21 Oct ID Week 2025: Shingrix Vaccine for Shingles Associated with Fewer Heart and Brain Adverse Events
Dr. Dehghani
MedicalResearch.com Interview with:
Ali Dehghani, DO
Department of Medicine
University Hospitals Cleveland Medical Center / Case Western Reserve University
Presenting Author, IDWeek 2025
MedicalResearch.com: What is the background for this study?
Response: Shingles (herpes zoster) is caused by reactivation of the varicella-zoster virus, which can inflame blood vessels and the nervous system. Evidence over the past decade has linked shingles to higher risks of heart attack, stroke, and dementia—but it was unclear whether the shingles vaccine might lessen those long-term effects.
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MedicalResearch.com: What are the main findings?
Response: Using data from over 100 U.S. health systems, we followed adults age 50 and older for up to five years. We found that people who developed shingles had a 20–30% higher risk of cardiovascular events, vascular dementia, and death compared with similar adults without shingles.
Those who had received the recombinant zoster vaccine (Shingrix) before their infection had substantially lower long-term risks—about 25% fewer major cardiac events, 40% lower early mortality, and nearly 50% less vascular dementia over time.
MedicalResearch.com: Is it the inflammation from reactivation of the virus that is associated with the adverse outcomes?
Response: Yes. When the dormant virus reactivates, it can spread along nerves into the walls of blood vessels, causing endothelial injury and inflammation. This sets off a cascade of clotting and immune activity that may lead to strokes, heart attacks, and chronic vascular changes. Vaccination appears to dampen this inflammatory response, likely by strengthening virus-specific immune control before reactivation occurs.
MedicalResearch.com: Has there been a change in the incidence of zoster since more adults have been vaccinated against varicella as a child?
Response: We’re beginning to see early signs of a gradual decline in shingles among younger adults who were vaccinated against chickenpox in childhood, but the effect is still evolving. Because shingles risk rises sharply after age 50, the larger impact will be seen decades after widespread childhood vaccination.
MedicalResearch.com: What should readers take away from your report?
Response: Shingles isn’t just a temporary rash—it can have lasting effects on the heart and brain.
The Shingrix vaccine appears to protect against both the infection and its long-term inflammatory consequences.
Adults over 50 should view shingles vaccination as part of comprehensive cardiovascular and cognitive prevention, alongside flu and pneumococcal immunizations and lifestyle measures.
MedicalResearch.com: What recommendations do you have for future research as a results of this study?
Response: Future studies should examine how shingles-related inflammation affects blood vessels and the brain in real time, and whether vaccination changes those immune pathways. Prospective imaging or biomarker studies could clarify the biologic mechanisms behind the protective signal we observed.
MedicalResearch.com: Is there anything else you would like to add? Any disclosures?
Response: These results add to a growing body of evidence that preventing or blunting viral inflammation can have long-term benefits for cardiovascular and neurologic health.
We hope this encourages more clinicians to discuss shingles vaccination proactively with their patients.
No relevant financial disclosures.
Citation:
Impact of Prior Zoster Vaccination on Cardiovascular, Dementia, and Mortality Outcomes Following Herpes Zoster Infection: A Matched Cohort Study
https://idweek.org/
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Last Updated on October 21, 2025 by Marie Benz MD FAAD
