Knowledge, attitude, and practice toward herpes zoster (HZ) and HZ vaccination: Concept elicitation findings from a multi-country study in the Asia Pacific

Herpes zoster (HZ) is a prevalent disease characterized by a painful rash. A multi‑country study was conducted to elicit public and physician knowledge, attitude, and practice (KAP) toward HZ disease and vaccination for the assessment of local factors influencing HZ vaccine perceptions in four Asian-Pacific countries/territories One-to-one qualitative interviews were conducted in 2022, among the public (people aged ≥ 50 years, adults with parents aged ≥ 50 years, zoster vaccine live-vaccinated individuals aged ≥ 50 years in Republic of Korea, and HZ patients; <i>n</i> = 78) and physicians (general practitioners and specialists; <i>n</i> = 24). Themes surrounding KAP toward HZ and HZ vaccination were summarized using a thematic analysis. A substantial knowledge gap related to HZ was observed among the public, including its causes, long-term impacts, and the at-risk population. There was a low perceived risk of HZ and low general awareness of HZ vaccine availability, although country/territory-specific differences existed. Fear of HZ-associated pain contributed toward vaccination intent among HZ patients and adults with parents aged ≥ 50 years. HZ-naïve adults who were encouraged to receive the vaccine by others were not motivated to do so due to optimism bias. Physicians were perceived to be a reliable source of information. However, physicians did not always proactively discuss HZ vaccination due to time constraints and a perceived need to prioritize other vaccinations including influenza and pneumococcal vaccines. Initiatives are needed to improve public awareness of HZ and its complications, in terms of overall impact on individuals and society, and highlight the important role of physicians in recommending vaccination.

带状疱疹（Herpes zoster, HZ）是一种以疼痛性皮疹为特征的常见疾病。本研究为一项多国研究，旨在针对亚太地区4个国家/地区，调研公众与医师对带状疱疹及其疫苗接种的知识、态度与实践（Knowledge, Attitude, Practice, KAP），以评估影响带状疱疹疫苗认知的本土因素。2022年开展了一对一定性访谈，受访对象包括公众（年龄≥50岁的人群、父母年龄≥50岁的成年人、韩国境内年龄≥50岁的带状疱疹减毒活疫苗接种者，以及带状疱疹患者，共78例）与医师（全科医师与专科医师，共24例）。本研究采用主题分析法对围绕带状疱疹及带状疱疹疫苗接种的KAP相关主题进行了归纳总结。调研发现公众对带状疱疹的认知存在显著缺口，涵盖其病因、长期影响以及易感人群等方面。尽管不同国家/地区间存在差异，但公众对带状疱疹的感知患病风险普遍较低，且对带状疱疹疫苗可及性的知晓率偏低。对带状疱疹相关性疼痛的恐惧，是带状疱疹患者与父母年龄≥50岁的成年人产生疫苗接种意愿的驱动因素之一。虽经他人鼓励接种疫苗，但未患过带状疱疹的成年人因乐观偏差而未产生接种动机。公众认为医师是可靠的信息来源，但由于时间有限，且认为需优先开展流感疫苗、肺炎球菌疫苗等其他疫苗的接种宣教，医师并未始终主动提及带状疱疹疫苗接种事宜。亟需采取相关举措，提升公众对带状疱疹及其并发症的认知，阐明其对个体与社会的整体影响，并强调医师在推荐疫苗接种方面的重要作用。