Knowledge of Herpes Zoster and Attitudes Toward Vaccination: A Questionnaire-Based Study in Outpatient and Online Settings.

BACKGROUND/OBJECTIVES: Herpes zoster (HZ) vaccination rates remain low globally despite the availability of effective recombinant vaccines. This study aimed to assess knowledge of HZ and HZ vaccination, willingness to vaccinate, and factors associated with vaccination willingness among at-risk populations in both outpatient clinic and online survey settings in Poland. METHODS: A questionnaire-based cross-sectional study was conducted between May and September 2025 in outpatient primary care clinics operated by Medical Center Medyk (Podkarpackie Voivodeship, southeastern Poland) and via online social media platforms. Participants included individuals aged ≥50 years with a history of HZ and individuals aged ≥18 years with at least one recognised HZ risk factor. Multivariable logistic regression and classification and regression tree (CART) analysis were employed to identify predictors of vaccination willingness. RESULTS: Valid responses were obtained from 212 onsite and 241 online participants. A prior history of HZ was significantly associated with correct responses to several knowledge items concerning HZ and HZ vaccination in both settings. Over 40% of initially hesitant or unwilling onsite participants reported a positive change in vaccination intention following medical consultation. CART models demonstrated good discriminative performance (AUC: online 0.841, onsite 0.861). The primary difference between settings was the source of information: online participants relied more heavily on the internet, whereas onsite participants more frequently cited healthcare professionals. CONCLUSIONS: Personal experience with HZ and engagement with healthcare professionals significantly influence vaccination willingness. Targeted educational interventions delivered through appropriate communication channels, with emphasis on physician engagement, may help improve vaccination willingness among at-risk populations.