Patient preferences toward herpes zoster vaccination among individuals aged 50 years or older in South Korea: Findings from a discrete choice experiment

In South Korea, the increasing incidence of herpes zoster (HZ) and aging population warrant consideration of HZ vaccination for older adults. There is a need to understand the HZ vaccine-related preferences of adults aged ≥50 years and adult children (working or financially independent adults contributing to healthcare decision-making for their parents aged ≥50 years). A discrete choice experiment was conducted to elicit HZ vaccine preferences of the HZ-naïve general public aged ≥50 years (<i>n</i> = 500), current/former HZ patients aged ≥50 years (<i>n</i> = 150), and adult children (<i>n</i> = 150). An online questionnaire was administered through March–May 2023; for each preference-elicitation question, respondents selected between three hypothetical HZ vaccine profiles, characterized by five attributes with varying levels, or “no vaccine”. Respondents generally accepted an increased number of doses (from one to two) for a longer protection duration (from ≥4 to ≥7 or ≥10 years). By mean relative importance (RI), protection duration (RI: 37.1%; 95% confidence interval [CI]: 36.0%, 38.1%), lifetime HZ risk reduction (27.3%; 95% CI: 26.3%, 28.4%) and short-term side effects (14.9%; 95% CI: 14.1%, 15.6%) had the strongest impact on respondents’ HZ vaccine decision-making. Adult children viewed short-term side effects with significantly greater RI than the general public and current/former HZ patients (19.1%, 13.5%, 15.2%, respectively, <i>p</i> &lt; .001). Respondents with selected comorbidities placed higher RI than those without comorbidities on protection duration (39.3% versus 34.2%, <i>p</i> &lt; .001) and lower RI on prevention of HZ-related complications (8.7% versus 10.4%, <i>p</i> = .007). Findings may guide health policy design/refinement and physician-patient conversations on HZ vaccination/vaccines. In South Korea, shingles typically affects adults aged ≥50 years, creating substantial burden on patients and their families. As multiple factors determine shingles vaccine choice, understanding individuals’ preferences when considering shingles vaccination for themselves/their family is important. An online questionnaire was conducted with 500 members of the general public aged ≥50 years, 150 patients aged ≥50 years currently/previously diagnosed with shingles, and 150 adult children aged 30–49 years (working/financially independent adults contributing to healthcare decision-making for/with their parents aged ≥50 years). For each question, respondents chose between three hypothetical shingles vaccines (each had five attributes with different variations) or “no vaccine”. Findings were used to examine respondents’ preferences when choosing shingles vaccines. Respondents were generally open to changes in a shingles vaccine attribute if it meant longer protection. For example, they were willing to accept an increase from one to two doses for protection if this allowed an increase in the minimum duration of protection from four to seven or 10 years. All groups ranked the duration of protection, a lowered chance of getting shingles throughout life, and short-term side effects as having greatest importance. Adult children deciding on their parents’ shingles vaccination cared more about having fewer short-term side effects and less about the duration of protection than other groups. Those with certain medical conditions prioritized duration of protection over prevention of shingles-related complications, unlike those without such conditions. Findings may assist doctors in their conversations with patients to support them in making informed decisions around shingles vaccination.