More evidence that the shingles vaccine may have protective effects beyond preventing shingles

The research findings that suggest that the shingles vaccine does much more than protect people against shingles continue to pile up.

For example, researchers that reported a protective effect against dementia in April 2025 reported findings in Cell that showed that the live-attenuated shingles vaccination, marketed under the name Zostavax, prevents or delays mild cognitive impairment and dementia and may slow down the development of dementia among those who have the disease.

Another recent finding was presented in October 2025 at IDWeek, the annual meeting of the Infectious Diseases Society of America (IDSA) and other professional groups.

Ali Dehghani, D.O., and George Yendewa, M.D., M.P.H., both of the Case Western Reserve University School of Medicine in Cleveland, explained that shingles, which is reactivation of the latent herpes zoster, triggers systemic inflammation, increasing risks of vascular and neurologic complications. Although researchers are still figuring it out, one theory is that by preventing shingles and the associated inflammation, shingles vaccination reduces the chances of developing a variety of vascular and neurologic conditions

Dehghani and Yendewa led a large retrospective cohort study assessing whether prior zoster vaccination influenced outcomes among adults aged 50 years and older who were diagnosed for the first time with herpes zoster. Using national data sources, the team matched patients 1:1 based on demographics, comorbidities, psychiatric history, chronic medication use and receipt of either of the two recommended shingles vaccines.

The cohort included 38,092 adults. The average age of the group was 69, two-thirds were women, and a similar proportion were White. Patients were followed from 90 days to as long as seven years after their shingles diagnosis.

According to this study, vaccination was associated with significantly lower risks of all-cause mortality and major adverse cardiovascular events (MACE), which included myocardial infarction, stroke and pulmonary embolism. Earlier observational studies had hinted at similar benefits, but the new analysis provides additional validation in a large, diverse population.

“Shingles is really more than just a rash,” Dehghani said in an ISDA news release issued during the October 2025 conference, which was held in Atlanta. “It seems to perturb the body in a way that puts the heart and the brain at serious risk, and it does that probably via inflammation, which has been revealed in prior studies.”

The research also focused on people living with HIV, who are known to have an elevated risk for cardiovascular and neurocognitive disease due to persistent immune activation and chronic inflammation. Dehghani presented the findings, utilizing the TriNetX Analytics Network to examine whether prior recombinant zoster vaccination could influence long-term systemic outcomes. The final study population for this included 3,146 adults, half vaccinated and half unvaccinated. The median follow-up was nearly three years for each group. After matching, the mean age was 58 years, and 69% were male. All participants were receiving antiretroviral therapy.

Compared with unvaccinated individuals, those who received the recombinant zoster vaccine had a 46% lower risk of all-cause mortality and a 39% lower risk of MACE. A nonsignificant trend toward lower dementia risk was also observed, although the study was not powered to detect differences in that outcome. No differences emerged between groups for psychiatric morbidity or parkinsonism.

In the news release, the authors noted that these findings are consistent with a broader understanding of how varicella-zoster virus reactivation may contribute to vascular injury, particularly in people living with HI.

For instance, an Italian study published in 2023 found that individuals with a history of shingles had higher odds of ischemic events. The results reinforce the importance of shingles prevention in high-risk populations.

The Center for Disease Control and Prevention’s Advisory Committee on Immunization Practices recommends two doses of the recombinant zoster vaccine, sold under the brand name Shingrix, for adults aged 19 years and older who are or will be immunocompromised, including people living with HIV. However, vaccination uptake remains suboptimal.