Prevalence of limitations and barriers of receiving herpes-zoster vaccine among patients attending PHC in Tabuk city, 2023, cross-sectional study

Background: Herpes Zoster (HZ), or shingles, is a vaccine-preventable condition that disproportionately affects older adults and immunocompromised individuals. Despite the availability of the HZ vaccine, uptake remains suboptimal in many settings, potentially due to poor awareness and misconceptions. Aim: This study aimed to assess the awareness, knowledge, attitudes, and barriers to HZ and its vaccine among residents of Tabuk City, Saudi Arabia. Methods: A cross-sectional, quantitative study was conducted among 500 patients aged 50 years and older attending primary healthcare centers (PHCs) in Tabuk City over a six-month period. Data were collected using a validated, structured questionnaire adapted from previous literature and translated into Arabic. The questionnaire covered demographics, knowledge of HZ and its vaccine, attitudes, and sources of information. Data were analyzed using SPSS version 28, with descriptive statistics and chi-square tests to examine associations between knowledge levels and participant characteristics. Results: Among the participants, 56.0% demonstrated good knowledge of HZ, while 44.0% had poor knowledge. Awareness of HZ (76.8%) and its vaccine (68.4%) was generally high; however, gaps remained in the recognition of symptoms and understanding of disease impact. Factors significantly associated with better knowledge included female gender (p = .012), non-Saudi nationality (p = .022), higher education (p = .001), employment (p = .001), prior infection or vaccination history (p = .001), and using the internet or healthcare professionals as information sources (p = .001). While 62.0% expressed willingness to receive the vaccine, acceptance increased to 81.4% if recommended by a physician. Fear of side effects and perceived low risk were the main barriers to vaccination. Conclusion: Although general awareness of HZ is high among the Tabuk population, significant knowledge gaps and misconceptions persist, especially regarding symptoms and vaccine safety. Keywords: Herpes Zoster, shingles, vaccine awareness, knowledge, attitudes, Saudi Arabia, primary healthcare, Tabuk, vaccination barriers.