Awareness and uptake of herpes zoster vaccine among patients with diabetes mellitus in the Aseer Region, Saudi Arabia: A cross-sectional study

Abstract

Herpes zoster (HZ) is a reactivation of the varicella-zoster virus. It is a common infection, especially among patients with diabetes mellitus (DM). This study aimed to assess the awareness and uptake of the HZ vaccine, as well as their determinants, among patients with diabetes DM in the Aseer Region, Saudi Arabia. An anonymous cross-sectional study was conducted using a self-administered questionnaire between July 1, 2024 and October 31, 2024. We randomly included participants aged 18 years or older with DM. The questionnaire addressed socio-demographic characteristics, medical history regarding HZ, diabetes control, awareness, perception, and uptake practices regarding the HZ vaccine. A total of 200 participants were included: 34.5% were aged over 50 years, 51.0% were males, 90.5% were Saudi, 68.0% were married, 40.5% held a university degree, 67.0% were nonsmokers, and 57.0% had chronic diseases other than DM. Of the studied participants, 18.5% reported a previous HZ infection. Older age, smoking, and comorbid chronic illnesses were significantly associated with HZ infection. A majority expressed positive perception toward the vaccine's effectiveness (77.0%), safety (82.5%), and side effects (80.0%). However, only 21.5% had actually received the vaccine. Predictors of awareness were being aged over 50 years (adjusted odds ratio [aOR] = 4.44, 95% confidence interval [CI]: 1.36-14.54, P = .014), divorced individuals [aOR = 12.70, 95% CI: 1.52-106.43, P = .019), and being nonsmokers (aOR = 0.36, 95% CI: 0.16-0.81, P = .014). The perceived side effects of the vaccine emerged as a significant predictor of vaccine uptake. Specifically, participants who believed the vaccine causes no side effects (aOR = 22.37, 95% CI: 2.31-216.32, P = .007). This study reveals a concerningly low vaccine uptake despite high levels of awareness and positive perception toward its effectiveness and safety. Efforts to maintain the high awareness and promote vaccination are needed.

Keywords: Saudi Arabia; diabetes mellitus; health service utlization; herpes zoster; vaccine hesitancy.

Figure 1.

Medical history regarding herpes zoster infection among the study participants.

Figure 2.

Awareness, behavior, and practices regarding the shingles vaccine among the study participants.

Figure 3.

Sources of advice on receiving the herpes zoster vaccine.