[HN Gopher] Evidence that the shingles vaccine prevents a good c...
       ___________________________________________________________________
        
       Evidence that the shingles vaccine prevents a good chunk of
       dementia cases
        
       Author : guiambros
       Score  : 491 points
       Date   : 2023-05-26 13:11 UTC (9 hours ago)
        
 (HTM) web link (twitter.com)
 (TXT) w3m dump (twitter.com)
        
       | bilsbie wrote:
       | I wonder if there's some kind of connection to the APOE4
       | genotype?
        
         | ABetaMale wrote:
         | The connection is probably that ApoE4 carriers clear out
         | amyloid beta deposits less efficiently than ApoE3/2 carriers
         | (see e.g. [1] among many other sources), whereas microbial
         | infection can induce amyloid deposits to form in the first
         | place (see e.g. [2]), although it's not the only mechanism
         | which can induce such deposits.
         | 
         | [1] Castellano et al (2011). Human apoE Isoforms Differentially
         | Regulate Brain Amyloid-b Peptide Clearance.
         | https://doi.org/10.1126/scitranslmed.3002156
         | 
         | [2] Eimer et al (2018). Alzheimer's Disease-Associated
         | b-Amyloid Is Rapidly Seeded by Herpesviridae to Protect against
         | Brain Infection. https://doi.org/10.2139/ssrn.3155923
        
       | wonderwonder wrote:
       | Biggest fear in life for me is Alzheimer's or something similar.
       | Looks like I'll be getting the shingles vaccine :)
        
         | notdang wrote:
         | Same fears for me. Wondering if there is a kind of a dead men
         | switch for it.
        
       | epicureanideal wrote:
       | Sounds like we should try to eliminate all long term infections
       | just to be sure, even if they seem mild or harmless.
        
         | DuckFeathers wrote:
         | [dead]
        
         | [deleted]
        
         | kens wrote:
         | I wonder if 100 years from now people are going to be
         | astonished that we were walking around full of bacteria and
         | viruses and thought it was fine.
        
           | ProjectArcturis wrote:
           | Many of the bacteria are certainly necessary. Healthy gut
           | flora is very important. The viruses probably not.
        
             | rikroots wrote:
             | Without viral help, none of us would be here to have this
             | conversation.
             | 
             | Retroviruses control gene expression in pregnancy -
             | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6177113/
        
               | ProjectArcturis wrote:
               | I had never heard of endogenous retroviruses before! They
               | raise the question: if a virus writes itself into the
               | genome, is it even a virus anymore?
        
           | monktastic1 wrote:
           | More likely, they will be astonished that we managed to
           | survive so long while still perceiving the natural world in a
           | reductionist manner instead of noticing the symbiosis and
           | holism that characterize and sustain it.
        
           | hhjinks wrote:
           | Haven't our digestive system co-evolved with a ton of
           | bacteria? Wouldn't we be pretty boned if we just kicked them
           | to the crub?
        
             | permo-w wrote:
             | going beyond this, complete speculation but I wouldn't be
             | surprised if there can be benefits to these long-term viral
             | infections alongside their harms
             | 
             | perhaps improving immune protection against more
             | immediately harmful viruses, for example
             | 
             | IANAD though. I could be completely wrong
        
             | debacle wrote:
             | Yes, and having the right bacteria in the wrong place, or
             | too much of the right bacteria, can be life threatening.
        
           | lacy_tinpot wrote:
           | Sterile environments are actually bad. So what'll probably be
           | astonishing is our lack of knowledge about how these viruses
           | and bacteria shape our lives for good and bad.
        
           | mkmk wrote:
           | There are about as many bacterial cells in your body as human
           | cells, so they could just as easily say the inverse.
        
             | fnord77 wrote:
             | 39 trillion bacteria 380 trillion virii 100 trillion human
             | cells
        
           | jareklupinski wrote:
           | until then, I will enjoy my yogurt
        
         | jvans wrote:
         | In any highly nonlinear system it's extremely difficult to
         | predict side effects of changes like this. It's plausible there
         | are benefits to things that seem mild or harmless and
         | eliminating them can have dramatically negative consequences.
        
       | neves wrote:
       | So if I have shingles I'd have less chance to have Alzheimer?
       | 
       | BTW: I had shingles before 50yo and I vaccinated thereafter.
        
       | PeterWhittaker wrote:
       | Summary: Wales used a cutoff date in 1933 to set eligibility for
       | the vaccine: born before, ineligible; born after, eligible. The
       | authors analyzed dementia rates in the populations born one week
       | before and one week after and found a significant decrease in the
       | vaccination population born one week after.
       | 
       | Given the unlikelihood of any other salient differences in the
       | two populations (they were all born within 14 days of each
       | other), they conclude that the vaccine had prophylactic effects
       | against dementia and further conclude that Alzheimer's may be
       | caused by a virus.
        
         | ZooCow wrote:
         | The vaccine was the shingles vaccine and it was administered in
         | 2013.
        
         | wrycoder wrote:
         | Only in women, per the tweets.
        
           | Filligree wrote:
           | Women get Alzheimer at a much higher rate, and it's not clear
           | why. Perhaps this could be related.
        
       | A_D_E_P_T wrote:
       | My question is: What of people who have never had chickenpox in
       | the first place, and have never been vaccinated for it? A
       | substantial fraction, though still merely a fraction, of the UK
       | population is in this category. (Back of napkin calculation, more
       | than a million people aged 60+ in the UK.)
       | 
       | If herpes zoster is a causative factor behind Alzheimer's, and if
       | the vaccine merely dampens the viral load (or some such thing) in
       | people who carry it, then people who have never had it -- and
       | have a HZ viral load of zero -- should exhibit a dramatically
       | lower rate of Alzheimer's.
        
         | detourdog wrote:
         | My family history has no memory of me having chicken pox. I had
         | shingles at around 13. I was full vaccinated and still caught
         | measles in 2011. The ages when I was receiving vaccinations was
         | living in rural Florida.
        
           | prirun wrote:
           | I have shingles in my left eye, since 2017. It didn't go away
           | because after after a year or 2 of dealing with it, a doctor
           | suggested I get my immune system checked. Turns out my immune
           | system is for shit (IgG levels got down to 80; they are
           | supposed to be 600-1500). They don't know the cause.
           | 
           | If you had shingles at 13, you must have had chicken pox
           | before that, because that's how it works: you get CP first,
           | it lies dormant in your nerve ganglia, then comes out as
           | shingles when you are stressed or your immune system is weak.
           | 
           | Since you said you were vaccinated against measles but still
           | caught them, it sounds like you might have an immune system
           | issue like me. My body doesn't make antibodies, so I have to
           | take weekly infusions of human IgG. IgA and IgM are also not
           | working, but those apparently aren't as important. And I
           | don't think there is any treatment to supplement them anyway.
           | 
           | Suggest you get an IgG, IgA and IgM blood test. If your
           | levels are really low, you could be a walking time bomb like
           | me. I was lucky and never got really sick, but while I was at
           | Mayo, the levels were so low (80), they sort of freaked out
           | and didn't want to let me leave without taking an infusion.
        
             | nick_ wrote:
             | Have you been taking valacyclovir?
        
           | phkahler wrote:
           | >> My family history has no memory of me having chicken pox.
           | I had shingles at around 13
           | 
           | Those are the same virus. Yours manifested as shingles even
           | though you were only 13.
        
             | detourdog wrote:
             | I have heard it both ways. Shingles at 13 is chicken pox
             | and one must have chicken pox to have shingles.
        
