A large new analysis suggests the recombinant shingles vaccine may deliver
benefits that go well beyond preventing a painful rash. Adults who received
Shingrix were 9% less likely to experience a broad set of cardiovascular
problems over a seven-year follow-up compared with those who received the
older, live-virus Zostavax vaccine, according to research
published in Nature Medicine
in September 2026.
The findings, from researchers at the University of Oxford, add to a growing
body of evidence that vaccines can influence long-term health in ways that
extend beyond the infections they target. If confirmed in randomized trials,
the results could reshape how clinicians weigh the value of routine adult
immunizations.
What the Study Found
The Oxford team analyzed electronic health records from 72,920 adults aged
60 and older, matching 36,460 Shingrix recipients with an equal number of
Zostavax recipients. Over seven years, Shingrix recipients showed measurable
reductions across several cardiovascular outcomes:
- 9% lower overall cardiovascular disease burden
- 10% lower ischemic heart disease burden
- 12% lower heart failure burden
- 12% lower stroke burden in men
- 7% lower atrial fibrillation burden in both sexes
“An intervention with the potential to decrease cardiovascular disease
risk would have enormous public health impact,” lead investigator Max
Taquet, PhD, an associate professor at Oxford’s Department of Psychiatry, said
in comments to Medical News Today. Cardiovascular disease remains the
leading cause of death worldwide, according to the
World Health Organization,
accounting for roughly 17.9 million deaths each year.
Why This Might Be Happening
Shingles, caused by reactivation of the varicella-zoster virus, is more than
a skin condition. Infection triggers systemic inflammation, and prior research
has linked acute shingles episodes with a temporary spike in stroke and heart
attack risk. Preventing shingles could therefore prevent the vascular
turbulence that follows it.
But the Oxford data hint at something more. Shingrix uses a novel adjuvant
called AS01
that produces a stronger, longer-lasting immune response than the live-virus
Zostavax. Researchers hypothesize that AS01 may modulate broader inflammatory
pathways, including levels of interleukin-6 (IL-6) — a cytokine
increasingly recognized as a
driver of atherosclerosis
and cardiovascular events.
“Shingrix uses an adjuvant that may produce longer-lasting
immune changes,” Cheng-Han Chen, MD, medical director at MemorialCare
Saddleback Medical Center, noted in interviews with Medical News
Today. Independent cardiologists reviewing the data cautioned, however,
that observational studies “do not prove cause and effect.”
How Shingrix Compares With Zostavax
Shingrix, approved by the U.S. Food and Drug Administration in 2017, largely
replaced Zostavax in clinical practice because it produces stronger and more
durable protection. According to the
U.S. Centers for Disease Control and Prevention (CDC),
Shingrix is more than 90% effective at preventing shingles and postherpetic
neuralgia in healthy adults aged 50 and older — and protection remains
above 80% at least a decade after vaccination.
Zostavax was discontinued in the United States in 2020. The CDC now
recommends two doses of Shingrix for all adults 50 and older, and for adults
19 and older with weakened immune systems.
Shingles by the Numbers
Roughly one in three adults in the United States will develop shingles
during their lifetime, the CDC estimates. Risk climbs sharply after age 50 as
immunity to varicella-zoster wanes. Complications include:
- Postherpetic neuralgia: A chronic nerve pain that can
persist for months or years after the rash clears. - Vision loss: When the virus involves the ophthalmic
branch of the trigeminal nerve. - Ramsay Hunt syndrome: Facial paralysis and hearing
changes when the facial nerve is affected.
What the Findings Do — and Don’t — Prove
The Oxford study is observational. Even with careful matching, unmeasured
differences between Shingrix and Zostavax recipients — such as
health-seeking behavior, socioeconomic factors, or preventive care habits
— could partially explain the results.
Two randomized controlled trials are currently underway that should provide
higher-quality evidence about whether Shingrix directly influences
cardiovascular outcomes. Until those results are available, experts stress
that the findings are hypothesis-generating rather than practice-changing.
“These results warrant further study,” Yu-Ming Ni, MD, a
non-invasive cardiologist at MemorialCare Heart and Vascular Institute at
Orange Coast Medical Center, told reporters. “This should not be the
primary reason to get the vaccine, but it is a promising secondary
benefit.”
Practical Takeaways
The primary reason to get Shingrix remains prevention of shingles and its
complications, which can be severe and long-lasting. Any cardiovascular
benefit — if confirmed — would be a welcome bonus. Consider
discussing vaccination with your healthcare provider if you:
- Are 50 or older and have not received Shingrix
- Are 19 or older with a condition or medication that weakens your immune
system - Previously received Zostavax and have not been re-vaccinated with
Shingrix, which the CDC recommends
Beyond vaccination, the pillars of cardiovascular prevention remain
unchanged: regular physical activity, a
heart-healthy eating pattern
such as DASH or the Mediterranean diet, avoiding tobacco, managing blood
pressure and cholesterol, adequate sleep, and stress reduction.
The Bigger Picture
Vaccines that provide unexpected downstream benefits are not without
precedent. Influenza vaccination has been repeatedly associated with lower
short-term cardiovascular event rates in people with existing heart disease,
and shingles vaccination has previously been linked with a
reduced risk of dementia
in earlier observational work. If randomized trials confirm the cardiovascular
signal, adult vaccination programs could take on a broader role in
population-level heart disease prevention.
For now, the message is measured: Shingrix effectively prevents a painful
and often serious infection, and it may do more than that. Speak with your
clinician about whether it is appropriate for you.
Disclosure: This content is for informational purposes only and is not
medical advice. Always consult a qualified healthcare provider before making
changes to your health regimen.