AHA/ASA past president, Ralph L. Sacco, MD, MS, FAHA offers perspective (via Skype) on ISC 20 presentation TP493. He is Chairman, Department of Neurology; Olemberg Family Chair in Neurological Disorders; Miller Professor of Neurology, Public Health Sciences, Human Genetics and Neurosurgery University of Miami, Leonard Miller School of Medicine; Executive Director, Evelyn F. McKnight Brain Institute; Senior Associate Dean for Clinical and Translational Science; Director, Clinical and Translational Science Institute; Chief of Neurology Service, Jackson Memorial Hospital; President, American Academy of Neurology 2017-19.
copyright American Heart Association 

"So this is a very interesting study, very large sample using Medicare data sets where they looked at people who have had the older shingles vaccine and then looked at the risk of stroke, both bleeding strokes and ischemic strokes among those who had the vaccine compared to a control group of people who didn't have the vaccine. And those that had the vaccine over age 60 were protected. They had a lower risk of stroke compared to those who had not had the vaccine. And this was for ischemic stroke as well as hemorrhagic stroke, so it is very intriguing. We know that more than 99% of people, age 40 or older, carry the chickenpox virus. We know that the vaccine is very effective in reducing shingles, which can be very disabling and we know that things like shingles can increase inflammation, and increase the risk of stroke. But this is the first time in a very large Medicare database that it was shown that those who got the vaccine had a lower risk of stroke."