       | sashank_1509 wrote:
       | This has to be one of the worst chain of reasoning I've seen and
       | it is depressing to see this come from a Stanford Professor.
       | 
       | In 1978 a sports columnist joked that the Superbowl could predict
       | the stock market. It went like this: If one of the 16 original
       | National Football League teams -- those in existence before the
       | NFL's 1966 merger with the American Football League -- won the
       | Super Bowl, the stock market would rise throughout the rest of
       | the year. If a former AFL team won, it would go down. This works
       | with a 74% success rate till 2021. What does this prove?
       | Literally nothing. The fact of the matter is the stock market and
       | games are irreducible complex systems with thousands of factors
       | contributing to their outcome. With such a system you cannot
       | figure anything out empirically because such complexity will
       | bring out thousands of correlations over any timeframe.
       | 
       | There are only 2 ways to make any sense of complex systems (human
       | bodies is also one of the most complex systems we know). One is
       | to have a causal chain of reasoning. For example say identify
       | some protein that causes Alzheimers and we also find that
       | shingles modifies this protein. Something like this would be the
       | gold standard. Now even if this does not work on a person, we can
       | be guided to deduce that some other condition is preventing the
       | vaccine from working or some other protein is also being damaged
       | etc etc.
       | 
       | If we want to be empirical we need a very carefully controlled
       | experiment (which might be impossible even if ethical). We need
       | two identically healthy humans, some way to induce Alzheimers in
       | both of them and then inject one with shingles vaccine and see if
       | it works. The fact is the medical establishment does not trust
       | our ability to find two identically healthy humans, so we instead
       | do this over thousands of people in a hope of extracting a causal
       | relationship (a randomized control trial). Notice the one major
       | aspect in this trial that the professor does not demonstrate? In
       | his trial there is no inducement of Alzheimers or Dementia.
       | Without that this whole exercise is meaningless. He seems to
       | drastically underestimate the complexity of human life, maybe the
       | group before 1933 in his dataset also did not take a host of
       | other vaccines which actually stops dementia and not this to name
       | a simple example.
       | 
       | Even worse he never tells us the number of humans being examined,
       | if its in 100k range maybe there is a small chance that there is
       | something here but I suspect this is in 1k range at which point
       | this whole study is a joke, you can find thousands of
       | correlations in a group as small as 1k humans. Heck even
       | randomized control trials require thousands of people and this is
       | most definitely a much worse trial than this. In what way does
       | this create a "Clean", "Causal", "Without confounders" relation
       | is beyond me and to me is a failure of the academic establishment
       | that someone can think like this after becoming a professor in
       | Stanford. I would be shocked if a graduate student talked like
       | this, much less a professor.
       | 
       | Edit: Upon reading the paper this conclusion seems to be based on
       | 5% of women in that period which is roughly 5000 women. Needless
       | to say there can be thousands of similarities between these 5000
       | women that is not explained by the vaccine.
        
         | ed wrote:
         | > Even worse he never tells us the number of humans being
         | examined
         | 
         | You might want to actually open the paper. N = 282,541.
         | 
         | They have data for 98% of the population of wales. Of the ~3m
         | people there, 282,541 were in the relevant age bracket.
        
           | sashank_1509 wrote:
           | I did quickly peruse the paper now. If I'm understanding it
           | right the probability of being affected by dementia goes from
           | 16% to 12% for the 2 different populations, and it also only
           | seems to work for women. For women it decreases from 17% to
           | 12% while for men it stays exactly the same. With these
           | numbers I rest my case, if this is being taken seriously by
           | the academic community I do not know what to say. What if
           | more women were diagnosed of dementia before that time period
           | (because say women were generally considered hysterical) and
           | a definitional change in dementia reduced diagnosis cases?.
           | What if hospitals were getting funded for taking more
           | psychiatry patients and then that reduced?. What if there was
           | a change in a popular birth control supplement? I cannot see
           | how this can lead to any clean conclusive hypothesis.
        
         | lesuorac wrote:
         | It's only a 75% success rate if you include the superbowls
         | prior to the claim being made. Obviously the guy looked at the
         | results of the superbowl prior to making his claim.
         | 
         | It drops down to 67% [1] when you look at only after 1978 and
         | since 2000 its 10/23 (43%) which really implies its headed
         | towards 50% (i.e. uncorrelated). The big difference here is
         | that you can get outliers in your data when you have a small
         | sample size (i.e. 50) but as the number of football games
         | approaches 5000 those outliers go away.
         | 
         | But in support of your point:
         | https://www.tylervigen.com/spurious-correlations
         | 
         | [1]: https://en.wikipedia.org/wiki/Super_Bowl_indicator
        
       | CommanderData wrote:
       | How about HSV-1/2? Combined this virus is present in about 2/3
       | people in the US, and resides dormant near the brain (with cold
       | sores).
       | 
       | I thought there's already a strong link with HSV and Dementia, is
       | there any more research looking at this virus and a vaccine?
        
         | untilHellbanned wrote:
         | Yes Ruth Itzaki has been talking about this for years.
         | https://www.beingpatient.com/ruth-itzhaki-alzheimers-viruses...
         | 
         | Potential Rosalind Franklin scenario.
         | 
         | https://www.healthspan.dev is making a mRNA vaccine. Sam Altman
         | funded company.
        
           | lifty wrote:
           | do you know if this vaccine will work for existing dormant
           | infections?
        
           | toomuchtodo wrote:
           | Not going to be surprised if the most common viruses are what
           | leads to cancer and mRNA is what becomes a cancer
           | preventative as protocols ramp against said viruses.
           | 
           | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994798/
           | 
           | > An estimated 15 percent of all human cancers worldwide may
           | be attributed to viruses, representing a significant portion
           | of the global cancer burden. Both DNA and RNA viruses have
           | been shown to be capable of causing cancer in humans.
           | Epstein-Barr virus, human papilloma virus, hepatitis B virus,
           | and human herpes virus-8 are the four DNA viruses that are
           | capable of causing the development of human cancers. Human T
           | lymphotrophic virus type 1 and hepatitis C viruses are the
           | two RNA viruses that contribute to human cancers.
           | 
           | https://pubmed.ncbi.nlm.nih.gov/25083895/
           | 
           | Kudos to anyone accelerating mRNA in this space.
        
             | epicureanideal wrote:
             | But why mRNA specifically instead of a protein or other
             | vaccine? What's the advantage?
        
               | ifyoubuildit wrote:
               | Not sure if this is the case for parent, but there was
               | such a huge marketing push behind the covid vaccines that
               | it's the first thing that jumps to everyone's mind in any
               | vaccine related topic.
               | 
               | It's kind of like after everyone being inundated with
               | talk about covid for years, there is a tendency to assume
               | every health issue is related to it. Some things
               | definitely will be, but it turns out the universe of
               | things that can go wrong with a human body goes far
               | beyond one recent virus.
        
               | toomuchtodo wrote:
               | It's not marketing, mRNA technology is truly a shift in
               | how rapid vaccine development can occur [1] [2].
               | 
               | [1] https://www.jci.org/articles/view/153721
               | 
               | [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8905605/
        
               | ifyoubuildit wrote:
               | It's not either/or, both things can be true. The mrna
               | vaccines have probably had more resources spent on
               | promoting them than any product in recent history (ie
               | marketing). I would argue that their mindshare is due to
               | that and not some innate ability of the public to know
               | what will be a successful pharmaceutical technology or
               | not.
               | 
               | This is all orthogonal to whether or not the tech
               | eventually delivers on all the possibilities.
        
               | adgjlsfhk1 wrote:
               | mrna vaccines are a lot harder for viruses to mutate away
               | from (and easier to adapt if they do) because they let
               | you target a gene sequence directly.
        
               | foobiekr wrote:
               | The one example of mRNA vaccines that we have has
               | resulted in the viruses by and large mutating away from
               | them and they haven't been adapted quickly.
        
               | dbsights wrote:
               | That doesn't really make sense. Target specifically, and
               | it only takes a minor mutation to escape.
               | 
               | A less-specific vaccine would create immunity against
               | multiple targets, and would logically require more
               | simultaneous mutations to create an escape variant.
               | 
               | Unless your goal is to sell a new vaccine every year
               | (chase your own escape variants, immunity-as-a-service),
               | then MRNA isn't obviously a win.
        
               | bsder wrote:
               | > Target specifically, and it only takes a minor mutation
               | to escape.
               | 
               | 1) Not all sections of a virus mutate at the same rate.
               | Some sections of a virus are highly conserved or the
               | virus simply dies. In Covid-19, for example, the spike
               | protein seems to be difficult to change significantly as
               | it provides the primary entry for the virus into cells.
               | 
               | 2) mRNA vaccines tell your immune system "target this
               | specific sequence" and can avoid problematic sequences.
               | 
               | Normally, you have no idea what section of the virus your
               | immune system locked onto. Even worse, if your immune
               | system grabs onto something common (EBV pieces causing MS
               | or alpha-gal from a tick bite, for example), it can hose
               | you bad.
        
               | dbsights wrote:
               | Covid-19 is actually a great example. The spike protein
               | was highly conserved until it became advantageous for it
               | mutate to evade the highly-specific immunity created by
               | mRNA vaccines. Then we got Omicron.
        
               | 2fast4you wrote:
               | Not an expert, but couldn't the mRNA vaccine target only
               | part of the virus genome that's stable across
               | mutations/variants? That would give you a broad vaccine
               | resistant to mutations
        
               | dbsights wrote:
               | Stable across mutations? On what timeframe.. Its been
               | stable so far.
               | 
               | However, create a population with narrow immunity based
               | on a single protein, and you create a selection pressure
               | that incentivizes mutations in that protein. Once a
               | successful mutation exists, it has a wide open field to
               | spread unchecked. With broad immunity (multiple proteins)
               | it is much less likely that a variant can realize the
               | multiple simultaneous mutations that would be required to
               | spread effectively.
        
               | anonymouskimmer wrote:
               | I'm half-assedly pulling this out of recollection. I
               | believe nucleic-acid based vaccines prompt a greater
               | response from the part of the adaptive immune system that
               | is not the antibody part, while protein-based vaccines
               | preferentially boost the antibody response. They do this
               | because the antigen is expressed within the cell.
        
