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

ABSTRACT

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; n = 78) and physicians (general practitioners and specialists; n = 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.

GRAPHICAL ABSTRACT

KEYWORDS:

• Herpes zoster
• vaccination
• public health
• concept elicitation
• knowledge
• attitude
• practice
• Asia-pacific

Acknowledgments

This study was funded by GlaxoSmithKline Biologicals SA. The authors acknowledge Audrey Colliou, GSK, for operational support, and Roeland van Kerckhoven, GSK, Singapore for publication management. Authors also thank Costello Medical for editorial assistance and publication coordination, on behalf of GSK, and acknowledge Loveena Sharma, Costello Medical, Singapore for medical writing and editorial assistance based on authors’ input and direction.

Disclosure statement

JC, RP, and SS are employed by and have stock ownership in the GSK Group of Companies. MC was employed by the GSK Group of Companies when this study was conducted. EH, HK, and CW are employed by the GSK Group of Companies. JS and RG are employees of Oracle Life Sciences (previously Cerner Enviza), which received fees related to the conduct of this study from the GSK Group of Companies. WSC has received honoraria from the GSK Group of Companies. CKL has received honoraria from the GSK Group of Companies, is a member of the Singapore Medical Council, founder of GP+ Co-operative Ltd, and Chair of Primary Care Networks Council. LMH, HNL, and ATYW have received consulting fees from the GSK Group of Companies. FC, KCH, and YS have nothing to declare.

Authors’ Contributions

Substantial contributions to study conception and design: JC, SS, JS, RG, FC, MC, WSC, EH, KCH, LMH, HK, CKL, HNL, YS, CW, and ATYW; substantial contributions to analysis and interpretation of the data: JC, SS, JS, RG, RP, MC, WSC, EH, KCH, LMH, HK, HNL, YS, CW, and ATYW; drafting the article or revising it critically for important intellectual content: JC, SS, JS, RG, RP, FC, MC, WSC, EH, KCH, LMH, HK, CKL, HNL, YS, CW, and ATYW; final approval of the version of the article to be published: JC, SS, JS, RG, RP, FC, MC, WSC, EH, KCH, LMH, HK, CKL, HNL, YS, CW, and ATYW.

Data availability statement

The datasets generated and/or analyzed during the current study are not publicly available due to maintaining participant confidentiality in qualitative interview recordings.

Ethics approval and consent to participate

This study covered multiple countries/territories and posed minimal risk to study participants. The above-country central Institutional Review Board (IRB), Pearl IRB, fully accredited by the Association of Accreditation of Human Resource Protection Program Inc. (AAHRPP) has confirmed that no ethical approval is required. Informed consent was obtained from all individual participants included in the study.

Supplementary data

Supplemental data for this article can be accessed on the publisher’s website at https://doi.org/10.1080/21645515.2024.2317446.

Additional information

Funding

This study was funded by GlaxoSmithKline Biologicals SA [Study identifier e-Track 217907]. Support for third-party writing assistance for this article, provided by Loveena Sharma, Costello Medical, Singapore was funded by GSK in accordance with Good Publication Practice [GPP 2022] guidelines (https://www.ismpp.org/gpp-2022).