This is actually a really cool and well-designed research study. Basically, Wales structured their rollout of the Shingles vaccine by not only setting a lower cutoff age but also establishing an upper cutoff age. This meant that you have a set of people within a few weeks of the upper cutoff who should be basically identical (at the population scale) but one set could receive the vaccine (under 50% did) and one could not (0.01% got the vaccine elsewhere). The upper cutoff part is important because dementia usually occurs later in life.
Before going into the results, I’ll take a moment to explain the difference in absolute and relative risk: If you have a 1.0% chance of something happening, this is a 1.0% absolute risk. If something reduces that chance by 0.5%, that is a 0.5% absolute risk reduction and a 50% relative risk reduction.
Onto the results: For the group eligible for the vaccine as a whole, there was a 1.3% reduction in absolute risk of dementia which correlates to an 8.5% relative risk reduction. When you account for the fact that less than 50% received the vaccine in the eligible group, the relative risk actually scales to roughly a 20% reduction. With these numbers, they double checked their results a few different ways using different approaches to try to account for various potential compounding factors (e.g., people who don’t get shingles tend to see the doctor less so they might not get diagnosed with dementia). Every single time, the numbers came out essentially the same. They even did a similar analysis using data from the UK NHS data and got similar results.
The results from this study aren’t totally surprising. It had been previously observed that people who have multiple bouts of shingles are more likely to have a dementia diagnosis and people who take anti-retroviral medications for an outbreak of shingles are less likely to receive a diagnosis of dementia. These facts being likely what lead them to perform this analysis. What's very interesting is we haven't seen much which impacts dementia risk to this magnitude.
Full Text Article in Nature: https://www.nature.com/articles/s41586-025-08800-x
Summary Article at ArsTechnica: https://arstechnica.com/science/2025...ia-protection/
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