         | foolfoolz wrote:
         | there's quite a bit of active HSV1/2 work being done although
         | it's very early stage. a few vaccines. a cure attempt.
         | unfortunately this virus is not seen as a target for funding.
         | some of the labs working on these are just sub-teams of larger
         | companies working to fight other medical challenges such as HIV
         | or cancer. those get the funding and they are able to set side
         | some money for HSV research.
         | 
         | probably because it's thought of as a simple skin virus when
         | more likely it's a nervous system virus that manifests most
         | visibly in the skin
        
           | CommanderData wrote:
           | Even if there were a strong link between HSV and Dementia, I
           | don't believe our governments would fast track or fund such
           | research because their priorities.
           | 
           | It would be nice if Gates or Elon Musk would bring the worlds
           | attention to these issues and if something positive comes out
           | of it would be a massive net positive to humanity.
        
             | foolfoolz wrote:
             | priorities are pretty clear. we spent <$20B on the covid
             | vaccine, operation warp speed. ukraine received $75B in the
             | last year from the u. s. if it was the same price, we could
             | have solved 4 highly infectious diseases in just the last
             | year. i'm not trying to get political on that specific war;
             | just military in general is where the money goes
        
               | hedora wrote:
               | Imagine if, after the first oil crisis, the US had
               | earmarked 10% of the military's middle east budget to R&D
               | for energy independence.
               | 
               | We would have solved the global warming problem by the
               | mid 1990's.
        
               | peterfirefly wrote:
               | A sufficient number of nuclear power plants would have
               | cost a lot less than that.
        
               | cmrdporcupine wrote:
               | You can't (well, couldn't) make steel or concrete from
               | electricity from a nuclear power plant. And up until
               | recently you couldn't really drive a car from the
               | electricity from a nuclear power plant. You can't plow or
               | plant a field, or pave a road, or so many other things.
               | 
               | I think if you look at a breakdown in sources of CO2
               | emissions, it's less than half. Yes, that's a lot, but
               | it's not the whole story.
               | 
               | I'm 100% for getting off fossil fuels. I drive electric.
               | But the transition is a hell of a lot more complex than
               | "build a lot of nuclear power plants."
        
               | readthenotes1 wrote:
               | Well, the US spends far more on elder care than on the
               | military, so you should say that that is where the money
               | goes.
               | 
               | https://en.m.wikipedia.org/wiki/Expenditures_in_the_Unite
               | d_S...
        
               | codethief wrote:
               | Note that those $20B were not for research but for
               | production and rollout. The research costs (for BioNTech)
               | were in the order of only $1B or two. Source (in German):
               | https://archive.is/L5oFm
               | 
               | Though, obviously, no research lives in a vacuum.
               | Companies profit from universities and the larger
               | educational system, from other researchers laying the
               | groundwork over the years etc.
        
               | yCombLinks wrote:
               | And we had multiple covid vaccines within under a year,
               | with holdups being studying effects and approvals. While
               | I agree we overspend on military, I don't think there's
               | evidence spending more money would have improved the
               | covid vaccine situation.
        
               | CommanderData wrote:
               | Then the opposite would be true? Less money we would have
               | got the same outcome. Slightly nonsensical.
               | 
               | We need time and more people looking at the issue =
               | money.
        
       | justinator wrote:
       | Good reminder to get the shingles vaccine. Never even gotten
       | chicken pox!
        
       | Ryder123 wrote:
       | This - a thousand times, this.
       | 
       | I spent 5-6 years dealing with something like long-covid (only it
       | started before covid). It had symptoms that seemed clearly
       | related to an infection, but I also noticed effects that were
       | similar to Alzheimer/dementia. Specifically sundowning.
       | 
       | I would become unthinkably exhausted and my mood would change
       | drastically between the hours of about 5:00 and 8:00pm. Later in
       | the evening, things would magically start clear up and I'd feel
       | closer to normal.
       | 
       | That was, by far, the worst period of my reasonably long life,
       | and it's still not something I'm over, I can just manage it much
       | better. If anyone is dealing with something similar, I'm happy to
       | talk about things that have worked for me.
        
         | JPLeRouzic wrote:
         | I have read weird statements by people who had ALS. Some
         | patients tell that some of their symptoms are seasonal. I am
         | curious what worked for you? Thanks!
        
         | JoshTko wrote:
         | Curious as well as to what worked for you. I might have a
         | milder version of what you have. Very similar in that it's
         | mainly during 5-8pm
        
       | chiefalchemist wrote:
       | I see the theory is based on the 2 Sept 1933 birth prior and
       | after. And after meant they were eligible for the shingles vax.
       | But not all born after that date got that vax. So what does the
       | data show for born after 2 Sept and vax vs no-vax?
       | 
       | The no-vax born after 2 Sept should be very similar to born
       | before 2 Sept, yes? Seems odd they didn't cover that base.
        
       | jvanderbot wrote:
       | Shingles (Herpes zoster) is implicated. The whole 'lifelong
       | nervous system infection' does seem a bit awful. I bet if we chip
       | away at new kinds of herpes viruses, we'll find a fairly drastic
       | reduction in Alzheimers.
       | 
       | "There is mounting evidence that herpes [simplex] leads to
       | Alzheimers", so, HSV1/2 also.
       | 
       | And apparently having APOE4 genome makes it all worse.
       | HSV1+APOE4=12x risk.
       | 
       | https://www.bbc.com/future/article/20181022-there-is-mountin...
       | 
       | EDIT: for clarity, the twitter thread showed that the shingles
       | vaccine drastically reduces risk
        
         | analog31 wrote:
         | Does this mean the chickenpox vax will eliminate Alzheimer's?
         | How many years til we know?
        
           | kodah wrote:
           | Chicken pox doesn't impact HSV1/2 which _a lot_ of people
           | have and is also implicated in this analysis. There is,
           | however, a doctor working on a cure and vaccine for HSV1 /2
           | that will hopefully be available within the decade.
        
             | NickM wrote:
             | _a doctor working on a cure and vaccine for HSV1 /2_
             | 
             | Can you share more information on this? Who is this doctor
             | you're referring to?
        
               | CommanderData wrote:
               | There's a sub reddit I discovered tracking HSV vaccine
               | progress (HSV cure research)
               | 
               | Unfortunately the most promising doctor that was working
               | on a vaccine was only able to show efficacy of 50% in
               | mice. A recent study also showed HSV likely infects more
               | than just cells near the brain. Potentially immune cells
               | too.
               | 
               | Gsk is working on one. Would be interesting to see the
               | results soon. This is a tough nut to crack and clearly
               | not enough money being funneled by governments, as
               | another person mentioned we have almost 3x the amount we
               | spent on covid for a new war.
        
               | mschuster91 wrote:
               | No idea about the doctor, but Biontech is starting
               | clinical trials [1], and there are a host of other
               | vaccine candidates. Some Russians claim they developed a
               | cure as well [2].
               | 
               | [1] https://investors.biontech.de/news-releases/news-
               | release-det...
               | 
               | [2] https://en.wikipedia.org/wiki/Herpes_simplex_research
               | #Vaccin...
        
               | gymbeaux wrote:
               | Somewhere on the internet is a website that is keeping
               | track of everyone working on HSV-1 and HSV-2 treatments,
               | but I'm not able to find it just now. There are several
               | entities working on HSV-1 and HSV-2 vaccines.
        
             | chasil wrote:
             | Unfortunately, there are several others that can be
             | asymptomatic.
             | 
             | "Nine herpesvirus types are known to primarily infect
             | humans... More than 90% of adults have been infected with
             | at least one of these, and a latent form of the virus
             | remains in almost all humans who have been infected."
             | 
             | https://en.wikipedia.org/wiki/Herpesviridae
        
           | tristor wrote:
           | The vaccine likely won't eliminate the virus or the existing
           | impacts of the virus.
        
             | zerocrates wrote:
             | Their idea in mentioning the chickenpox vaccine is that if
             | the shingles vaccine is effective against dementia in this
             | way, then you'd expect an even greater effect from kids
             | generally having gotten the chickenpox vaccine and
             | therefore not getting infected with the varicella zoster
             | virus in the first place.
        
           | icegreentea2 wrote:
           | It's very very unlikely that chickenpox vax will eliminate
           | Alzheimer's, both in terms of chickenpox vaccine
           | effectiveness, as well as there are almost certainly non-VZV
           | "causes" for Alzhiemer's.
           | 
           | But yes, it's quite likely that widespread chickenpox vaccine
           | will help reduce Alzheimer's rates.
           | 
           | It'd probably be a few more decades before you'd expect the
           | cohort that received childhood chickenpox vaccines to reach
           | an age where we'd see siginficant rates of Alzheimer's. Even
           | then, it would it'd probably be quite difficult to
           | disentangle.
        
