Targeting age-appropriate adults' vaccine hesitancy to the herpes zoster vaccine in Ningbo, China: A latent profile analysis

Abstract This study aims to clarify the profiles of the psychological antecedents to the herpes zoster vaccine (HZV) among age-appropriate adults in Ningbo. A multistage stratified sampling method was employed to take samples We performed a face-to-face questionnaire survey among adults aged 40 years and older in late 2023. Participants were asked to report demographics, knowledge of HZV, the modified 5C vaccine hesitancy scale, and HZV uptake intention. Confirmatory factor analysis (CFA) was utilized to evaluate the modified 5C scale's validation, and latent profile analysis was used to identify distinct profiles. A total of 2100 participants were investigated, and 2025 valid cases were kept for further analysis. The CFA showed good reliability and validity for the modified 5C scale. The findings indicated three profiles: “skeptics” (24.15 %; high complacency, constraint), “believers” (38.67 %; high confidence, calculation, collective responsibility), and “free riders” (37.19 %; median confidence, calculation, collective responsibility, high complacency, constraint). Compared to believers, skeptics and free riders were older, more likely to reside in urban and suburban areas, lacked Urban Employee Basic Medical Insurance, and knew less about vaccine-related knowledge. From the highest to the lowest on vaccination intention were believers, then free riders, and finally skeptics under four distinct scenarios (recommendations from HCWs, from friends and family, from the media and internet, and HZV is free of charge). Based on 5C psychological antecedents, we identified two other profiles in addition to believers. This research may help build tailored immunization strategies to lessen vaccine hesitancy and increase willingness to receive HZV. • The 5C scale comprehensively analyzes determinants of vaccine hesitancy from five dimensions: confidence, complacency, convenience, calculation, and collective responsibility. Our study was the first to assess the age-appropriate adults' vaccine hesitancy to the Herpes zoster vaccine by using the 5C scale. • To determine the antecedents of vaccine hesitancy, latent profile analysis would be the most appropriate type of statistical technique, because vaccine hesitancy is a complex and dynamically shifting term that challenges the traditional perspective of a simple dichotomization of an individual's behavior into acceptance or refusal. • Based on 5C psychological antecedents, our study identified the following three profiles: “skeptics,” “believers,” and “free riders,” which may help build tailored immunization strategies to lessen vaccine hesitancy and increase willingness to receive the Herpes zoster vaccine.