{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T12:20:57Z","timestamp":1783599657641,"version":"3.55.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Several observational studies and recent natural experiments suggest that herpes zoster vaccination is associated with fewer subsequent dementia diagnoses. Quasi-experimental analyses that exploit date-of-birth eligibility thresholds, largely involving the live attenuated zoster vaccine, strengthen causal inference by reducing confounding from preventive-care behaviors and healthcare utilization; however, they do not establish mechanism or distinguish disease prevention from delayed diagnosis. Three nonmutually exclusive pathways merit direct evaluation: reduced cumulative varicella-zoster virus reactivation burden, including recurrent and possibly unrecognized events; vaccine-induced immune modulation that alters immune aging and inflammatory responses; and neurovascular and neuroinflammatory injury as intermediate pathways linking zoster to later cognitive decline. Priority should now shift to stronger causal designs, pathway-focused analyses of reactivation and vascular intermediates, and prospective studies incorporating longitudinal immune phenotyping and blood-based biomarkers.<\/jats:p>","DOI":"10.1093\/cid\/ciag358","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T11:44:03Z","timestamp":1780659843000},"source":"Crossref","is-referenced-by-count":0,"title":["Zoster Vaccination and Dementia: Interpreting the Signal and Testing the Mechanisms"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2512-7919","authenticated-orcid":false,"given":"Nadine","family":"Rouphael","sequence":"first","affiliation":[{"name":"Hope Clinic, Infectious Diseases Division, Department of Medicine, Emory University , Decatur, Georgia 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