           | nostrebored wrote:
           | It was my understanding that shingles and chickenpox
           | vaccination are positively correlated
        
             | brewdad wrote:
             | If you mean the vaccine leads to shingles in those who
             | receive it, I don't think there is evidence for that. When
             | I had shingles in my early 40s, my doctor did mention that
             | she is seeing it occur earlier in adults who never received
             | the vaccine. The working theory was that we don't come in
             | contact with the virus nearly as much as we used to and our
             | immune systems can't suppress it as easily when it flares
             | up. I don't know if that's actually been studied though.
        
           | xattt wrote:
           | MMR-V was first approved in 2005 in the US. Alzheimer's-type
           | dementia usually has onset in the mid-60s and 70s.
           | 
           | However, there are other dementias (i.e. vascular) that have
           | other etiologies.
        
             | in_cahoots wrote:
             | Nitpicky, but the chicken pox vaccine came out in 1995 (not
             | combined with MMR). So that's 10 fewer years to wait :)
        
               | robocat wrote:
               | Introduced in 1995 in US, but usage increased over a
               | decade - see first graph: https://xkcd.com/1950/
        
               | xattt wrote:
               | Vaccine approvals in years that end in Roman numeral V!?
               | That's hardly a coincidence! /s
        
               | Scoundreller wrote:
               | 1995 for USA. '84 for Germany and Sweden:
               | 
               | https://apps.who.int/iris/bitstream/handle/10665/242227/W
               | ER8...
        
               | hinkley wrote:
               | So we should start seeing early results in the next
               | decade?
        
         | yosito wrote:
         | This raises a question that probably hasn't been answered yet:
         | does the shingles vaccine prevent Alzheimers?
         | 
         | (Edit: sorry, I read the comments before reading the link)
        
           | tim333 wrote:
           | "We estimate that over a 7-year follow-up period, getting
           | vaccinated averts one in five new dementia diagnoses."
        
           | tempfortwitt90 wrote:
           | The anti vax screw will probably wonder if injecting the
           | vaccine actually increases your odds of Alzheimers since
           | you're getting a partial version of the virus when doing so.
        
             | slashdev wrote:
             | The data from this study is pretty definitive that it
             | decreases your odds, not increases them.
        
               | tempfortwitt90 wrote:
               | [flagged]
        
               | slashdev wrote:
               | I could see that. It's irrational, but people are often
               | irrational.
        
               | peterfirefly wrote:
               | I take massive downvotes as a sign of my being right.
               | 
               | I got massively downvoted on reddit in 2014 by putinbots,
               | for example. I also regularly get downvoted here when I'm
               | right.
        
               | _a_a_a_ wrote:
               | That is both arrogant and 95% of the time wrong.
               | Accordingly, I have upvoted you. Take it how you will.
        
               | tempfortwitt90 wrote:
               | IMO hes technically right. If you're wrong, people
               | correct you. If you're right but they know they can't
               | really argue the matter, they downvote.
        
               | Dylan16807 wrote:
               | People downvote wrong posts plenty on top of corrections,
               | or if they just don't want to bother.
        
               | peterfirefly wrote:
               | I am currently at -2 :)
        
               | _a_a_a_ wrote:
               | Some HN'ers aren't very bright, is all.
        
               | striking wrote:
               | It's boring flamebait. I don't disagree with you but I've
               | read this comment a hundred times and it doesn't seem
               | especially necessary in this conversation compared to any
               | other.
        
               | nequo wrote:
               | I think you might be getting the down votes because
               | antivaxers will always find a way to justify their
               | vaccine fears, so it is futile to insert them into the
               | discussion when it isn't about them.
        
               | mistrial9 wrote:
               | polarizing people into "us versus them" as the intro
               | sentence has one aim only; not welcome here.
        
               | lamontcg wrote:
               | You're probably getting downvoted by: 1. antivaxxers
               | (there's a pile of them here on HN). 2. toxic positivity
               | (people who think you are the problem because you're
               | being so negative). 3. reading comprehension challenged
               | (lots of people just don't parse sarcasm and irony well
               | at all). Those three add up to a lot.
        
               | rootusrootus wrote:
               | First on the list is probably the folks who are tired of
               | reading uninspired political comments about the
               | opposition. Whether I agree with the sentiment or not, I
               | can recognize that it serves no useful purpose. Nobody
               | who reads what I write here is going to change their
               | ideology as a result.
        
               | pohl wrote:
               | That won't stop 'em. Confidently-asserted lies are more
               | compelling, it seems.
        
               | MarcoZavala wrote:
               | [dead]
        
             | DaniloDias wrote:
             | It would be ideal to wait for the people you hate to
             | express the ideas you hate before hating them.
        
               | tempfortwitt90 wrote:
               | I never stated which one I was.
        
               | Dylan16807 wrote:
               | That's worse. Unprompted mocking was the _best_
               | interpretation of your post.
        
             | e44858 wrote:
             | Seems the chickenpox vaccine actually does indirectly
             | increase your chances of getting Alzheimer's:
             | https://pubmed.ncbi.nlm.nih.gov/18999945/
             | 
             | " With childhood varicella vaccination in the United States
             | have come concerns that the incidence of herpes zoster may
             | increase, because of diminishing natural exposure to
             | varicella and consequent reactivation of latent varicella
             | zoster virus."
             | 
             | "As the rates of VRHDs and the associated charges have
             | decreased, there has been a significant increase in HZHDs
             | and associated charges, disproportionately among older
             | adults."
        
               | anonymouskimmer wrote:
               | The chickenpox vaccine absolutely decreases the chances
               | of the people getting the vaccine of getting dementia.
               | This has a side-effect of decreasing the exposure of
               | older adults to new chickenpox infections, which
               | increases their odds of developing shingles.[1]
               | 
               | But as long as those older adults are getting the shingle
               | vaccine, their odds of getting dementia should reduce as
               | well.
               | 
               | [1] - Intermittent infection with chickenpox boosts the
               | adaptive immune response to the chronic chickenpox
               | infection that most people who ever caught the disease
               | have. This intermittent boosting helps prevent flareups
               | of the chronic chickenpox infection (also known as
               | shingles), which is likely the causative factor in
               | chickenpox-related dementia. Alternatively, instead of
               | getting intermittently infected with chickenpox, they
               | could just get a shingles vaccine instead to boost their
               | immune response against their previously acquired chronic
               | infection.
               | 
               | I presume that this intermittent exposure to chickenpox
               | is greatest in adults with children (and grandchildren).
               | Possibly explaining the decrease in dementia for older
               | people with adult children: https://www.sciencedirect.com
               | /science/article/pii/S235282732...
               | 
               | > Having 3+ children, adult daughter(s), or biological
               | children was associated with lower risk of cognitive
               | impairment.
        
               | tempfortwitt90 wrote:
               | Does it lower it compared to not getting the virus nor
               | the vaccine?
               | 
               | Seat belts lower car accident deaths. But not lower than
               | simply not driving. Isn't this a similar example?
        
               | idiotsecant wrote:
               | Yes, not getting viruses at all is preferable to getting
               | vaccines. If you figure out how to make that one work let
               | me know.
        
               | labster wrote:
               | Make 90%+ of your neighbors get vaccinated, then bask in
               | your glorious herd immunity.
        
               | anonymouskimmer wrote:
               | Never getting the virus is always better. The chickenpox
               | vaccine helps prevent chronic viral infection.
               | 
               | Assuming you're asking about whether shingles vaccination
               | is comparable to re-exposure.
               | 
               | For the youth a vaccine should absolutely reduce the risk
               | better than having a chronic infection to actively fight
               | against when it flares up.
               | 
               | For non-chickenpox-vaccinated adults, I have no clue. I
               | would expect shingles vaccination would be comparable as
               | it effectively does the same thing. But there might be an
               | added response from other parts of the adaptive immune
               | response against a viral invader.
               | 
               | Regardless, with respect to the chickenpox vaccine, I
               | think it's better to take a risk on the current middle-
               | aged folks and elderly in favor of basically eliminating
               | all of the risk for the young and future generations.
               | Since this risk increase would be primarily for middle-
               | aged folks and elderly who have children and
               | grandchildren (as childless adults are already at
               | increased risk from fewer re-exposure routes), I think it
               | makes moral sense that they preference the health of
               | their descendants over themselves.
        
               | anonymouskimmer wrote:
               | > The chickenpox vaccine absolutely decreases the chances
               | of the people getting the vaccine of getting dementia.
               | 
               | I'm a bit too certain with this phrasing. This should be
               | theoretically the case given that vaccination decreases
               | the odds of getting a chronic herpes zoster infection.
        
           | xattt wrote:
           | > does the shingles vaccine prevent Alzheimers?
           | 
           | That's what the pre-print addressed.
        
