Latent profiles in herpes zoster vaccine hesitancy among middle-aged and elderly adults: A cross-sectional study in Shanghai, China.

Abstract

Background: Herpes zoster (HZ) poses health risks for adults aged ≥ 50. Despite vaccine effectiveness, uptake remains low due to hesitancy. This study explored heterogeneity in HZ vaccine hesitancy using latent profile analysis (LPA), guided by the 5C model.

Methods: A cross-sectional survey of 833 adults aged ≥ 50 was conducted in Shanghai (March-September 2024) using stratified cluster sampling. Data included sociodemographics, psychological antecedents (Chinese 5C scale: Confidence, Complacency, Constraints, Calculation, Collective Responsibility), vaccine literacy, and information-seeking behavior. LPA was performed using Mplus 8.3; model fit assessed via Akaike information criterion, Bayesian information criterion, entropy, and likelihood ratio test. Group comparisons used χ² tests and logistic regression (SPSS 28.0).

Results: Two profiles emerged (1) Prudent Observers (37.9%)-low confidence and collective responsibility, high chronic disease prevalence (72.5%), lower education, and only 1.9% vaccinated. (2) Proactive Advocates (62.1%)-high confidence, collective responsibility, higher income, and education. Only 34% had encountered HZ vaccine information, mostly regarding safety and side effects; sources were mainly social networks and media.

Conclusions: The study revealed the multidimensions of HZ vaccine hesitancy, highlighting the critical role of confidence, collective responsibility, and tailored health communication. The identified profiles underscored the need for differentiated interventions, targeted education for Prudent Observers and reinforcement of social norms for Proactive Advocates.