Millennials across America (at least in our own minds) have a lot to grouse over: graduating into a labor market ravaged by the 2008 financial crisis, hamstrung by arcane systems of predatory student loan debt, and an eternal guilt by association with twee music and “awesomesauce” memes. But there is at least one great silver lining.
A sprawling examination of the medical records of over 85 million U.S. adults conducted by healthcare professionals and data scientists with the Epic Health Research Network has documented a steep decline in shingles cases for adults under the age of 35. Researchers with Epic, a public benefit corporation, attributed this generational divide on the disease—essentially a reactivation of the same varicella-zoster virus that causes chickenpox in children—to the U.S. chickenpox vaccination program instituted in 1995. In short, the program worked.
The oldest cohort that Epic’s researchers looked at, elder Gen Xers born between 1968 and 1975, contracted shingles at an average rate of 181.9 cases per 10,000 people, roughly 26 times that of the youngest adults born between 2006 and 2008. For millennials born between 1986 and 1990, that rate dropped down by more than half to 76.7 cases per 10,000 people. But the sharpest decline came right at the boundary at which America’s 1995 policy became standard for newborns. In what’s undoubtedly good news for Gen Z too, the rate plummeted by this point in the mid-90s to just 17.3 shingles cases per 10,000.
“That break coincides with the first birth cohorts eligible for routine childhood chickenpox vaccination, though we did not evaluate whether patients had received the childhood chickenpox vaccine,” Epic’s team noted.
The right jab
Epic’s researchers, including physician Sam Butler from the group’s clinical informatics division and data scientist Joe Deckert, attributed the clear decline in shingles cases among people born just before the 1995 vaccination policy took effect to the flexibility with which the policy was applied.
“Because the 1995 rollout also offered catch-up vaccination to susceptible older children, this was a gradual transition rather than a sharp birth-year cutoff,” Butler, Deckert, and their coauthors explained. Thus, they noted the benefits extended to “a smaller effect into somewhat older groups, including part of the 35–39 band.”
But the drastic nature of the drop for those born in 1995 and after was nevertheless remarkable. The decline in shingles cases between the 1991–1995 and 1996–2000 age groups, where the rate dropped from 45.5 to 17.3 per 10,000—a 62% fall—was “sharper than the change between any other adjacent cohorts,” they noted.
In other words, it’s compelling confirmation of the theory that early childhood vaccinations against chickenpox carry a lower risk of catching shingles later in life than natural immunity earned the hard way, via infection with the virus out in the wild.
Rash decisions
Obviously, Epic’s results are welcome data for those hoping to maintain U.S. medical policy on early childhood vaccinations. A bout of shingles can lead not only to painful, burning rashes and blisters, but also potentially to long-term nerve pain and other chronic conditions. And this childhood vaccination program has been under threat ever since Robert F. Kennedy, Jr.—the anti-vaccine activist, denim athleisure-wear proponent, and U.S. health secretary—assembled a vaccine recommendation panel last year that voted against the routine combination of measles, mumps, rubella, and varicella (chickenpox) vaccines for children under four.
Granted, a U.S. District Judge in Massachusetts did rule against RFK Jr.’s Department of Health and Human Services (HHS) this past March, preserving this childhood policy in response to a lawsuit against HHS led by the American Academy of Pediatrics. But it has been equally clear from the ongoing court filings that the department has no intention of backing down.
As HHS spokesman Andrew Nixon put it last spring: “HHS looks forward to this judge’s decision being overturned just like his other attempts to keep the Trump administration from governing.”
