Newer shingles vaccine linked to lower heart disease risk, ‘natural experiment’ shows
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- Shingrix was associated with a 9% lower overall cardiovascular burden — covering coronary heart disease, heart failure, and stroke — over seven years versus the older Zostavax vaccine, in a Nature Medicine study of 72,000 adults 60+.
- Coronary heart disease dropped 10% and heart failure fell 12% in the Shingrix cohort; strokes were 12% lower in men but not significantly reduced in women, and atrial fibrillation was 7% lower overall, translating to about a 1% absolute reduction in cardiovascular events.
- Oxford researchers designed a natural experiment comparing vaccinated patients on either side of Shingrix's October 2017 U.S. approval date, using electronic health records from the TriNetX network of 60 health systems to minimize 'healthy vaccine bias.'
- Co-author Maxime Taquet said Shingrix 'may be the first vaccine that protects the heart and the brain,' noting the same Oxford team previously linked it to lower dementia rates, though the cardiovascular mechanism remains speculative.
- Study co-authors hypothesized that the AS01 adjuvant, present in Shingrix but not Zostavax, may induce 'trained immunity' that alters cytokines and endothelial cells lining blood vessels, potentially reducing atherosclerosis — and pointed out that Zostavax showed no cardiovascular protection.
- The DAN ZOSTER trial, a randomized study of about 162,000 people in Denmark, is underway with first results anticipated in 2027, which the authors say is needed to confirm causality before clinical implications firm up.
Why it matters: If the observational link holds in randomized trials, the millions of older adults who already receive Shingrix for shingles prevention could gain a modest but population-wide cardiovascular dividend — the authors flag 1% absolute event reduction that, scaled across vaccinated populations, could prevent a substantial number of heart attacks, strokes, and heart-failure cases. The 2027 DAN ZOSTER readout will be the next real test.
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