Abstract
Background/Objectives: Herpes zoster (HZ) poses a substantial risk to adults aged ≥ 50, particularly those with chronic disease, and may lead to postherpetic neuralgia. Following Saudi Arabia's introduction of the recombinant zoster vaccine (RZV), we assessed the RZV's uptake among adults ≥ 50 and their willingness to receive it and examined how knowledge and attitudes influenced these outcomes. Methods: In 2024, we conducted a cross-sectional, interview-based study in the outpatient clinics of a Riyadh tertiary hospital using a structured questionnaire adapted from the literature to assess knowledge, attitudes, and practices regarding HZ and RZV. Results: Among 333 participants, HZ vaccine uptake was low (12%). Among the unvaccinated, 45.7% (134/293) were willing to be vaccinated, and knowledge of HZ and RZV was low (mean: 3.84/14). Uptake was most strongly associated with physician recommendation (OR: 7.5; 95% CI: 2.79-20.11), followed by greater knowledge (OR: 1.42; 95% CI: 1.19-1.67). Willingness was best predicted by higher attitude scores (OR: 1.28; 95% CI: 1.12-1.48). The most reported barrier was low perceived risk (27%; n = 79). Conclusions: Uptake among adults aged ≥50 with chronic disease was low due to poor knowledge and low perceived risk, yet many were willing to be vaccinated. Enhancing physician-patient counseling and targeted campaigns addressing HZ risk and RZV misconceptions could increase uptake.