazing to see that something that's supposed to prevent a physical ailment can also help keep our brain healthy, too." The authors reported receiving funding from GlaxoSmithKline, the manufacturer of Shingrix. They noted that the company had no control over the study design, the analysis, or the decision to publish the findings.