Season 2: Episode 11 - Shingles Vaccine May Cut Dementia Risk

Andie Morataya

Welcome to the Better Living Through Data podcast everybody! I'm Andie Morataya, and I'm joined by Anthony Pero.

Anthony Pero

Wow, Andie Morataya - starting today with a new last name - did I hear you correctly?!

Andie Morataya

You heard right! New name, same game!

Anthony Pero

Well Andie, congrats on your recent wedding!

Andie Morataya

Thanks so much Anthony! I want to dive into this episode with a number that is currently rewriting what we know about preventative care: seventeen. Just seventeen.

Anthony Pero

Seventeen? That sounds like a remarkably small clinical threshold. What are we measuring here, Andie?

Andie Morataya

It is incredibly small. It represents the number of older adults you need to vaccinate with the recombinant shingles vaccine to prevent exactly one case of dementia. This is coming out of a massive new study just published in the Annals of Internal Medicine.

Anthony Pero

One in seventeen is an exceptionally low number needed to treat, especially for a condition as devastating and complex as dementia. Usually in population health, we are looking at numbers in the hundreds or thousands to see that kind of absolute impact.

Andie Morataya

Exactly! The researchers, led by Dr. Kaley Hayes from the Brown University School of Public Health, found a 5.8 percentage point absolute reduction in dementia risk over four years. On a relative scale, that is a 24% reduction in risk for those who got the recombinant shingles vaccine, or RZV, compared to those who did not.

Anthony Pero

A twenty-four percent relative risk reduction in a newly admitted skilled nursing facility population is massive. Remember, these are individuals transitioning into post-acute or long-term care, which is a period of high vulnerability. But Andie, what is the biological mechanism here? How does a shingles shot protect your brain?

Andie Morataya

Well, the paper points to a few possibilities. The primary theory is that the shingles virus, varicella-zoster, causes severe systemic inflammation when it reactivates. That viral activity can trigger a neuroinflammatory cascade in the brain.

Anthony Pero

And that neuroinflammatory cascade is exactly what accelerates the accumulation of misfolded oligomers, amyloid plaques, and neurofibrillary tangles. Basically, by using the vaccine to block the virus from reactivating, we are preventing the massive wave of inflammation that acts as tinder for cognitive decline.

Andie Morataya

Right! And it might also have broader immunomodulatory effects. It is like the vaccine is training the immune system to keep the brain's environment stable.

Anthony Pero

This is where the science gets incredibly practical, but we have to talk about how they actually proved this. To run a traditional randomized controlled trial on this scale, following half a million frail older adults over four years to see who develops dementia, is practically impossible and arguably unethical. So, the researchers used a target trial emulation.

Andie Morataya

And the engine behind that emulation was our very own PointClickCare de-identified electronic health record database. They analyzed data from over 500,000 residents across community nursing homes in nearly every state.

Anthony Pero

Five hundred thousand residents. That sheer volume of real-world data is what allowed them to control for fifty-seven baseline and time-varying covariates. They matched clinical records, medication orders, cognitive function scales, and even linked that EHR data with Medicare claims to track exactly what happened to these patients, even after discharge from the facilities.

Andie Morataya

It is a masterclass in how B2B health tech and real-world data can solve clinical mysteries that traditional trials cannot touch. But Anthony, amidst all this amazing data, there was one statistic in the study that felt like a punch in the gut: 1.73%.

Anthony Pero

One point seven three percent. That is the actual percentage of eligible residents in the study who actually received the RZV vaccine within twelve months of admission. That is a staggering clinical gap.

Andie Morataya

It is a tragedy, honestly! Over ninety-eight percent of these vulnerable older adults, who are already at a higher risk for both shingles and dementia, did not get vaccinated. From a marketing and clinical operations standpoint, this transition window, when they enter a skilled nursing facility, is the ultimate missed opportunity for preventative care.

Anthony Pero

It absolutely is. When a patient is admitted, clinicians are hyper-focused on the immediate crisis, like rehab after a hip fracture or stabilizing a cardiac event. Vaccinations like RZV get pushed to the back burner, and once they are discharged, they slip through the cracks. But this data shows that the admission window is the perfect time to assess eligibility, make the recommendation, and administer the dose.

Andie Morataya

So the call to action here is clear. We have the clinical evidence, we have the real-world data proving the massive downstream cognitive benefits, and now we need the operational push to close that 1.73% gap.

Anthony Pero

Exactly. Real-world data from PointClickCare has exposed both the breakthrough connection and the delivery failure. Now it is up to the healthcare ecosystem to act on it.

Andie Morataya

That is all for today's quick take. We will link the Annals of Internal Medicine study in today's episode description.

Anthony Pero

Sounds good Andie! I would also like to remind our listeners that right now, they can access our new AI powered natural-language research tool "Study Buddy".

Andie Morataya

That's right! You can also find a link in the description to learn more about Study Buddy and sign up for free access!

Anthony Pero

And that brings us to the end of today's episode! Thanks everyone for listening in!

Andie Morataya

Thanks all, see you next week on the Better Living Through Data podcast!