Herpes zoster vaccination coverage and associated factors among individuals aged ≥50 years in Zhejiang, China: A population-based cross-sectional study

Abstract

Background

The herpes zoster (HZ) vaccination coverage remains low and existing research is limited. This study aimed to investigate factors associated with vaccination coverage and reasons for vaccination/non-vaccination across economic levels among individuals aged ≥50 in Zhejiang province.

Methods

A cross-sectional survey was conducted from March to May 2024 using multistage convenience sampling method. 10,500 individuals were recruited from 175 community health centers or township hospitals across 35 counties in Zhejiang Province. Chi-square test and multivariate logistic regression were used to analyze factors associated with vaccination coverage.

Results

Among 10,500 participants (mean age: 65.08), the vaccination coverage was 1.93%. Higher education level (college or higher vs primary school or below: OR = 2.609, 95% CI: 1.703–3.996) and doctor's recommendation (OR = 7.311, 95% CI: 5.032–10.621) were key factors associated with higher vaccination coverage. Among participants, vaccination motivations varied by monthly income: family recommendation and community promotion were the main drivers for those with incomes <5000 yuan, whereas “Someone close has had HZ” was most common for those with incomes ≥5000 yuan. The main non-vaccination reason for adults with monthly income of ≤10,000 yuan was “lack of vaccine knowledge”, while “Unnecessary to get vaccinated” was the primary reason for the >10,000 yuan group. Television (64.64%), doctor (59.81%), and family member (50.92%) were the main ways of obtaining vaccine information, and individuals aged ≥70 years preferred to obtain vaccine information from family members compared to those aged 50–59 and 60–69 years.

Conclusion

HZ vaccination coverage among individuals aged ≥50 in Zhejiang Province remains low, with higher education and doctor's recommendation identified as key facilitators. A multifaceted strategy is recommended to improve coverage, including targeted health education via trusted channels like television, integrating vaccine prescriptions into clinical practice, and government-subsidized programs to ensure equitable access and reduce disease burden.