Episode 6: Vaccines, Dementia Risk, and Data That Drives Change

Andie Cartwright

Hey everyone, welcome back to Better Living Through Data. I’m Andie Cartwright, joined as always by Anthony Pero. Anthony, we got a new study to chew on today—and it’s a big one for anyone watching long-term care. So, herpes zoster vaccine and dementia risk… honestly, those aren’t two things I would put together. But, turns out, there’s some pretty compelling evidence now that getting the recombinant shingles vaccine is linked to a lower chance of developing dementia if you’re newly admitted to a nursing home.

Anthony Pero

Yeah, Andie, and this is huge. The researchers identified over five hundred thousand residents in U.S. nursing homes and found that those who got the recombinant herpes zoster vaccine—RZV, for short—within the first year of their admission, saw a 24% relative reduction in developing dementia over a four-year follow up. That’s not just a statistical blip either. The absolute difference was about 6%, so 18.8% cumulative incidence with the vaccine, versus 24.6% without. That’s a real difference for a vulnerable group.

Andie Cartwright

Yeah, and to put a face to those numbers—think of a group of residents coming into a facility. Those who got RZV were meaningfully less likely to get dementia, which is just kind of wild. And, Anthony, I know you’ve seen firsthand how vaccine adoption in care settings isn’t as fast or as smooth as the data makes it look.

Anthony Pero

Absolutely, the numbers are great but real-world uptake is tricky. You know, there was this one facility I worked with—this goes back a few years—they had everything set up to provide vaccines but still saw low uptake, mostly because families didn’t know what the vaccine did or thought shingles was kind of benign, so why bother? And honestly, sometimes just tracking who’s eligible and making sure the shots get into arms is a logistical tangle. That’s been true for flu, it’s true for shingles…

Andie Cartwright

Right, and I think this study really highlights what’s at stake. It isn’t “just” about preventing shingles outbreaks—it’s potentially a way to protect cognitive health for people who are at really high risk. I mean, we’ve talked a lot on recent episodes about how important it is to close these gaps for vulnerable populations in long-term care. Maybe this is a wake-up call to take those logistics—and the education piece—a lot more seriously.

Anthony Pero

Totally. We just need to move this from PDF to practice, right? The opportunity’s there, but we gotta meet it with the right tools and willpower.

Andie Cartwright

Now, before we get too ahead of ourselves, I want to poke at the methods here, because when I first saw “observational study,” I thought, okay, what’s the catch? But these researchers really tried to make this as rigorous as possible. They emulated a randomized trial, but using existing data from PointClickCare Life Sciences' EHRs across U.S. nursing homes. So, it's not just a broad survey—it's pulling from real-world, longitudinal data on people coming into care, which is kind of the holy grail for population health insights.

Anthony Pero

Yeah, and it’s fantastic seeing methods like this hit the mainstream. They set it up as a retrospective cohort and used this ‘clone censor’ approach—which, let’s be honest, sounds like sci-fi, but is legit—basically, they use statistical methods to try to mimic the conditions of a randomized control trial. There’s always that risk of bias in observational studies, so what really impressed me is their use of negative controls. They looked at outcomes like wellness visits and hip fractures, which shouldn’t, in theory, be affected by the zoster vaccine, to check for hidden bias. And even after those checks, their findings about reduced dementia risk held pretty firm.

Andie Cartwright

That’s such a key point, Anthony—so much in the news gets overhyped because of weak data. Here, it feels like they really tried to pull at every thread to see if the findings would unravel, and it didn’t. And maybe this is my marketing brain talking, but it reminds me a lot of how we approach campaign analytics. You’re always looking for those confounding variables: Was it the campaign that worked, or were our best customers just more active already? When you have robust data and you ask the right questions, you can make these near-experimental conclusions—without the cost or ethical headaches of a clinical trial.

Anthony Pero

That’s a, uh, not terrible analogy, Andie. Actually, it’s spot on. This sort of rigorous data linkage is exactly why PointClickCare Life Sciences’ EHR is so meaningful for the life sciences space—hey, little plug, but it’s true. When you can match medication, diagnoses, outcomes, all longitudinally, you enable studies that just couldn’t be done even five, ten years ago. The fact that the bias-adjusted effects dropped a little, but the association was still really strong, makes the results pretty credible, in my view.

Andie Cartwright

You nailed it. And, like we talked about last episode, real-world data isn’t perfect, but if you use all the right tools, it can be super powerful. These methods let us inch closer to causality—even if we always need to interpret with a bit of humility about what we don’t know.

Anthony Pero

Alright, so let’s dig into who actually benefits the most from the RZV. What stands out is that women, and people who hadn’t had the older live shingles vaccine, saw the most pronounced reduction in dementia risk. The effect in men was there, just a little less robust—and for people who’d already had the older vaccine, well, the extra kick from RZV wasn’t as big. So, it points us straight to these groups as priorities for targeted vaccine initiatives.

Andie Cartwright

Exactly—and yet, even with that benefit, the study points out uptake is still really low overall in newly admitted nursing home folks. This is almost déjà vu from our recent episode on flu vaccination, right? You can have the best intervention in the world, but if people don’t get it—because of knowledge gaps, workflow friction, or plain old inertia—the population benefit just doesn’t materialize. We’re still not hitting the mark on outreach and care coordination for those most at risk.

Anthony Pero

Right on, and it’s important to remember that these residents are often not only more vulnerable to shingles, but also to the complications of dementia. So improving vaccination rates isn’t just a box-checking exercise—it could delay or prevent serious decline for people at a crossroads in their health journey. From my payer-provider days, I honestly think partnerships are key. If you bring together the payers, facility staff, the families, you can drive meaningful change—sort of like we saw with those big pushes in flu vaccination campaigns. But it’s gonna require tailored messaging, better tracking, probably more incentives…

Andie Cartwright

That’s where the continuous, granular data comes back into focus. If we know who’s coming in, their past vaccine history, their health risks—we can target those efforts way more precisely. I keep seeing this recurring theme: whether it’s medication access, flu shots, or something newer like dementia prevention, data can be a game-changer if we put it into practice. And I have to say, the idea that maybe—just maybe—we could reduce dementia risk with a vaccine already on the market? That’s inspiring. And, well, a little bit of a call to action for long-term care teams everywhere.

Anthony Pero

Couldn’t agree more. It’s a challenge, but also one of the most exciting frontiers in population health work right now. So, I think we’ll leave it there for today. We’ll keep following the data—and the impact it’s making for aging and vulnerable communities—in the next episodes.

Andie Cartwright

Thanks, Anthony, and thanks to everyone listening. If you’re involved in senior care, or you just geek out about how data can make life better, keep tuning in. We’ve got more to come. Take care, everyone!

Anthony Pero

See you next time, Andie! Bye, everyone.