The barriers and facilitators of herpes zoster vaccination intentions of urban residents in China: a qualitative study

Abstract Background In an aging society, herpes zoster (HZ) increases the health burden on infected patients. While quantitative studies point to a lack of willingness to accept the HZ vaccine in China, there is limited number of studies with in-depth qualitative analysis on HZ vaccination intention...

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Main Authors: Beibei Yuan, Chao Long, Ming Wang, Elizabeth Maitland, Stephen Nicholas, Xianjing Qin, Weiying Zhao, Dawei Zhu, Ping He
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Global Health Research and Policy
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Online Access:https://doi.org/10.1186/s41256-025-00413-1
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author Beibei Yuan
Chao Long
Ming Wang
Elizabeth Maitland
Stephen Nicholas
Xianjing Qin
Weiying Zhao
Dawei Zhu
Ping He
author_facet Beibei Yuan
Chao Long
Ming Wang
Elizabeth Maitland
Stephen Nicholas
Xianjing Qin
Weiying Zhao
Dawei Zhu
Ping He
author_sort Beibei Yuan
collection DOAJ
description Abstract Background In an aging society, herpes zoster (HZ) increases the health burden on infected patients. While quantitative studies point to a lack of willingness to accept the HZ vaccine in China, there is limited number of studies with in-depth qualitative analysis on HZ vaccination intention. This study undertakes a qualitive study method to identify the barriers and facilitators behind urban residents’ HZ vaccination intention in three China cities, and contributes towards some targeted vaccination promotion suggestions to China and other LMICs with similar low coverage of HZ vaccination. Methods We conducted 12 focus group discussions in three cities of China. In each discussion we recruited 3 to 6 participants aged 20 and older to catch the views on the HZ vaccine from residents with a wider age range. Participants were recruited by purposive sampling techniques. Guided by the health belief model, thematic analysis was used to group participants’ HZ vaccine attitudes and to identify the barriers and facilitators to HZ vaccination. Results The attitude of 59 participants participating in the focus group discussions showed a low-level acceptability of the HZ vaccine with only 27.1% (16/59) displaying a willingness to HZ vaccine uptake. The barriers to HZ vaccination included limited or incorrect conception on HZ prevalence, risk factors, susceptibility, symptoms, prevention and treatment methods, and the high cost of the HZ vaccine. Perceived vulnerability to HZ, fear of HZ pain and individuals' financial capacity were the strongest facilitators to HZ vaccination. In addition, it was found that advocacy of HZ vaccination by health professionals or government financial subsidies to HZ vaccination, could attenuate the above barriers to HZ vaccine uptake. Conclusions Our study revealed a series of barriers and facilitators of HZ vaccination intention. We recommend HZ education and advocacy by health workers and government health officials to address the limited HZ knowledge and HZ misconceptions, and the government (or health insurance providers) to pay or subsidize the high costs of HZ vaccination to increase the HZ vaccination rate.
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spelling doaj-art-3177bd933d1441ee98f30241fb40d9212025-08-20T03:18:27ZengBMCGlobal Health Research and Policy2397-06422025-04-0110111310.1186/s41256-025-00413-1The barriers and facilitators of herpes zoster vaccination intentions of urban residents in China: a qualitative studyBeibei Yuan0Chao Long1Ming Wang2Elizabeth Maitland3Stephen Nicholas4Xianjing Qin5Weiying Zhao6Dawei Zhu7Ping He8China Center for Health Development Studies, Peking UniversityChina Center for Health Development Studies, Peking UniversityChina Center for Health Development Studies, Peking UniversitySchool of Management, University of LiverpoolHealth Services Research and Workforce Innovation Centre, Newcastle Business School, University of NewcastleHealth Policy Research Center, Guangxi Medical UniversitySchool of Medicine, Shaoxing UniversityDepartment of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking UniversityChina Center for Health Development Studies, Peking UniversityAbstract Background In an aging society, herpes zoster (HZ) increases the health burden on infected patients. While quantitative studies point to a lack of willingness to accept the HZ vaccine in China, there is limited number of studies with in-depth qualitative analysis on HZ vaccination intention. This study undertakes a qualitive study method to identify the barriers and facilitators behind urban residents’ HZ vaccination intention in three China cities, and contributes towards some targeted vaccination promotion suggestions to China and other LMICs with similar low coverage of HZ vaccination. Methods We conducted 12 focus group discussions in three cities of China. In each discussion we recruited 3 to 6 participants aged 20 and older to catch the views on the HZ vaccine from residents with a wider age range. Participants were recruited by purposive sampling techniques. Guided by the health belief model, thematic analysis was used to group participants’ HZ vaccine attitudes and to identify the barriers and facilitators to HZ vaccination. Results The attitude of 59 participants participating in the focus group discussions showed a low-level acceptability of the HZ vaccine with only 27.1% (16/59) displaying a willingness to HZ vaccine uptake. The barriers to HZ vaccination included limited or incorrect conception on HZ prevalence, risk factors, susceptibility, symptoms, prevention and treatment methods, and the high cost of the HZ vaccine. Perceived vulnerability to HZ, fear of HZ pain and individuals' financial capacity were the strongest facilitators to HZ vaccination. In addition, it was found that advocacy of HZ vaccination by health professionals or government financial subsidies to HZ vaccination, could attenuate the above barriers to HZ vaccine uptake. Conclusions Our study revealed a series of barriers and facilitators of HZ vaccination intention. We recommend HZ education and advocacy by health workers and government health officials to address the limited HZ knowledge and HZ misconceptions, and the government (or health insurance providers) to pay or subsidize the high costs of HZ vaccination to increase the HZ vaccination rate.https://doi.org/10.1186/s41256-025-00413-1BarriersFacilitatorsHerpes zoster vaccinateVaccine hesitancyQualitative study
spellingShingle Beibei Yuan
Chao Long
Ming Wang
Elizabeth Maitland
Stephen Nicholas
Xianjing Qin
Weiying Zhao
Dawei Zhu
Ping He
The barriers and facilitators of herpes zoster vaccination intentions of urban residents in China: a qualitative study
Global Health Research and Policy
Barriers
Facilitators
Herpes zoster vaccinate
Vaccine hesitancy
Qualitative study
title The barriers and facilitators of herpes zoster vaccination intentions of urban residents in China: a qualitative study
title_full The barriers and facilitators of herpes zoster vaccination intentions of urban residents in China: a qualitative study
title_fullStr The barriers and facilitators of herpes zoster vaccination intentions of urban residents in China: a qualitative study
title_full_unstemmed The barriers and facilitators of herpes zoster vaccination intentions of urban residents in China: a qualitative study
title_short The barriers and facilitators of herpes zoster vaccination intentions of urban residents in China: a qualitative study
title_sort barriers and facilitators of herpes zoster vaccination intentions of urban residents in china a qualitative study
topic Barriers
Facilitators
Herpes zoster vaccinate
Vaccine hesitancy
Qualitative study
url https://doi.org/10.1186/s41256-025-00413-1
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