Are there Boltzmann brains in the vacuum

"Boltzmann brains" are human brains that arise as thermal or quantum fluctuations and last at least long enough to think a few thoughts. In many scenarios involving universes of infinite size or duration, Boltzmann brains are infinitely more common than human beings who arise in the ordinary way. Thus we should expect to be Boltzmann brains, in contradiction to observation. We discuss here the question of whether Boltzmann brains can arise as quantum fluctuations in the vacuum. Such Boltzmann brains pose an even worse problem than those arising as fluctuations in the thermal state of an exponentially expanding universe. We give several arguments for and against inclusion of vacuum Boltzmann brains in the anthropic reference class, but find neither choice entirely satisfactory.