Good write up by Dr Topol
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hope you feel better soon 
Well, old smallpox vaccines were initially used to help with monkeypox (mpox) when it started surging
But Jynneos is a new vaccine dedicated to mpox (and also works against smallpox). I see little harm in taking this and probably much easier to get this than some old smallpox vaccine.
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Hmm, $300 for an old vaccine is not exactly what I would call cheap.
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Well… it’s new.
But I agree $300 isn’t exactly inexpensive — but may be covered by many insurance companies.
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Shingrix is $761 USD here in Hong Kong. Is that more or less expensive than other parts of the world?
In India it is about INR 12000 per dose (~USD 140) at the doctor’s office (I am planning on getting it next month when I travel to Chennai)
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I already got mine as a kid, have a little scar to prove it 
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CDC advisers recommend lowering the age for RSV shots to 50-59 years
The CDC currently recommends the vaccine for adults age 75 and older and at-risk adults ages 60 to 74.
“What’s swaying me is there clearly are people in that 50 to 59 years age group, for example lung transplant patients, …that would clearly benefit from having access to this vaccine,” Jane Zucker, one of the voting members of the panel, said ahead of the vote.
If the recommendation is adopted by the CDC, it would make about 30% of U.S. adults in that age group eligible for the RSV vaccine, according to panelist Michael Melgar.
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I get an RSV shot every year. 20 USD and shots given out at my workplace.
They don’t want us to get sick.
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This chart simply does not show that. While the rates are going up for all age groups, they are still relatively low in the 40’s.
As to your surprise that it’s not as great magnitude of risk as your expectations…… I don’t really know what to say— if 400% greater risk seems low to you.
Let’s talk RSV vax.
I am about to be 59 and my doc doesn’t advise it for me.
I can’t remember if you are older than I am, but is this something we are all getting?
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I’m got the flu shot. RSV should also be good.
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Show what? There are two facts that these graphs show:
- Older people are more at risk.
- Young people now have a similar risk as people aged ~60yo in the 90s.
So if you say “Young people are not at risk” based on your knowledge of the 90s, you’re wrong.
This chart in Sweden (that only starts in 2005, I’d love to see before) shows a similar trend:
The massive difference between young and old people is that shingles is still way worse among old people in terms of long-term pain (PHN):
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By the way, that’s why the age for recommended vaccination has been decreased all over the world over the past decades:
- UK: 70+ in 2013 => 65+ in 2023 => 60+ in 2025 (progressively over the next few years)
- US: 60+ in 2006 => 50+ in 2011
- Canada: 60+ in 2008 => 50+ in 2018
- Israel: 60+ before => 50+ in 2023
Of course, the government cares about cost. They only make a decision if it is cost-effective for them in the short-term. Shingrix is approved from age 50 but there are ongoing trials looking at the efficacy on younger healthy people:
- NCT06932523 from age 40
- NCT06874842 from age 40
- NCT06801509 from age 40
- NCT05856084 from age 30
- NCT05636436 from age 18
Given the increase in incidence in younger people, the good results showing long-term efficacy, and the ongoing trials, it’s pretty sure that in a few years the shingles vaccine will be recommended from an even younger age all around the world (40yo?).
My parents seem to think I had a very mild case of chickenpox when I was young, though my recent Varicella Zoster IgG test came back negative, indicating no prior infection. Based on the information in this thread would it be wise to get both a chickenpox and shingles vaccine? Or is the shingles vaccine unnecessary?
Each person may have their own way of thinking of things. But if I were you, I’d first get the course of chickenpox vaccine, and then after 6 months or so, get the shingles course (shingrix).
The mix-and-match of different vaccines should result in a more robust immunity.
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