A Dementia Vaccine? Most Americans Say Yes

Most Americans 50 and older said they would be interested in receiving a vaccine that could reduce their risk of dementia if they were at high risk, survey data showed.

Nearly three in four survey respondents (72.1%) said they would likely or definitely receive such a vaccine, said J. Felipe Montano-Campos, PhD, of the University of Southern California Schaeffer Center for Health Policy and Government Service in Los Angeles, and co-authors.

One-fifth of respondents (20.8%) weren’t sure, and 7.2% said they likely or definitely would not, Montano-Campos and co-authors reported in a JAMA Network Open research letter.

Women were more likely than men to express hesitation (23.0% vs 18.5%) and were less likely to say definitely yes (29.1% vs 38.5%). Black adults had the highest levels of hesitation and were nearly half as likely as white adults to say they would definitely get the vaccine (19.8% vs 35.8%).

“Older adults are highly interested in receiving a preventive dementia vaccine, while relatively few are opposed,” Montano-Campos said in a statement. “As vaccine options emerge, efforts may be needed to address hesitancy among some groups, including those at higher risk for dementia.”

No vaccine is approved to prevent dementia, but several studies have suggested links between shingles vaccination and a lower risk of dementia in older adults. A “natural experiment” in Wales found that people who received the live-attenuated zoster vaccine (Zostavax), which is no longer available in the U.S., had a 20% lower risk of dementia. A recent study of Medicare beneficiaries showed that receiving the currently approved recombinant zoster shot (Shingrix) was associated with a 33% lower risk of any dementia type.

Last year, a study of U.S. patients linked AS01-adjuvanted vaccines for two different pathogens — the respiratory syncytial virus vaccine (Arexvy) and the recombinant zoster vaccine — to a lower incidence of dementia. That finding led some researchers to speculate that the adjuvant, which stimulates the immune system, may play a role.

To examine public attitudes toward a preventive dementia vaccine, Montano-Campos and colleagues surveyed 1,529 adults ages 50 and older from the Understanding America Study, a nationally representative internet panel of adults. Respondents were asked about their interest in receiving a low-cost, multidose vaccine that would reduce the risk of dementia by half if they were at high risk.

The weighted sample had a mean age of 65.6 years, and 52.5% were women. Most survey respondents (73.7%) were white, 14.6% were Hispanic, and 11.7% were Black. Overall, 45.7% had a college degree or a higher level of education.

Definitely “yes” responses to the vaccine ranged from 31.1% of people ages 50-59 to 35.1% of those 70 and older.

Higher-income respondents (OR 1.64, 95% CI 1.22-2.20) and those with a college degree or higher (OR 1.44, 95% CI 1.17-1.78) were more willing to receive the vaccine than others. Respondents who said that they or someone close to them had dementia also were more willing to be vaccinated (OR 1.43, 95% CI 1.19-1.73).

Several preventive strategies, including immunotherapies and vaccine-based approaches that might delay or reduce Alzheimer’s disease risk, are under development, Montano-Campos and co-authors pointed out.

“Our findings have important implications for the implementation of emerging preventive dementia vaccines, suggesting the need for targeted communication and engagement to ensure equitable uptake,” they wrote.

The study used hypothetical vignettes and may not fully capture clinical decision-making, the researchers acknowledged.