Another reminder to get your vaccines, and the connection to new dementia prevention research

Debra L. Glasser, M.D.

PHOTO BY GLORIA TOWNE

The Covid 19 pandemic left many people behind on healthcare follow-ups for both prevention and ongoing care of chronic conditions (with current staff shortages at every level of healthcare not helping this situation). Staying up to date on vaccines has also suffered since the pandemic and is an important part of taking care of our health. Our primary care doctors, NPs, and PAs are excellent at looking at the whole picture, including reminding us of vaccines due.

If you do not have a primary care professional, get one. Click here for a how-to article.  I will not say this will be easy or fast in these times…. but at least get an appointment scheduled, even if some months out.

If you know you are due for vaccines (that is nearly everyone for flu and a COVID-19 booster), simply go to your chosen pharmacy to get them. Some pharmacies require appointments, others do not. This relatively new availability of vaccines at pharmacies is one of the positive healthcare changes of late. Pharmacists are highly trained professionals who can not only give the shots but advise on them as well.

…and while you are at it, get all your vaccines updated! WHY?

• Vaccines give us the tools to develop immunity (i.e., the weapons to fight from within) against the diseases they are designed to both fight and prevent. Some vaccines have almost eliminated their target infections, for instance, polio and measles. Other vaccines, like flu and COVID-19, if they do not prevent you from being infected, they prevent you from having serious and deadly complications from the infection.
• For instance, flu shots may not prevent you from getting the flu but they prevent you from being as sick as you might be - shorten the duration (how many days of work do you want to miss?), reduce the misery of the symptoms (admit it: fever, coughing, feeling wiped out and all those body aches are miserable), and prevent complications such as pneumonia and hospitalization (especially in the elderly or those with compromised immunity and lung disease).

A man puts a puzzle piece into a head-shaped puzzle on a table. Memory and dementia concept.

Vaccines may prevent dementia and Alzheimer’s disease too!

The data is new, but several studies published this year, strongly suggest this is true. Research in the US and the UK suggests that all the routine vaccines studied to date (on influenza, shingles, Tdap = tetanus, and pneumococcal) seem to reduce the recipient’s risk of dementia and death from dementia. Amazing!

The data so far looks robust:

• FLU VACCINE: Get your flu vaccine three years in a row and reduce your risk of Alzheimer’s Disease (AD) by 20% over the next 4-8 years; get it six years in a row and reduce your risk by 40%. In addition, your risk of getting AD increases after being infected with influenza.
• SHINGLES VACCINE: it looks like the older vaccine, Shingrix, which requires two doses, is best for dementia deterrence. It prevents 20% or 1 in 5 cases of new dementia. If that is not good enough, the vaccine is 97% effective in preventing shingles in those 50–69 years old and 91% effective in those over 70. That is a good thing for two reasons: 1 Shingles is a miserable disease while you are having it and once the skin breakout is healed, some people are left with terrible nerve pain, called herpetic neuralgia. One: a third of us will get shingles (unvaccinated) and two: those with a history of shingles have a higher risk of dementia.
• PNEUMOCOCCAL VACCINE: has also been shown to decrease the risk of getting dementia, though the reduction of risk is less than for flu and shingles vaccines.   This vaccine prevents the most common bacterial causes of severe pneumonia. This is important because bacterial pneumonia is often the final event for the elderly.  
• To top off this good news, even the TETANUS VACCINE (Tdap) that is recommended every ten years (or more often if you get a tetanus-prone injury or wound) is being shown to reduce the risk of dementia. Also, there is an interesting research theory that the ‘p’ in the Tdap (for pertussis, or whooping cough) prevents pertussis bacteria from colonizing the nose and possibly traveling to the brain via the smelling nerves, causing brain inflammation. Fascinating and creepy.

What are the vaccines doing??!!

This is the million-dollar question that researchers are scrambling to answer.   The answers may provide important insight into the causes of AD and dementia, which is the beginning of finding treatments and prevention.

Currently, three theories are being explored to answer why vaccines may prevent dementia:

1) It may be that dementia is caused by the direct effect of the infection itself on the brain (i.e., maybe the virus or bacteria itself is the cause of AD), or perhaps the body’s reaction to the infection is making the brain susceptible to dementia. This would be explained by those having the diseases above having an increased risk of dementia.

2) Perhaps the vaccines themselves and/or the way they act on our system to reduce immune reactivity in the brain, which can cause brain damage, may be why vaccines are making a difference in dementia rates

3) The immune reaction from the vaccine itself possibly is repairing early brain damage that could lead to dementia

Stay tuned for further research! “Science can be messy (and complicated, like life) but eventually leads to truths.”

Whatever is going on, it appears that brain health and the immune system are related SOMEHOW.

Although this research is new and preliminary, the findings are both fascinating and exciting because dementia is a terrible condition.

It lends yet another reason to get those vaccines for their primary reasons (to prevent the disease in you and the rest of our community) and now maybe to prevent dementia too!  

Postscript definition:

From the CDC:

‘Dementia is not a specific disease but rather a general term for the impaired ability to remember, think, or make decisions that interfere with everyday activities. Alzheimer’s disease is the most common type of dementia. Though dementia mostly affects older adults, it is not a part of normal aging.’

Dementia is so prevalent that almost everyone has known or loved someone who was taken away from them by this terrible condition.

Practicing a healthy lifestyle is one way to prevent dementia but certainly not a guaranteed way to avoid the condition. Worse yet is that once someone has dementia, there are no particularly effective treatments.  Learning that getting our routine vaccines as recommended may stave off dementia is very promising news indeed.

Debra L. Glasser, M.D., is a retired internal medicine physician who lives in Olympia. Got a question for her? Write drdebra@theJOLTnews.com