In an era where infectious diseases continue to challenge global health infrastructure, the study of vaccination uptake and the myriad factors influencing it becomes paramount. A recent qualitative investigation conducted in urban China provides a profound insight into the behavioral and systemic intricacies surrounding herpes zoster vaccination intentions. Herpes zoster, commonly known as shingles, poses significant morbidity risks, especially among the elderly, making vaccination a critical preventive measure. Yet, despite the availability of effective vaccines, uptake remains suboptimal in many urban settings, a phenomenon this new research endeavors to illuminate.
Herpes zoster vaccination is unique in that it targets a virus that remains latent in the body and reactivates later in life, primarily affecting older adults and immunocompromised individuals. The clinical burden of shingles includes severe neuropathic pain, known as postherpetic neuralgia, which can severely diminish patients’ quality of life. Therefore, understanding vaccination dynamics in densely populated urban areas where healthcare resources are relatively accessible holds valuable lessons for public health strategies.
This study adopts a qualitative methodology, emphasizing the lived experiences and perceptual frameworks of urban residents in China. By delving into individual narratives, the research unveils the complex interplay of cultural beliefs, knowledge gaps, health literacy, and systemic barriers that collectively shape vaccine decision-making. The approach contrasts with quantitative surveys by allowing a richer, more nuanced understanding of the psychological and social dimensions influencing health behaviors.
One of the pivotal findings centers on the role of informational accessibility and trust. Interviewees expressed ambivalence and sometimes skepticism towards vaccine safety and efficacy. Despite endorsement by healthcare professionals, misinformation and anecdotal adverse event reports amplify hesitations. This distrust is compounded by inconsistent messaging across media platforms and a perceived lack of tailored communication by health authorities, underscoring the critical need for targeted educational campaigns that resonate with urban populations.
Moreover, the study highlights logistical challenges as a significant barrier. While urban centers in China boast advanced medical infrastructure, issues such as inconvenient clinic hours, costs associated with vaccination, and bureaucratic hurdles dampen the motivation to pursue vaccination. These practical impediments emphasize that beyond awareness, structural facilitators must be optimized to translate intention into action.
Sociocultural dynamics also emerged as influential components. The cultural context in China, where traditional medicine and health practices hold sway, sometimes engenders conflicting attitudes towards Western preventative interventions like vaccines. For some participants, these traditional perspectives foster skepticism or preference for alternative remedies. The intersection of cultural belief systems with modern healthcare paradigms creates a delicate environment in which public health messaging must be carefully crafted to avoid alienation.
The study further exposes the role of perceived susceptibility and severity in vaccination intent. Individuals who considered themselves at high risk for complications or who had personal or familial experiences with herpes zoster were more inclined to seek vaccination. This psychological appraisal of risk informs the adoption of preventive behaviors, pointing to the potential effectiveness of personalized risk communication strategies to bolster vaccine uptake.
Notably, social influences and norms play a catalytic role. The endorsement or discouragement from family members, peers, and community leaders significantly sways individual decisions. The communal fabric and collective decision-making models prominent in Chinese society render social networks as vital channels for disseminating pro-vaccination attitudes. Leveraging these networks could, therefore, amplify positive health behaviors on a population scale.
A key facilitator identified involves trust in healthcare providers. Positive patient-provider relationships and recommendations from trusted medical professionals significantly enhance vaccination intentions. Such findings advocate for empowering healthcare workers with comprehensive information and communication skills to effectively counsel patients about herpes zoster vaccination benefits and address concerns.
Additionally, the study addresses the impact of policy and insurance coverage on vaccination intentions. Participants cited cost as a deterrent, highlighting the imperative for public health policies that subsidize or otherwise reduce the financial burden associated with immunization. In contexts where vaccination is not fully covered, disparities in uptake are more pronounced, potentially exacerbating health inequities.
In exploring the psychological constructs underlying vaccine hesitancy, the study also incidentally acknowledges the global parallels. Vaccine hesitancy is a multifaceted phenomenon influenced by trust, knowledge, and socio-environmental factors worldwide. The insights drawn from urban China contribute to the broader discourse on how tailored approaches, respecting cultural, societal, and infrastructural variations, can shape successful immunization campaigns globally.
Furthermore, this research underscores the importance of dynamic and adaptable public health strategies. The urban landscape in China is rapidly evolving, characterized by shifting demographics, economic factors, and health system reforms. Public health initiatives must therefore be nimble, incorporating ongoing feedback from urban residents to remain relevant and effective in mitigating vaccine-preventable diseases such as herpes zoster.
The implications of the study extend beyond vaccination intentions to inform health communication, service delivery design, and policy formulation. By elucidating the barriers and facilitators from the perspective of the target population, policymakers and healthcare providers gain actionable intelligence to tailor interventions. The incorporation of community voices into program development invariably promotes more sustainable health outcomes.
In summary, the qualitative analysis of barriers and facilitators for herpes zoster vaccination in Chinese urban populations adds a critical dimension to the understanding of vaccine uptake dynamics. The interplay of trust, culture, accessibility, and social influence elucidated by this study offers a roadmap for enhancing immunization strategies in similar demographic contexts worldwide. As the global community grapples with vaccine hesitancy, these findings signal the enduring need for context-sensitive, person-centered approaches to public health promotion.
The comprehensive nature of this study highlights the potential for future research to expand upon these findings, exploring intervention efficacy or comparing rural versus urban perspectives. As the burden of herpes zoster represents a growing public health challenge with aging populations, optimized vaccination programs supported by insights such as these could yield significant benefits in morbidity reduction and healthcare resource optimization.
Ultimately, this research embodies the critical nexus of behavioral science, epidemiology, and health policy, reinforcing that tackling vaccine hesitancy requires an integrated, multidisciplinary effort. The nuanced understanding gained from the voices of urban Chinese residents offers a valuable template that can inspire similar qualitative inquiries elsewhere, advancing the global mission of enhancing vaccine coverage and protecting vulnerable populations from preventable diseases.
Subject of Research: Barriers and facilitators influencing herpes zoster vaccination intentions among urban residents in China.
Article Title: The barriers and facilitators of herpes zoster vaccination intentions of urban residents in China: a qualitative study.
Article References:
Yuan, B., Long, C., Wang, M. et al. The barriers and facilitators of herpes zoster vaccination intentions of urban residents in China: a qualitative study. glob health res policy 10, 19 (2025). https://doi.org/10.1186/s41256-025-00413-1
Image Credits: AI Generated