       | epaulson wrote:
       | Ben Recht is skeptical:
       | https://twitter.com/beenwrekt/status/1662124696186544128
        
       | drewg123 wrote:
       | The most interesting thing that I saw was: " _We find strong
       | protective effects of the vaccine for women but none for men, and
       | that this diff is driven by Alzheimer's (not vascular) dementia._
       | "
       | 
       | I've been meaning to get around to getting the shingles vaccine.
       | I was all set to head out the the pharmacy to get it immediately
       | until I read that..
        
         | teraflop wrote:
         | You have to be careful how you read that. The researchers did
         | not _find that the shingles vaccine does not protect men_ (from
         | dementia caused by Alzheimer 's). They _failed to find
         | statistically significant evidence_ , in their studied
         | population, that the vaccine protects men.
         | 
         | As the preceding sentence says, this can be plausibly explained
         | by the fact that shingles is more common in women, so whatever
         | protective effect the vaccine has is larger and more
         | measurable.
        
           | A_D_E_P_T wrote:
           | The paper found absolutely no effect in men. That is to say:
           | No trend nor indication that it might protect men.
           | 
           | Sometimes trends seem suggestive of a real effect, but don't
           | rise to statistical significance. That is not the case here.
           | 
           | This is in Figure 4 of the preprint.
        
             | regularfry wrote:
             | It could also be that there is a potential effect that this
             | study would have been underpowered to detect, _and_ by
             | chance no trend was visible in this population. That 's not
             | inconsistent, or even particularly unlikely, if I'm
             | understanding it right.
        
               | A_D_E_P_T wrote:
               | (A) To suggest that the lack of effect in men is a
               | statistical anomaly, and that there IS an effect we're
               | not seeing.
               | 
               | (B) To suggest that the effect in women is a statistical
               | anomaly, and that there's nothing there but a fluke.
               | 
               | These things, from the data, are approximately equally
               | likely. Because there was zero effect in men -- in fact,
               | men who took the vaccine were apparently more likely to
               | be diagnosed with Alzheimer's, though this trend was
               | extremely slight.
        
               | shkkmo wrote:
               | > These things, from the data, are approximately equally
               | likely.
               | 
               | They aren't. The paper states that 95% confidence
               | interval for men includes a maximum protective effect of
               | up to -1.9 while the 95% confidence for women include a
               | minimum effect of -1.3.
               | 
               | Thus it is far more likely that there is a protective
               | effect for man than no protective effect for women.
        
               | A_D_E_P_T wrote:
               | Are you ignoring the fact that it might have a negative
               | effect, rather than a protective effect?
               | 
               | The range for men is -1.9 to +2.1 -- which averages out
               | to +0.2 -- which indeed makes it seem as though the
               | vaccine's trend is to make one slightly more susceptible
               | to Alzheimer's, rather than less susceptible, which is
               | itself borne out in the figure's trend line. (Fig 4.)
               | 
               | For women it's -5.3 to -1.3.
        
               | shkkmo wrote:
               | >Are you ignoring the fact that it might have a negative
               | effect, rather than a protective effect?
               | 
               | Nope. We can be 95% confident that there is an effect for
               | women but we can't be 95% certain that there is no effect
               | for men.
               | 
               | Given that the error ranges overlap, we don't even have a
               | high level of certainty that the effect for men doesn't
               | equal the effect for women.
               | 
               | > The range for men is -1.9 to +2.1 -- which averages out
               | to +0.2
               | 
               | Technically it averages out as +0.1
        
               | A_D_E_P_T wrote:
               | > we can't be 95% certain that there is no effect for
               | men.
               | 
               | They're at P=0.93 right now. So they're very close.
               | 
               | Whereas, for women, P=0.0013.
               | 
               | Taking everything into consideration, that's exactly what
               | I'd call "a high level of certainty that the effect for
               | men doesn't equal the effect for women."
        
               | lamontcg wrote:
               | That means there's a decent chance that the real effect
               | in men is in the range e.g. [-1.9, -1.0] but this study
               | was unlucky or underpowered in men to see that effect.
        
               | Imnimo wrote:
               | Doesn't this mean that the chance of a true but
               | unobserved -1.9 magnitude effect in men is much greater
               | than the chance of a true but unobserved +0.0 magnitude
               | effect in women?
        
               | A_D_E_P_T wrote:
               | Sure, but, by the same token, it also means that there's
               | a chance of a true but unobserved +2 magnitude effect in
               | men.
        
               | adgjlsfhk1 wrote:
               | this isn't necessarily true. if the study had 1000 women
               | and 100 men, it would be a lot more likely that the
               | result in men was wrong. similarly, if the effect was 20x
               | weaker in men than women, but still existed you would be
               | much more likely to see no effect in men even though
               | effects existed for both.
        
               | A_D_E_P_T wrote:
               | Not necessarily true in a theoretical sense, sure.
               | 
               | But there's absolutely no indication that they enrolled
               | 10x (or even 2x) more women than men. Nor is there any
               | indication of any effect in men, 20x weaker or otherwise.
               | (If we're charitable, it's pretty much a flat zero.)
        
               | sbierwagen wrote:
               | Total study size was 282,541 people, 128,322 men and
               | 154,218 women.
               | 
               | From supplementary material 1, page 27: https://www.medrx
               | iv.org/content/10.1101/2023.05.23.23290253v...
        
         | bigbillheck wrote:
         | Get it anyway, you don't want shingles.
        
           | throwaway173738 wrote:
           | Yeah Shingles is awful.
        
             | phkahler wrote:
             | Even a mild case sucks a lot.
        
           | [deleted]
        
         | WillPostForFood wrote:
         | Also, the study was based on the Zostavax, the live virus
         | shingles vaccine. It was discontinued in 2020 (at least in the
         | US) in favor of Shingrix which doesn't have live virus. Unclear
         | whether Shingrix will have the same effects, though seems
         | reasonable to think it might.
        
         | loeg wrote:
         | You should get the vaccine. Shingles is awful.
        
         | theonething wrote:
         | So you're hesitating to get the shingles vaccine because you
         | found out it might not protect you against dementia? Don't you
         | want to be protected against shingles?
        
       | syngrog66 wrote:
       | The mechanisms of schizophrenia inside the brain also look alot
       | like an inflammation or otherwise a kind of an infection immune
       | system response, though an over-reaction. I'm making a broad
       | characterization, of course.
       | 
       | The parasite toxoplasma gondii was initially noticed to be
       | present in lots of folks with this type of mental illness (and
       | bipolar) but there hasnt been a 100% correlation.
        
       | anonymouskimmer wrote:
       | Yet another reason to try to avoid getting infected with
       | diseases. A 'stronger' immune system (which is really only
       | 'stronger' at defending against the disease that you just
       | caught!) isn't worth the risk of long-term side effects from a
       | chronic infection.
        
         | DuckFeathers wrote:
         | [dead]
        
         | permo-w wrote:
         | > which is really only 'stronger' at defending against the
         | disease that you just caught!
         | 
         | if this was the case, we wouldn't have the smallpox vaccine, or
         | many others. not to mention the massive increase in general
         | disease susceptibility when children aren't exposed to these
         | agents at a young age
        
           | anonymouskimmer wrote:
           | I don't understand what you are saying, because it appears to
           | not follow what I stated. (Edit: Okay, I've got it now.)
           | 
           | A chickenpox infection as a child will indeed help prevent
           | against future chickenpox infections (which, for _this
           | particular virus_ , are indeed worse when first infected as
           | an adult). It may have some slight efficacy against other
           | herpesviruses, too, or it could enable a stronger disease
           | from a related virus due to antibody-dependent enhancement.
           | But more likely a chickenpox infection, and related acquired
           | immune responses, will do jack-all with respect to any other
           | infectious agent.
        
         | saiya-jin wrote:
         | Immunity not having challenges, especially early in life, is a
         | sure recipe for a miserable life full of allergies (and
         | probably more, autoimmune problems are a vast domain).
         | 
         | Not sure I would want to take a small risk of topic discussed
         | with almost sure chance of this. Maybe some form of risk is
         | unavoidable, and part of life. Of course only till we fully
         | crack our dna manipulation without any side effects, but thats
         | 22nd century stuff at best.
        
           | anonymouskimmer wrote:
           | Environmental, non-disease challenges are important to
           | develop proper immune response. Catching the flavor of the
           | day does jack all, and might actually prompt some autoimmune
           | responses and lymphomas (due to the increased activity of the
           | immune system in response to infection).
           | 
           | People who never acquire a chronic herpes zoster infection
           | are highly unlikely to benefit from a shingles vaccine with
           | respect to this sort of dementia.
        
