Abstract
OBJECTIVE: This study aims to evaluate adults' willingness to receive the herpes zoster (HZ) vaccine in Saudi Arabia and identify key factors influencing their decisions. METHODS: A cross-sectional study was conducted among adults aged ≥18 years across five Saudi regions from August to September 2024. Data were collected using an Arabic electronic questionnaire covering vaccination prevalence, knowledge, willingness, barriers, and strategies to enhance HZ vaccine uptake. RESULTS: Among 579 participants, only 14.3% of older adults aged 50+ years (54/377) received the vaccine, with an overall HZ vaccination rate of 10.9%. The primary motivators were healthcare provider recommendations (57.1%) and awareness of benefits (34.9%). Of non-vaccinated individuals, 51.7% expressed willingness to vaccinate if barriers were removed, while 48.3% remained unwilling. The main barrier was a lack of awareness (41.9%). Vaccination rates were significantly higher among residents of the eastern region (26.5%, p = 0.001), those aged 60+ years (25.6%, p = 0.001), and urban residents (12.6%, p = 0.004). Among the non-vaccinated, willingness to vaccinate was higher among individuals from the southern region (64.3%, p = 0.001), aged 30-49 years (53.8%, p = 0.001), urban dwellers (52.3%, p = 0.004), highly educated (56.4%, p = 0.020), recipients of other vaccines (57.7%, p = 0.001), and those with prior shingles diagnoses (57.9%, p = 0.006). CONCLUSION: HZ vaccination remains underutilized in Saudi Arabia despite moderate awareness levels. Healthcare provider recommendations, public education, and system-level interventions are critical to improving uptake. National strategies must address disparities in access, knowledge, and provider engagement to enhance preventive healthcare outcomes for at-risk populations.