Barriers to herpes zoster vaccine uptake: evaluating knowledge, attitudes, and practices in Saudi communities

Background: Herpes zoster (HZ), commonly known as shingles, remains a public health concern, particularly among older adults and immunocompromised individuals. This study aimed to evaluate the knowledge, attitudes, barriers, and practices regarding HZ and its vaccine among the general population in Saudi Arabia. Methods: A cross-sectional study was conducted among 507 participants in Saudi Arabia between January and June 2024. Data were collected using a structured, close-ended questionnaire. Descriptive and regression analyses were performed with a statistical significance set at p < 0.05. Results: Awareness of HZ was high (79.7%), but awareness of the HZ vaccine was lower (57.2%). Knowledge scores were significantly higher among females (B = 1.372, p < 0.001), individuals with above a bachelor's degree (B = 1.725, p < 0.001), and those with a history of chickenpox (B = 0.466, p = 0.018). Barriers to vac cine uptake included concerns about side effects (16.4%), cost (7.0%), and a preference for natural immunity (37.4%). Only 7.7% of individuals aged 50 years and above had received the vaccine. Multivariable logistic regression revealed that awareness of the HZ vaccine was inversely associated with vaccination intention (OR = 0.5, 95% CI: 0.3–0.8, p = 0.001), while uncertainty about chickenpox history was positively associated (OR = 2.3, 95% CI: 0.6–1.2, p = 0.015). Healthcare provider recommendations significantly influenced vaccination intention, with 41.2% of participants indicating they would take the vaccine if recommended by a doctor. Conclusion: The study highlights significant gaps in awareness and knowledge of HZ and its vaccine, as well as key barriers to vaccine uptake in Saudi Arabia. Addressing these barriers requires targeted educational cam paigns, cost-reduction strategies, and enhanced healthcare provider communication.