Uptake, Willingness, and Determinants of Herpes Zoster Vaccination in Adults with Chronic Diseases in Riyadh, Saudi Arabia

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.