Associations of herpes zoster disease perceptions, altruism and family harmony with herpes zoster vaccination uptake among older adults in Shenzhen, China

Herpes zoster (HZ) poses a substantial health burden among older adults, yet HZ vaccination coverage remains low in mainland China. This study examined the associations between HZ vaccination uptake and factors at both individual and interpersonal levels. This was a cross-sectional survey conducted in Shenzhen, China, between August and October 2024. A total of 1,556 Shenzhen residents aged ≥60 y with established administrative health records were recruited through multistage random sampling. Multivariable multilevel logistic regression models were fitted (level 1: individual participants; level 2: community health centers). Among the participants, 8.0% received a HZ vaccination. After adjusting for background characteristics that were significantly associated with HZ vaccination uptake in the literature and this study, better understanding (coherence) (AOR: 1.15, 95%CI: 1.07, 1.24) was associated with higher HZ vaccination uptake. Being tired of receiving repeated vaccination (vaccination fatigue) (AOR: 0.79, 95%CI: 0.62, 0.99) was correlated with lower HZ vaccination uptake. There is a strong need to improve HZ vaccination coverage among older adults in China. These findings identified potentially modifiable psychosocial factors that warrant evaluation in prospective or intervention studies.