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Very interesting talk by @mendelrandom.bsky.social on the apparent effect of shingles vaccines on dementia. Clear discontinuity from shingles vaccines on shingles, but not on dementia, in this much larger follow up in England, using similar analytic choices as the Wales study that showed a benefit.

Notably not the original ones, though (which in fact focused on the competitor). The journal club discussions have been *fascinating*

Devil's advocate here: Of course the company who stands to gain from a true effect investigates the possible effect. Imagine the reverse: no pharmaceutical company has any incentive. Would there even be as many studies? (That said: RCT or bust)

I'm a tool of big pharma (not GSK, fwiw), and I tend to agree with you. I think national health organizations should definately be doing their own studies. Given all that, I think the benefits of the shingles vaccine to protect against shingles is enough. Any knock effects are just icing.

I can also state that I got the shingles vaccine when I hit 50. There was no question in my mind about it.

Fully agreed! I find it very frustrating that it's not approved at younger ages, even to take privately. Different countries also have fairly different age thresholds for approval (let alone universal recommendations/publicly funding it)

TBH it just shows how hard this stuff is to do, and the many traps that are easy to fall into when working with these types observational data - where you have no control over the data generating process. This seems to be “kicking the tyres” on SAIL findings, which is how it should be.

People also need to think about how the extremely expensive access fees for SAIL and related systems mean only pharma has access to the relevant data, with all but the best funded public researchers shut out.

Can you say more about the data sources, Thomas? I was curious about this!