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. 2025 Dec;21(1):2488093.
doi: 10.1080/21645515.2025.2488093. Epub 2025 Apr 18.

Herpes zoster vaccination: Primary care provider knowledge, attitudes, and practices

Nikita Stempniewicz  1 , Eric Davenport  2 , Jinyi Wang  2 , Carolyn Sweeney  3
Affiliations

Herpes zoster vaccination: Primary care provider knowledge, attitudes, and practices

Nikita Stempniewicz et al. Hum Vaccin Immunother. 2025 Dec.

Abstract

Primary care providers (PCPs) play a key role in vaccine recommendations and uptake, but limited information exists about PCP knowledge, attitudes, and practices regarding herpes zoster (HZ) vaccination. Clinical trials have shown that recombinant zoster vaccine (RZV) significantly reduces the risk of developing HZ. Hence, RZV is recommended by the US Advisory Committee on Immunization Practices (ACIP) for adults aged ≥50 years and immunocompromised adults aged ≥19 years. However, RZV uptake varies across age groups, and is lower for adults aged 50-59 compared to those aged ≥60 years. Using a cross-sectional web-based survey, this study described provider knowledge of HZ risk factors, ACIP recommendations, attitudes toward HZ vaccination, and HZ vaccination practices/barriers. Among 301 licensed PCPs in the US, knowledge of HZ risk factors was high, but only 29% were fully aware of the ACIP recommendations. PCPs indicated that HZ vaccination was important for patients aged 50-59, 60-69, and ≥70 years, with importance increasing with advancing age. During a typical week, an average of 44% (standard deviation = 32%) of PCPs reported initiating a conversation about HZ vaccination among adults aged 50-59 years. Key perceived barriers to recommending HZ vaccines to adults were contraindications and insufficient time to assess risk factors, while perceived HZ vaccine administration challenges included patients' out-of-pocket costs and lack of motivation. Results suggest that PCPs may benefit from updated information about ACIP recommendations, while both patients and providers may benefit from streamlining the vaccination process and educational efforts focused on addressing perceived barriers.

Keywords: Advisory Committee on Immunization Practices; Recombinant zoster vaccine; herpes zoster; knowledge, attitudes, and practices; primary care providers.

Plain language summary

Shingles (herpes zoster) typically causes a painful rash on the torso, and people often develop pain at the rash site, which can last for several months. Shingles is more common in older people and those whose immune system is compromised. To help prevent shingles, a vaccine called recombinant zoster vaccine (RZV) is recommended in the United States (US) for adults aged 50 years and over and for immunocompromised adults 19 years and over. However, people aged 50–59 years are less likely to have received shingles vaccination compared to older age groups. In this study, 301 primary care providers (PCPs) in the US completed a survey about shingles and vaccination. Most PCPs knew the risk factors for shingles, but only 29% were fully aware of the shingles vaccine recommendations in the US. PCPs generally believed in the importance of vaccinating adults 50 years and over against shingles, with the perceived importance increasing with the patient’s age. The PCPs identified various barriers to shingles vaccination, but interestingly, some of these barriers were based on outdated information, particularly regarding out-of-pocket costs, which have been largely addressed by recent changes in legislation. Providing updated information to PCPs about the current vaccination recommendations for shingles prevention and addressing misconceptions could help to improve shingles prevention. Additionally, educating patients about shingles could further support improvements, and help reduce the overall burden of shingles.

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Conflict of interest statement

Nikita Stempniewicz is employed by, and holds financial equities in, GSK. Eric Davenport, Jinyi Wang, and Carolyn Sweeney are employed by RTI Health Solutions, which received funding from GSK to conduct the research that is the subject of this publication. RTI Health Solutions also received funding from other pharmaceutical companies to conduct research not related to this work. The authors declare no other financial and non-financial relationships and activities.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Knowledge of the approved indications for HZ vaccination (Q15)*.
Figure 2.
Figure 2.
Knowledge of the ACIP recommendations for HZ vaccination (Q16)*.
Figure 3.
Figure 3.
Perceived (a) risk of developing HZ (Q20), (b) importance of HZ vaccination (Q21), and (c) likelihood of recommending HZ vaccination (Q22), according to patient age.
See this image and copyright information in PMC

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