adssx
#27
The evidence is quite strong due to natural experiments, repeated in several countries, most recently: A natural experiment on the effect of herpes zoster vaccination on dementia 2025
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adssx
#28
Nonsense: the rate among people aged 40–49 is now almost what it used to be in people aged 60–69 in 1998.
See: Vaccines for longevity - #176 by adssx
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Yeah, even just anecdotally, I know people who’ve had Shingles in the last few years, and most of them were under 60. My wife in early 40s, her brother in late 30s, one of my colleagues in mid 40s, my dad in his late 60s. The only other cases I’d ever heard before that was my great aunt who got it decades ago, while she was in her 90s. So at least to my personal perspective there’s a re-occurrence.
And everybody said what a miserable experience it was. So yeah, I’ll be seeking out this vaccine - to avoid the miserable experience, and if I can pick up even a fraction of an 8y long -23% risk reduction of CVD, that’s another win.
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AJD
#30
Your anecdotal experience is, unfortunately, not characteristic of the overall population. It is comparatively low risk before age 60.
If the vaccine could be given 4, 5, 10 times, then starting it earlier would make sense. But my understanding (and perhaps I am wrong) is that its efficacy is pretty much only high with two doses. That protection seems to last about 10 years.
That means that getting it earlier would leave those people much more vulnerable later in life when the risk is higher and resistance lower.
Of course, if boosters were tested we might be able to re-up protection. If that were true then getting it earlier might make sense.
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There’s probably a good chance a booster will be developed in the next 10 years.
adssx
#32
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adssx
#33
Again: the risk before age 60 today is as high as it was above age 60 in the 90s. Yes, it’s still lower than people aged 60 today (because the risk in that age group increased as well) but it’s not low.
See also:
https://www.nationalgeographic.com/premium/article/shingles-common-young-people-under-50
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adssx
#34
Exactly, in the UK they said in October 2024 that they would offer a single dose of Shingrix as a booster to people aged 80+ who received the “old” and less effective Zostavax: JCVI statement on the shingles (herpes zoster) vaccination programme - GOV.UK
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AJD
#35
I would say significant. Not sure what data you’re looking at but there are multiple studies of both vaccine types, and they all seem very positive.
https://www.nature.com/articles/s41591-024-03201-5
https://www.nature.com/articles/s41586-025-08800-x
AJD
#36
I’m not sure why you keep saying that. Even your own data simply don’t say that.
The risk at age 40–although higher than it used to be—is still below that of 60 year olds at any time in the data presented. Moreover, if protection only lasts ~10 years, immunizing at 40 is literally cannibalizing later protection when it is most needed.
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adssx
#37
Wow! It seems that you do not know how to read a chart based on the nonsensical line that you drew. Here’s the correct line showing that the rate in people aged 40–49 in 2019 was almost equal to the rate in people aged 60–69 in 1998 (and is higher than in 50–59yo back then).
You find that in other countries such as Sweden: Vaccines for longevity - #194 by adssx
Or Canada:
I cannot find data comparing 1990 vs 2024 in the same country, but based on all the above trends, it seems that most likely the rate in people aged ~40 today is higher than in people aged 60+ back then.
We know that protection lasts more than 10 years (but we don’t know how long): Shingles: Live Zoster vaccination = 23% risk reduction in MACE - #32 by adssx
And you can get boosters, as I wrote above the UK will start doing that soon.
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OK, but what does that mean? How is giving people who are unvaccinated a shot of Shingrix a “booster”? Isn’t that simply called “vaccination”? Booster implies that they already had a vaccine, and now are getting a dose (“booster”) to remind the immune system of a previous vaccine exposure. Also, what about people who got Shingrix more than 10 years ago, do they not get a booster? Very confusing.
adssx
#39
I edited my message. By “booster” I obviously meant for people who already got vaccinated with the previous one. For people who got Shingrix more than 10 years ago, as of today, there is no evidence that boosting is needed as protection lasts at least 11 years. We don’t have data yet for longer. Shingrix was first approved in 2017 (11y data comes from RCT cohorts).
2 Likes
Thank you. I am somewhat worried about a decline in effectiveness over time. I wish it were possible to just get the vaccine on demand (if you pay), instead of all these age restrictions and prior vaccination restrictions. My wife is 16 years younger than me, and recently I got the RSV vaccine, but she was refused, because she was not 60. Advisers to the CDC recommended lowering the age eligibility for the RSV vaccine, but apparently that’s not good enough for the local pharmacy. It’s depressing when adults are being treated like children by the medical establishment. If you pay, you should be able to get any vaccine on demand.
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adssx
#41
She might be able to get it with a prescription from a doctor saying she is at risk: https://www.reuters.com/business/healthcare-pharmaceuticals/us-cdc-advisers-weigh-lower-age-recommendation-rsv-vaccines-2025-04-16
And yes, it’s annoying that you can buy everything that can destroy your health freely (fast food, UPF, sugar, cigarettes, alcohol, etc.) but you cannot buy freely what can protect you!
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AJD
#42
Even substituting your line for my crappy freehand line, it still isn’t true. The risk exceeds that of 50 year olds in 1998 but not 60 year olds.
But the numbers are more revealing than that fact. The risk appears to have risen from 2 in a thousand to 5 in a thousand which is still a low risk.
But honestly, none of this matters if boosters are available and effective in unlimited repetitions. The problem is not whether or not 40 year-olds get the vaccine—but whether 40 year-olds are still protected when they’re 70 or 80 if they do so.
adssx
#43
The issue is not that your line was “crappy” but not horizontal 
I wrote “the rate among people aged 40–49 is now almost what it used to be in people aged 60–69 in 1998”. This is exactly what the chart in the US shows. Canada and Sweden show similar trends.
And do you know the concept of confidence interval? And trend extrapolation?
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A few days before this paper came out, I decided to go ahead and get the Shingrix vaccine. What motivated me at age 69 is that my wife has a coworker around 40 years of age who just came down with a nasty case of shingles. I’d been thinking about getting the vaccine for the last year or two. This provided a good reminder and some motivation.
After the initial vaccination I felt fine for the first 12 hours and then like crap for the next 18 hours or so, but I’m glad I went ahead and got it done. It now appears there might even be some additional benefits beyond shingles prevention, which is an added plus.
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Sorry I am a bit lost about why people think there will be less effectiveness if you take a vaccine early? Is there any reason to believe that a booster in 10 or 15 years would not “work” if you were already vaccinated? I’m not an immunologist, but I’ve never heard of this idea before.
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Agreed. I was under the impression that the opposite was the case: a booster after prior vaccination exposure would be more responsive, as it already has some trace immunological memory, so it’s not starting from scratch. But my impression might be mistaken, so I’m eager to be enlightened.
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