       | psychphysic wrote:
       | Serious deja vu did I not read about this study a year ago on HN?
       | I can see this is recent in date but can't shake the feeling...
       | 
       | https://pubmed.ncbi.nlm.nih.gov/35434253/ perhaps this
        
       | pazimzadeh wrote:
       | > We found clean, CAUSAL evidence that the shingles vaccine
       | prevents a good chunk of dementia cases. So, could a virus cause
       | Alzheimer's > YES
       | 
       | Not to be pedantic, but the BCG vaccine is used as treatment for
       | bladder cancer but nobody is claiming that Tuberculosis causes
       | bladder cancer. In order to claim that shingles is causal (rather
       | than that the vaccine affects immune/other function), you would
       | have to fulfill Koch's postulates or measure virus levels in
       | various patients.
       | 
       | The effect is still interesting.
        
         | pessimizer wrote:
         | "Could be" is the way we describe possibility in English. There
         | may be an enormous amount of evidence that tuberculosis doesn't
         | directly or indirectly cause bladder cancer. None of that
         | evidence comes from the fact that vaccination against TB is
         | effective against bladder cancer. That fact _in isolation_
         | could obviously be used as supporting evidence for TB being the
         | cause of bladder cancer.
        
         | kps wrote:
         | I think they said that. "CAUSAL evidence that the shingles
         | _vaccine_ prevents", yes; " _could_ a virus cause Alzheimer's",
         | yes. The causal claim is for the vaccine, not the virus.
        
       | 0xcafefood wrote:
       | https://www.medscape.com/viewarticle/975400 is interesting and
       | seems to directly contradict what is claimed here.
       | 
       | "Herpes zoster does not appear to increase dementia risk -- on
       | the contrary, the viral infection may offer some protection, a
       | large population-based study suggests."
        
         | Quarrel wrote:
         | The evidence in the parent study is MUCH stronger than the
         | evidence in the study you link (and is newer).
         | 
         | Science advances.
        
       | nahnahg wrote:
       | [dead]
        
       | loeg wrote:
       | It would be great if people under 50 could get this vaccine
       | without a prescription (in the US), now many years after it has
       | been generally available to boomers.
        
       | treis wrote:
       | This seems like a math artifact caused by splitting into two
       | groups and then curve fitting the two groups separately. Those
       | two curve fits don't line up at the discontinuity but there's no
       | reason to expect that they would.
       | 
       | The image in tweet 8 is really the damning one. It shows a big
       | gap, but if you fitted the entire set it'd be nearly a straight
       | line with a tiny blip caused by the vaccine.
        
         | selimthegrim wrote:
         | Regression discontinuity
        
       | ghoogl wrote:
       | [dead]
        
       | ablyveiled wrote:
       | This would not explain the precipitous rise in Alzhemier's rates
       | seen in developed countries and mostly in the last few decades. I
       | maintain that alzheimer's is type 3 diabetes.
        
         | jjk166 wrote:
         | There's a precipitous rise in old people, and especially
         | otherwise healthy old people in developed countries. All those
         | who would have died of perhaps an upper respiratory disease or
         | an untreated infection before they had a chance to develop
         | Alzheimer's are no longer being eliminated early. We see
         | similar trends for most age related diseases like cancer and
         | heart disease. It's only natural that as we get better at
         | dealing with diseases we can cure we would see more of the ones
         | we can't. That's not to say there couldn't be other
         | environmental factors at play, but a rise in Alzheimer's does
         | not necessarily mean a rise in whatever causes Alzheimer's.
        
           | everybodyknows wrote:
           | > All those who would have died of perhaps an upper
           | respiratory disease or an untreated infection before they had
           | a chance to develop Alzheimer's are no longer being
           | eliminated early.
           | 
           | OP claimed a rise in rates, not absolute numbers. Is there
           | any plausible reason that reducing other causes of mortality
           | might possibly cause a rise in fraction of the elderly
           | population that develops Alzheimer's?
        
             | graeme wrote:
             | Depends if they meant rates or rates by age. If you mean
             | population rates, then rising life expectancy caused by a
             | decrease in other causes of death would absolutely
             | increased overall pop alzheimer's rates.
             | 
             | If other causes of death were eliminated, you might also
             | see an increase in alzheimer's amongst those in the same
             | age bracket. This might be clearest with an example.
             | 
             | Suppose we eliminated heart disease. Life expectancy would
             | increase. What would happen to the rates of other disease?
             | They would go up within age groups. Because you still have
             | to die of something. If heart disease can't take someone
             | out, that means some other factor will be available. Much
             | of the time people have more than one condition.
        
             | jjk166 wrote:
             | And this effect produces an increase in rates. Let's say
             | that an entire population gets two dice. They roll the
             | first one, if it's even they're out, otherwise they roll
             | the next one. About 1 in 12 people are going to roll a 6 on
             | that second dice. Now let's say for that first dice, you're
             | only out if you get a 6. Now the odds of getting a 6 on the
             | second dice is about 1 in 7, not because the second dice is
             | any more likely to get a 6 but because a greater percentage
             | of people who would roll 6's are rolling that second dice.
             | The first dice in this analogy are diseases that we can now
             | deal with, the second dice are the more intractable
             | diseases.
        
             | pessimizer wrote:
             | Depends on if the rise is specifically in the fraction of
             | the elderly population, or if it's in the fraction of the
             | general population.
             | 
             | If the rise is in the fraction of the general population,
             | then an increase in the proportion of the general
             | population that was elderly would be expected to increase
             | the numbers of a disease of the elderly, even if nothing
             | was happening.
             | 
             | If there were a rise in the proportion of e.g. 80 year-olds
             | that were developing Alzheimer's, that'd be a different
             | story. Although you'd still have to ask yourself if some of
             | the conditions that were increasing the proportion of the
             | population that are 80 year-olds were disproportionately
             | extending the life of people with a propensity for
             | Alzheimer's.
        
         | cheschire wrote:
         | I almost brushed off your message at first, but decided to look
         | it up. You have now made me aware of something I had never
         | heard of, thanks!
         | 
         | https://www.verywellhealth.com/why-is-alzheimers-called-type...
        
           | riceart wrote:
           | It's a bunch of crap. Maybe shouldn't look for medical
           | information from a social worker on a clickbait site.
           | 
           | Diabetes (specifically Type 2) is correlated with Alzheimer's
           | - how that makes for a useful new classification of diabetes
           | is nonsense.
           | 
           | This would be about as sensical as calling nicotine addiction
           | Type 2 lung cancer.
           | 
           | It also doesn't help
           | 
           | > However, classifying Alzheimer's as type 3 diabetes is
           | controversial
           | 
           | No, not in the medical community it isn't. That there are
           | some crackpots and quacks out there doesn't change that -
           | there is not serious debate ongoing about this in medicine.
           | 
           | It wouldn't be a viable name anyway as the number 3 has
           | already been reserved/in common use in actual clinical and
           | research practice for pancreatogenic diabetes.
        
         | mjhay wrote:
         | It doesn't have to be mutually exclusive. Metabolic syndrome
         | causes all sorts of general havoc with just about everything
         | you can think of, which would probably include neuron's ability
         | to maintain homeostasis or fight a latent infection.
         | 
         | Most everyone (at least older people who never got a chickenpox
         | vax) has a latent varicella zoster (the shingles/chickenpox
         | virus) infection, but only a minority will get Alzheimer's. It
         | could easily be true that varicella is causal in most
         | Alzheimer's, but also that many of those cases would never have
         | happened without compounding risk factors like metabolic
         | syndrome.
        
         | SeanLuke wrote:
         | AFAIK the rise in Alzheimer's was well correlated with the rise
         | in life expectancy.
        
         | georgeg23 wrote:
         | >> precipitous rise in Alzheimer's rates in developed countries
         | 
         | Besides the older human demographics, it's certainly possible
         | the virus strains are evolving to be more aggressive and cause
         | problem more often. From a virus perspective, it wants to be as
         | viral as possible without killing the host. Alzheimer's seems
         | like a reasonable allowance.
        
         | slashdev wrote:
         | We've had rises in herpes viruses in developed countries.
         | Shingles is a type of herpes virus. So I wouldn't be too quick
         | to make that judgment. Also in an aging population, it would
         | have to be a relative rise in Alzheimer's, not an absolute one.
         | I don't know the data, so I can't say which it is.
         | 
         | But Alzheimer's is a complex disease, it may well be there are
         | multiple factors involved. I also am inclined to think there's
         | something to your hypothesis, there is some data to support it.
        
         | kakoni wrote:
         | > I maintain that alzheimer's is type 3 diabetes.
         | 
         | With type 1 diabetes there is growing evidence that
         | coxsackievirus B virus is somehow involved.
        
         | hkt wrote:
         | It might explain it if herpes is implicated..
        
