Herpes zoster vaccine intention among patients with systemic lupus erythematosus: a health belief model–based cross-sectional study

Introduction The herpes zoster (HZ) vaccine has the potential to provide significant health benefits for patients with SLE given their heightened susceptibility to infection. However, its uptake remains limited by various barriers, including patient vaccination behavior. This study examines the influence of demographic factors, knowledge, and Health Belief Model–based perceptions on HZ vaccination behavior among SLE patients in Indonesia. Methods A cross-sectional, questionnaire-based study was carried out at Ciptomangunkusumo Hospital, Jakarta, from August to October 2025. Data were obtained through face-to-face interviews using a validated Indonesian questionnaire assessing sociodemographic characteristics, vaccination history, knowledge, and related perceptions. The primary outcome was intention to receive the vaccine. Bivariate and multivariate analyses were performed to determine independent predictors. Results Among 333 participants, 23.4% had prior HZ and 0.6% had been vaccinated. Vaccination intention was higher in those with prior HZ, prior awareness, higher perceived risk, and belief in vaccine effectiveness. Cues to action and perceived benefits significantly increased intention, while barriers reduced it. Multivariate analysis identified urban residence, HZ history, use of immunosuppressants, vaccine awareness, trust in efficacy, eligibility confidence, health-care provider recommendation, and perceived susceptibility as key determinants. Conclusion A substantial gap was observed between HZ vaccination coverage (0.6%) and intention (43.2%) among patients with SLE. Healthcare recommendation and financial policies may help overcome key barriers and improve vaccine uptake among this high-risk population.