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Authors and Affiliations

1. Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA

   Emily Rayens, Lina S. Sy, Lei Qian, Bradley K. Ackerson, Julia Tubert, Yi Luo, Punam P. Modha, Raul O. Calderon & Hung Fu Tseng

2. GSK, Rockville, MD, USA

   Elizabeth Chmielewski-Yee, Driss Oraichi & Huifeng Yun

3. GSK, Collegeville, PA, USA

   Carol Koro

4. Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland, Baltimore, MD, USA

   Carol Koro

5. Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA

   Hung Fu Tseng

Contributions

E.R. is the guarantor of the work and accepts full responsibility for the integrity of the study and the decision to publish. E.R., L.S.S., L.Q., B.K.A., J.T., Y.L., E.C-Y., D.O., H.Y., C.K., and H.F.T. designed and conducted this study, including interpretation of data. L.Q., J.T., and Y.L. performed statistical analysis. P.P.M. and R.O.C. provided administrative, technical, and material support. E.R. drafted the manuscript. All authors critically revised the manuscript and contributed to the final drafting. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

Corresponding author

Correspondence to Emily Rayens.

Competing interests

The authors declare the following competing interests: E.R., L.S.S., L.Q., B.K.A., Y.L., P.P.M., and H.F.T. received research funding from AstraZeneca. E.R., L.S.S., L.Q., B.K.A., J.T., Y.L., P.P.M., and H.F.T. received research funding from Moderna. ER and BKA received research funding from F2G, Inc. L.S.S., L.Q., and B.K.A. received research funding from Dynavax. B.K.A., J.T., and R.O.C. received research funding from Pfizer. B.K.A. received research funding from Genentech. E.R., L.S.S., L.Q., B.K.A., Y.L., P.P.M., and H.F.T. received research funding from GSK (unrelated to this study). E.C-Y., D.O., H.Y., and C.K. are employed by GSK and hold financial equities in GSK. The authors declare no other financial or non-financial interests.

Peer review information

Nature Communications thanks the anonymous reviewers for their contribution to the peer review of this work. A peer review file is available.

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Meeting(s) where the information has previously been presented

Findings from this study were presented at the Alzheimer’s Association International Conference 2025.

Trademark statement

Shingrix is a trademark owned by or licensed to GSK. Zostavax is a trademark of Merck.

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