       | scythe wrote:
       | In short:
       | 
       | - Wales imposed an arbitrary hard cutoff (1933-9-2) on shingles
       | vaccine, giving excellent randomization in a natural experiment
       | 
       | - Randomization confirmed by comparison of preexisting conditions
       | 
       | - Individuals born after Sept 2, 1933 show a noticeable
       | discontinuity in dementia diagnoses compared to those born prior
       | to Sept 2, 1933, as seen in Figure 3
       | 
       | - Analysis indicates a 20% relative risk reduction across several
       | types of dementia from receiving the VZ vaccine.
       | 
       | This is not like the EBV-MS connection: nothing in the stats so
       | far suggests that varicella zoster is essential or nearly so to
       | developing Alzheimer's disease or other dementia, but it is
       | strong evidence that it contributes to the development of
       | dementia.
        
       | [deleted]
        
       | lliamander wrote:
       | For people who have already had chickenpox/shingles, is there any
       | potential benefit from getting the vaccine?
        
         | imagainstit wrote:
         | Shingles is the latent chickenpox you already were infected
         | with reactivating so people who already had chickenpox is
         | exactly who the vaccine is for.
         | 
         | You can have shingles multiple times, any time the virus
         | reactivates.
        
         | privacyking wrote:
         | The vaccine reduces the likelihood of future flare-ups as well
         | as their severity.
        
         | scythe wrote:
         | Yes. Shingles is effectively chronic.
        
       | tikkun wrote:
       | That seems like a big deal!
       | 
       | Related reading on this topic:
       | https://www.hardtowrite.com/pathogens/
        
       | mjhay wrote:
       | Similarly, there is now extemely strong evidence that the
       | Epstein-Barr is causal in multiple sclerosis. The vast majority
       | of people are infected with EB, with most never having symptoms.
       | However, a nonsignificant minority aren't. A large-scale study of
       | data covering 10 million US military service people found that
       | those infected with EB were 32 times more likely to develop MS.
        
         | pitaj wrote:
         | For anyone else reading, EBV is the virus behind mononucleosis.
        
           | make3 wrote:
           | ahhhh I'm in danger.
        
             | hinkley wrote:
             | We all are.
        
         | killjoywashere wrote:
         | The paper mjhay refers to:
         | https://doi.org/10.1126/science.abj8222
        
         | SeanLuke wrote:
         | Epstein-Barr has long been thought to be a culprit in
         | everything from MS to dementia to especially CFS. But that's a
         | real problem: there are no antivirals developed that are
         | particularly effective against it. EBV research has been a
         | backwater in medicine.
        
           | jkingsman wrote:
           | > EBV research has been a backwater in medicine
           | 
           | Truth. I moderate a forum for people suffering from
           | Mononucleosis and the overwhelming feeling is abandonment and
           | fear. Granted there's some inverse survivorship bias --
           | people who feel well supported and educated by the medical
           | system usually don't post in support groups -- but it's so
           | hard seeing so many people suffering for so long (SO LONG --
           | years of fatigue and malaise, in many cases) for something
           | that has basically no first-line therapy.
        
             | giraffe_lady wrote:
             | Academic disciplines and medical research being famously
             | kind to disabled people entering them too, right?
        
             | londons_explore wrote:
             | With most of these patients living decades after diagnosis,
             | you would imagine that a reasonable chunk of them would
             | give the rest of their life to researching a cure for their
             | disease.
             | 
             | Yet, while it seems common to do charity awareness
             | fundraisers at marathons, it does not seem common for
             | people to go learn biochemistry and work on solving the
             | problem directly.
             | 
             | Compare that to tech, where a huge chunk of the people here
             | have probably written a computer program to solve some itch
             | of theirs. Saying "I'm doing a charity fundraiser to fix
             | the print preview bug in libreoffice" would be crazy.
             | 
             | I wonder if perhaps these people all have so little useful
             | productivity left that it isn't even worth starting to
             | learn biochemistry?
        
               | RobotToaster wrote:
               | Getting access to the resources required for infectious
               | disease research without qualifications is difficult.
        
               | lazide wrote:
               | Someone suffering a debilitating illness (often later in
               | life) is probably only slightly more likely to be able to
               | contribute useful research here than someone actually
               | already dead.
               | 
               | What with them suffering the debilitating illness and
               | all, and being well past the age where it would be
               | natural to do a major life change like become a medical
               | research.
               | 
               | You might as well be wondering why Ukraine isn't
               | encouraging pregnant women to go to the front. I mean,
               | what else do they have to do?
        
               | macintux wrote:
               | Abandoning one's livelihood to spend years in poverty
               | studying advanced science at university in the distant
               | hope that in a few decades you might contribute to a cure
               | is a little different from taking a few weekends, or even
               | a few months of weekends, to scratch a programming itch.
        
               | lumb63 wrote:
               | GP does have something right, though. Throwing more money
               | at a problem does not always yield a faster or improved
               | solution. This is well-known in software, but maybe not
               | in other fields.
               | 
               | Money needs to go to educating and recruiting more people
               | to the field. It is not as accessible as programming, and
               | so is harder, but the same concept applies.
        
               | anonymouskimmer wrote:
               | "Money needs to go to employing more people in the
               | field."
               | 
               | Provide the employment (at decent wages) and the people
               | will get the training. Provide the education and
               | recruitment without the decent employment and you'll have
               | a lot of ex-job people in other jobs.
        
               | odyssey7 wrote:
               | Indeed, the path to a research career -- necessary for
               | the grants and facilities you'll need to test your
               | hypotheses -- involves such high barriers that you would
               | almost need to already be on that path by your freshman
               | year in undergrad.
        
               | hgxtlnces wrote:
               | [dead]
        
               | echelon wrote:
               | I was on the biochem track in undergrad. I was
               | particularly interested in disease metabolics and
               | cloning.
               | 
               | I switched to tech and entrepreneurship because it
               | scratched more itches, provided substantially more money,
               | didn't come with the stresses of academia, and could
               | conceivably put me on a path to returning to biochem with
               | loads of resources and full research independence.
               | 
               | I see biochem companies getting venture funding now, but
               | that wasn't always the case. And they're still
               | unfavorable relative to tech ventures.
               | 
               | I still don't think the grad school + academia path is
               | comfortable enough for those that take it. It's a real
               | labor of love, and I admire those that stick with it.
        
               | anonymouskimmer wrote:
               | Plenty of alternatives to academia, but then you're
               | working on a company's projects. And yeah, the cost of
               | equipment, not to mention consumables, is prohibitive.
        
               | Mezzie wrote:
               | Also it's absurdly difficult to be an academic with a
               | chronic disability, speaking as someone with a chronic
               | disability (MS) who was diagnosed in grad school and who
               | left the sector because of it.
               | 
               | Moving multiple times, as is usually necessary during the
               | post-doc years, means moving away from your support
               | system and interrupting your continuity of medical care.
               | Your activities of daily living require more time: You
               | can't spend 12+ hours a day in a lab if you need to sleep
               | for 12 hours a day. You aren't usually paid enough to pay
               | for all the little extras that make life easier as a
               | disabled person: No delivery services, no supplements, no
               | helpful but extra costing medical services like
               | massages/PT/etc. And stress usually worsens your
               | prognosis: Academia's reliance on competition and
               | stressing out post-docs combined with stress being
               | associated with relapses was one thing that made me nope
               | out. I'm not risking my ability to walk for your
               | institution's prestige.
        
               | piloto_ciego wrote:
               | I have MS and am in grad school. It is very hard.
        
               | Mezzie wrote:
               | I was 'lucky' in that I had my first relapse in the last
               | semester of my Master's program, so I could limp along
               | and finish the degree and decide not to pursue a PhD. An
               | academic career was right out, especially as a first-
               | generation student.
        
               | piloto_ciego wrote:
               | I decided to go to gradschool after the big relapse took
               | me down. I'm going to do this in spite of MS. Fuck MS. My
               | MS has hit me in both eyes and ruined my old career (I
               | was a pilot).
               | 
               | Anyway, I'm going to push myself to build new neurons
               | faster than it bashes the old ones. I'm learning Spanish,
               | do some programming for school every day, and walk a lot.
               | It helps - even if my vision is pretty bad I feel it
               | really helps.
               | 
               | I did 2 years of Tysabri and then switched to Lemtrada in
               | January. One more dose of that and then theoretically I'm
               | done. Going backpacking this summer in Spain as a big
               | "fuck you" to MS. I'm slowed down quite a bit but not
               | beaten. I will get better or die trying.
               | 
               | It is very hard though, things take longer to do - it's
               | like I have ADD now or something? I have constructed some
               | compensatory strategies, but yeah... it is hard. Hard to
               | explain but it's definitely a real thing and especially
               | if I don't get enough sleep.
               | 
               | My old career is over (hard to fly if you can't see
               | well), the new one is going to be software engineering/
               | AI stuff in spite of this shit.
               | 
               | Whatever you do don't give up. MS is a cruel bitch, but I
               | plan on outlasting this asshole. We're not far from a
               | real restorative cure.
        
