Shingles vaccines, chickenpox, Shingrix

Sean said:
In clinical trials, [the Shingrix vaccination] was shown to be 97% effective in preventing shingles in adults aged 50-69...
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My understanding is that Shingrix has been shown to protect against shingles for at least seven years.

It was also advised to update tetanus shot every 10 years, but recent studies show that it's effective for 40 years. Who knows. I try not to step on nails and wear shoes outdoors.
 
Kitty said:
They do offer it to everyone, at least up to age 79. Part of the problem could be that some GP practices are better at sorting it out than others.
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I think we're both half-right! Age Concern says, 'The eligibility criteria changed on 1 September 2023. You’ll be eligible for a free shingles vaccine once you turn 65 following this date and will remain eligible until you turn 80. However, if you turned 65 before this date, you'll have to wait until you turn 70 to be eligible for the vaccine.' So there is a dead zone, but only for some. It makes zero sense.
Kitty said:
Oh I definitely got off lightly with shingles, but I often have bag experiences. Ask my cat. :emoji_sweat_smile:
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Cats and bags are often closely involved.
 
It's confusing isn't it?

The Canadian website says this:

Who​

  • RZV is recommended for individuals 50 years of age and older without contraindications.
  • Individuals 50 years of age and older without contraindications who received LZV, or who have had a previous episode of HZ, should be vaccinated with RZV after at least one year.
  • RZV is also recommended for individuals 18 years of age and older who are or will be immunocompromised.

Why​

  • Nearly 1 in 3 Canadians develops HZ in their lifetime. The incidence and severity of both HZ and PHN increases sharply after 50 years.
  • The risk of HZ among younger adults who are immunocompromised is comparable to or higher than the general population aged 50 years and older. Complications of acute HZ are potentially severe and more common in individuals who are immunocompromised.
  • Treatment options for HZ and PHN have limited effectiveness.
  • RZV is safe and effective in reducing the incidence of HZ and PHN, including among people who are immunocompromised.
And yet some provinces who manage healthcare services are only offering it for free for ages 65-70, while other provinces don't cover the cost at all.
 
Sasha said:
I think we're both half-right! Age Concern says, 'The eligibility criteria changed on 1 September 2023. You’ll be eligible for a free shingles vaccine once you turn 65 following this date and will remain eligible until you turn 80. However, if you turned 65 before this date, you'll have to wait until you turn 70 to be eligible for the vaccine.' So there is a dead zone, but only for some. It makes zero sense.
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Sorry I thought you meant 65 now, in which case you would be eligible.

The guidance makes sense from the point of view of administration. If the eligibility changed from 70 to 65 on 1 September 2023 and you were already 65 by then, the new rule doesn't apply; your eligibility is under the old rule. (Don't judge me, I worked for a borough council.)

From the point of view of health protection, it makes no bloody sense at all.
 
Especially when recent studies show that it can reduce the risk of dementia by 20% and other conditions.

No proactive measures put in place, just guesses and reactive measure responding to events after they have already occurred and trying to save a few bucks which will cost healthcare more in the end.
 
Mij said:
@MeSci

I posted the study several years ago on the forum but can't find it. Here is a study that states ≥30 years, if your interested in reading it.
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When I click on that link I get:

"Your session has timed out. Please go back to the article page and click the PDF link again."

Don't worry - I haven't really got the brainpower to read articles at the moment.
 
Mij said:
It was also advised to update tetanus shot every 10 years
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I got a puncture wound in my foot just before the pandemic, and as I was at the surgery anyway for a blood test, I asked if I ought to have a tetanus injection. GP asked whether I'd had one before; I told him yes but in 1970. He said "Ah, you'll be fine."

I wasn't sorry—I remember the date because it hurt like mad!—but 50 years seemed a fair while. He was right, though, I was fine.
 
Jonathan Edwards said:
And I seem to remember that you have more poisonous snakes to tread on than anywhere else in the world!
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We certainly do, including some in my backyard, like the Death Adder, though the invasive introduced cane toads (also highly toxic) have taken a lot of snakes out of the game, at least until they learn to not eat cane toads.

We have a wide range of sometimes lethal poisonous/venomous animals, on land and in water, even the platypus! Plus non-toxic ones, mainly lots of crocs in the north and sharks most everywhere around the coast.

A bunch of plants too. Like stinging trees, capable of delivering among the most extreme and long lasting pain known. (e.g. Dendrocnide moroides)

One of the more interesting questions in evolution is why are there so many highly toxic lifeforms here. Some of them seem lethal to the point of absurdly wasteful. The Inland Taipan being the classic example.

MeSci said:
We don't have rabies in the UK either.
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I did not know that. Wikipedia says that Australia, New Zealand, western Europe, UK, Japan, and one or two others, plus most island nations, are rabies free, with some other places making good progress in that direction.
 
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Sean said:
We certainly do, including some in my backyard, like the Death Adder, though the invasive introduced cane toads (also highly toxic) have taken a lot of snakes out of the game, at least until they learn to not eat cane toads.

We have a wide range of sometimes lethal poisonous/venomous animals, on land and in water, even the platypus! Plus non-toxic ones, mainly lots of crocs in the north and sharks most everywhere around the coast.

