EULAR 2026 Immunization Guidance: Day-zero planning, Shingrix strongly recommended; new dementia risk reduction evidence
Key Questions
What are the key updates in EULAR’s 2026 immunization guidance?
EULAR’s updated guidance, the first in 15 years, emphasizes day-zero vaccination planning regardless of disease activity and strongly recommends Shingrix for all rheumatology patients.
Does the shingles vaccine reduce dementia risk?
Two large studies in Annals of Internal Medicine found the recombinant zoster vaccine reduces dementia risk by 24% in nursing home residents, adding a non-specific benefit beyond shingles prevention.
Who should receive the Shingrix vaccine according to EULAR?
EULAR strongly recommends Shingrix for all immunocompromised rheumatology patients to fill existing gaps in European guidance for this population.
Why is day-zero planning important in EULAR guidance?
The guidance stresses initiating vaccination planning immediately at diagnosis or treatment start, irrespective of current disease activity, to improve uptake in rheumatology patients.
What evidence supports shingles vaccination beyond infection prevention?
Recent research shows Shingrix may lower dementia risk within a year of administration in older adults, providing an additional compelling reason for vaccination.
EULAR updated its immunization guidance after 15 years, emphasizing day-zero vaccination planning regardless of disease activity, and strongly recommending Shingrix for all patients. This fills a gap for immunocompromised adults, though European guidance; it provides actionable recommendations for rheumatology patients and providers. New evidence from two large studies (Annals of Internal Medicine) shows Shingrix reduces dementia risk by 24% in nursing home residents, adding a compelling non-specific benefit that strengthens the case for shingles vaccination in older adults. A recent opinion piece questions the plausibility of the dementia effect, but the evidence remains strong.