               | sterlind wrote:
               | I can't think of many people who've learned to program to
               | fix a bug that's bothering them. and learning to program
               | in your free time is much easier than switching careers,
               | getting a PhD and securing funding for your lab.
               | 
               | nevertheless, I know a number of people with my genetic
               | disorder (Ehlers-Danlos syndrome) who have become
               | researchers, doctors and PTs because of it. but that's a
               | genetic disorder, so it hits you early enough in life to
               | sway your choice of major.
               | 
               | also, while I get what you're saying about having "little
               | useful productivity left," it comes across as a bit
               | insensitive.
        
               | renewiltord wrote:
               | Principally barrier to entry in the field due to high
               | costs, low iteration rate, required space, safety of
               | operation, and poor information sharing practices in the
               | field.
               | 
               | That's what I would guess. Because otherwise, there's the
               | concerned uncle effect: unaffected agent who has close to
               | maximal aligned incentive.
        
               | prewett wrote:
               | Given the high requirements to enter the field, and a
               | likely mismatch of interests between many of the patients
               | and the interests required, it would probably be more
               | effective to try to fund some researcher directly.
               | Identify someone doing high-quality research in an
               | adjacent area and offer a direct grant of $50k or
               | something to research towards a cure.
        
               | munchbunny wrote:
               | Programming is much, much easier to learn to a
               | professional level than biochemistry, and open source is
               | much, much cheaper and easier to enter and navigate than
               | medical academia/pharma industry, and adding a software
               | feature is (generally) much easier than discovering or
               | developing a drug.
               | 
               | I think it's a valid question but expectations have to be
               | tempered by the question of how many people have the
               | means to follow through. Not many are in a position to go
               | (back) to school for a doctorate just to start working on
               | the problem 5-10 years later.
        
               | marcus_holmes wrote:
               | We don't gatekeep tech. Literally anyone can create a PR
               | and submit it to an open repo for consideration.
               | 
               | You can't do the same for biotech. You need a PhD, a
               | reputation, a ton of funding, a bunch of papers, to be
               | even considered for "this person has a clue about this
               | medical issue and might have an answer".
               | 
               | Listening to maintainers talk about their experiences
               | dealing with random weird PRs from random weird
               | submitters, I'm not sure we're doing it right by not
               | gatekeeping it more ;)
        
               | robbiep wrote:
               | It's not gatekeeping, it's being able to contribute by
               | having foundational knowledge.
               | 
               | Anyone can (and people often do) make big contributions
               | in health, but it's hard without deep knowledge.
               | 
               | Not everyone who does software engineering needs a
               | computer science degree.
               | 
               | Meanwhile if I head out to the pub on the weekend I hear
               | people post cancer diagnosis waxing lyrical about how
               | they're beating their breast cancer with
               | surgery+chemo/radiotherapy with a diet high in
               | antioxidants, ignorant of the fact that one of the ways
               | radiotherapy and chemotherapy works is by sctually
               | causing oxidative damage, so they're working against it.
               | One of the many ways that doing your own research is
               | counterproductive
        
           | RobotToaster wrote:
           | >there are no antivirals developed that are particularly
           | effective against it.
           | 
           | What happened to the research into DRACOs? A few years ago I
           | kept hearing about them, but they seemed to vanish.
        
           | Gatsky wrote:
           | Antivirals probably won't help as most infections are silent,
           | a vaccine is needed. Moderna is working on one.
        
         | Llamamoe wrote:
         | EBV reactivation also plays a major role in ME/CFS, a condition
         | that can affect people almost as severely as MS, but at any
         | age. HHV-6 and 7 infections have also been implicated.
        
         | xattt wrote:
         | EB vs non-EB history also seems to imply distinct but similar
         | conditions.
        
         | whimsicalism wrote:
         | The evidence implicating EBV in MS is not nearly as strong as
         | this causal evidence.
        
           | dtech wrote:
           | It's incredibly strong evidence that it's a required but not
           | sufficient condition. I've seen professionals have serious
           | suspicions that the single EBV-negative MS case from the
           | study [1] OP mentioned was a false negative, but apparently
           | it's not easy to confirm.
           | 
           | A single EBV-negative MS case. While there were 955 MS cases
           | that developed in the 0.5M that were EBV-negative at the
           | start of military service. You'd expect there to be about 50.
           | That's pretty compelling evidence.
           | 
           | [1] https://www.usmedicine.com/clinical-topics/multiple-
           | sclerosi...
        
         | piloto_ciego wrote:
         | Can confirm, I have MS and I got EBV about a decade before MS
         | took me down.... It's crazy what a tiny little virus can do.
        
       | semidetached wrote:
       | At my annual mandatory physical yesterday my doctor told me that
       | there's a new shingles vaccine that's around 90% effective as
       | opposed to the 60-70% effectiveness of the previous vaccine. It's
       | a two-shot vaccine as opposed to the single shot for the old one.
       | I turned it down, but will probably ask for it now. I got the
       | previous vaccine a few years ago, and then got shingles a few
       | months later, although it was a fairly mild case and I assume
       | that the vaccination probably had a positive effect on that
       | outcome. The funny thing is that I recognized the incident as
       | shingles, and called for an appointment immediately and informed
       | them of my suspicion. At my appointment two days later the doctor
       | prescribed some anti-viral pills and said they were best started
       | immediately after recognizing the infection. I started laughing,
       | as did he.
        
         | kamranjon wrote:
         | Is there any benefit to getting the vaccine after you've
         | already gotten shingles?
        
           | Rustwerks wrote:
           | You can get shingles again.
        
           | imagainstit wrote:
           | Yes, shingles is reactivation of latent herpes zoster
           | (chickenpox) usually acquired in childhood. The vaccine
           | prevents these reactivations You can have shingles multiple
           | times, and some people are more prone to recurrences.
        
             | revelio wrote:
             | Clearly it doesn't, given that semidetached just said he
             | took the vaccine and then within months got shingles.
        
           | loeg wrote:
           | Yes. Risk of Shingles doesn't decrease after an outbreak
           | (sadly).
        
         | sib wrote:
         | The shingles vaccine that I got 4 years ago was a two-shot
         | vaccine. Is this another new(er) vaccine?
        
         | loeg wrote:
         | Shingrix is the "new" one but it's been on the market for
         | several years.
        
       | hannob wrote:
       | Did a quick Google search, and it appears that this isn't a new
       | hypothesis, and previous studies had conflicting results.
       | 
       | That seems to be relevant and in direct contradiction:
       | https://www.alzheimersresearchuk.org/no-link-between-shingle...
       | While this is only a correlational result, well, while
       | correlation does not mean causation, you really can't have
       | causation without correlation. So it seems there are conflicting
       | results.
       | 
       | Let's see if this new result holds up. FWIW I'll still certainly
       | get my shingles vaccine once I'm old enough to fall into the
       | recommendation. Shingles is known to be a nasty disease, and
       | making it less likely to get is by itself probably more than
       | enough reason to get the vaccine.
        
         | kps wrote:
         | It's not a direct contradiction because it's about active
         | shingles, not the presence or level of the virus. It could be
         | that the virus can cause two things independently.
        
       | thenerdhead wrote:
       | Very interesting. I recently watched the Michael J. Fox
       | documentary(Still) and even he commented on an earlier infection
       | as a teen "could've" been linked to his condition, but we'll
       | never know.
       | 
       | Also having gone through two extended bouts of long covid now, I
       | think it reactivated a family history of rheumatoid arthritis in
       | me temporarily although I've never formally been diagnosed with
       | it or struggled with it.
       | 
       | We're all just walking balls of disease causing germs eh?
        
         | tim333 wrote:
         | There's a lot of weird disease stuff going on. There was an
         | article on how schizophrenia is linked to some multi million
         | year old retrovirus that hangs out in our genome.
        
           | el_benhameen wrote:
           | Been a while since my reading on the subject, but maternal
           | flu infection during pregnancy has been linked to development
           | of schizophrenia, too.
        
         | mabbo wrote:
         | The thing with Fox is that there were four people on the same
         | TV or movie set that all wound up years later ill with
         | Parkinson's.
         | 
         | But it's such a rare illness that most people who have it won't
         | have ever met someone else with it before they got sick. For
         | four people who all worked together to have it, it's a
         | statistical anomaly if the disease is purely by chance.
        
           | thenerdhead wrote:
           | Wow TIL:
           | https://en.wikipedia.org/wiki/Leo_and_Me#Parkinson's_disease
        
       | blastro wrote:
       | I recently read some speculation that Alzheimer's might be
       | related to prion diseases like wasting and mad cow disease.
       | That's one possible explanation for cattle mutilations also,
       | which is a really weird rabbit hole to go down.
        
       | briantakita wrote:
       | Will be interesting to see the study go through the peer reviewed
       | process & whether it will be published by a journal.
        
       | marcus_holmes wrote:
       | I have herpes simplex. Should I get the shingles vaccine?
        
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