A bunch of plants too. Like stinging trees, capable of delivering among the most extreme and long lasting pain known. (e.g. Dendrocnide moroides)

One of the more interesting questions in evolution is why are there so many highly toxic lifeforms here. Some of them seem lethal to the point of absurdly wasteful. The Inland Taipan being the classic example.
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You forgot to mention the drop bear :emoji_koala::skull::dizzy:
 
Just to confuse things a bit, rabies is one of the many types of lyssavirus that exist around the world. They are often named after the area where they are found. Eg, European Bat Lyssavirus and Australian Bat Lyssavirus (ABLV). They are prevented with rabies vaccine. I know this because I ended up in emergency in March after a bat bit me on both sides of my little finger when I was prising it from my cat's mouth. If contracted, it is fatal without vaccination protection.

I phoned the hospital emergency department immediately and drove there straight away. I had washed my bleeding finger thoroughly and disinfected it before I left home but I had to stand in a busy hospital corridor and wash it again for 15 minutes straight. After a while I could see staff huddling and eyeing this woman who didn't stop washing her hands. Very uncomfortable!

I had the first of 4 rabies vaccinations and some rabies immunoglobulin (from someone in America) in emergency then, over the next 10 days, I had the next 3 vaccinations. The 2nd one was 'interesting' with jabs in numerous spots around my fingernail area with no anaesthetic. Ouch!! The volume of vaccine for this second vaccination is so large it needed to be injected in four different places apart from my finger.

It is estimated that 1% of healthy Australian bats carry the virus but up to 30% of sick ones do.

My cat was fine thank goodness because rabies vaccine for cats is not available in Australia.
 
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More likely to get struck by lightening than get tetanus. So why boosters?

Date: August 27, 2025

Source: Oregon Health & Science University

Summary:
Researchers propose that the U.S. could safely drop adult tetanus and diphtheria boosters, saving $1 billion annually, since childhood vaccinations provide decades of protection. Evidence from the U.K. shows that skipping boosters has not led to higher disease rates.

Slifka noted that dropping the 10-year schedule for adult boosters would more closely match guidelines recommended by the World Health Organization.

The review bolsters previous OHSU research in 2016 and in 2020 that concluded the combined vaccine produced at least 30 years of immunity, well beyond the current recommendation of every 10 years for adults from the U.S. Centers for Disease Control and Prevention. The vaccine is usually given as a combined tetanus, diphtheria and pertussis vaccine, known as DTaP.
 
Herpes zoster vaccination and incident dementia in Canada: an analysis of natural experiments

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Background​

Two natural experiment studies have found evidence that live attenuated herpes zoster vaccination prevents or delays dementia onset. We aimed to determine the effect of live attenuated herpes zoster vaccination on incident dementia diagnoses among people aged 70 years and older using a natural experiment in Ontario, Canada, and to triangulate these findings, using a second natural experiment in Ontario and a quasi-experimental approach that uses data from multiple Canadian provinces.

Methods​

Our analysis of natural experiments included people born in Canada between Jan 1, 1930, and Dec 31, 1960, who were registered with one of 1434 primary care providers in the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) on Sept 15, 2016. We compared patients born immediately before versus immediately after Jan 1, 1946, in our primary analysis, and immediately before versus immediately after Jan 1, 1945, in our secondary analysis, as these thresholds determined eligibility for herpes zoster vaccination in Ontario. The key strength of this natural experiment is that these comparison groups are not expected to differ in their health characteristics and behaviours given that all that divides them is a small discrepancy in age. Dementia diagnosis was established using electronic health records data from Jan 1, 1990, to June 30, 2022, from the primary care practices. We used a population-representative survey of people aged 65 years or older in Ontario to measure herpes zoster vaccination uptake. Using regression discontinuity analysis, we estimated the difference in vaccination uptake and dementia diagnoses between individuals born immediately on either side of the eligibility thresholds for herpes zoster vaccination. Additionally, we used synthetic difference-in-differences and a synthetic control method to compare trends in dementia incidence (before versus after the start date of the herpes zoster vaccination programme) among birth cohorts in Ontario who were eligible for vaccination with the same birth cohorts (all of whom were ineligible for vaccination) in other provinces of Canada.

Findings​

We extracted data on 464 637 patients who were registered with a primary care provider in the CPCSSN as of Sept 15, 2016. Of 232 124 patients born in Ontario included in the analysis, 125 719 (54·2%) were female, 106 354 (45·8%) were male, and 51 (<0·5%) had missing information on sex. Patients born immediately before versus immediately after the two eligibility thresholds for herpes zoster vaccination did not differ in their health characteristics at the time of the start date of the vaccination programme, except for a large difference in their probability of receiving herpes zoster vaccination. Being born immediately before versus immediately after Jan 1, 1946, decreased the probability of receiving a new dementia diagnosis by an absolute difference of 2·0 percentage points (95% CI 0·4–3·5, p=0·012) over a 5·5-year follow-up. Using the Jan 1, 1945, threshold, dementia diagnoses were also reduced by 2·0 percentage points (0·2–3·8, p=0·025) over 5·5 years. After the start of the programme, new dementia diagnoses among the birth cohorts eligible for herpes zoster vaccination in Ontario were significantly less common than in the same birth cohorts in other Canadian provinces that did not have a herpes zoster vaccination programme.

Interpretation​

This analysis of natural experiments provides evidence, which is more likely to reflect a causal relationship than previous evidence from more standard observational data analyses, that herpes zoster vaccination prevents or delays incident dementia. Mechanistic research into this effect could provide insights into the pathophysiology of dementia and maintenance of neuroimmune health in older age.
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