Knowledge, attitude, and practice toward herpes zoster (HZ) and HZ vaccination: Concept elicitation findings from a multi-country study in the Asia Pacific

Figures & data

Table 1. Screening criteria for respondents enrolled in the study.

Respondent Group	Screening Criteria
Respondents ≥50 years and naïve of HZ (regardless of past HZ vaccination, except for Republic of Korea)	≥50 years Aware of HZ Non-rejectors of preventive vaccines Middle to upper income Never experienced HZ Able to read and understand English and/or Traditional Chinese (Hong Kong); Traditional Chinese (Taiwan); English and/or Simplified Chinese (Singapore); Korean (Republic of Korea) Able to provide informed consent via e-mail and complete the interview via virtual platforms Not a board-certified physician
Respondents ≥50 years and have been vaccinated with a ZVL vaccine (Republic of Korea only)	≥50 years Aware of HZ Non-rejectors of preventive vaccines Middle to upper income ZVL-vaccinated Able to read and understand Korean Able to provide informed consent via e-mail and complete the interview via virtual platforms Not a board-certified physician
Adults with parents aged ≥50 years	30–49 years Has parent(s) ≥50 years Aware of HZ Key decision maker/makes decisions together as a family regarding healthcare (including vaccination) decisions for their parents Non-rejectors of preventive vaccines Middle to upper income Working or financially independent Able to read and understand English and/or Traditional Chinese (Hong Kong); Traditional Chinese (Taiwan); English and/or Simplified Chinese (Singapore); Korean (Republic of Korea) Able to provide informed consent via e-mail and complete the interview via virtual platforms Not a board-certified physician
Current or former HZ patients	≥50 years Aware of HZ Non-rejectors of preventive vaccines Middle to upper income Currently experiencing or has been previously diagnosed with HZ Able to read and understand English and/or Traditional Chinese (Hong Kong); Traditional Chinese (Taiwan); English and/or Simplified Chinese (Singapore); Korean (Republic of Korea) Able to provide informed consent via e-mail and complete the interview via virtual platforms Not a board-certified physician
Physicians (including GPs and specialists)	At least 3 years of clinical experience in their specialty Treats HZ patients and/or is responsible for administering or recommending vaccines for adults in routine practice Able to provide informed consent via e-mail and complete the interview via virtual platforms

GP: general practitioner; HZ: herpes zoster; ZVL: zoster vaccine live.

Table 2. Sample size of respondents per country/territory for qualitative interviews.

		Hong Kong (n= 24)	Singapore (n = 24)	Republic of Korea (n = 30)	Taiwan (n = 24)
General Population (n = 102)
Respondents ≥50 years and naïve of HZ (regardless of past HZ vaccination, except for Republic of Korea)	50–64 years	3	3	3 (non-vaccinated)	3
	≥65 years	3	3	3 (non-vaccinated)	3
Respondents ≥50 years and have been vaccinated with a ZVL vaccine (Republic of Korea only)	50–64 years	-	-	3	-
	≥65 years	-	-	3	-
Adults with parents aged ≥50 years		6	6	6	6
Current or former HZ patients	Mild^a	3	3	3	3
	Moderate/severe^b	3	3	3	3
Physicians (Including GPs and Specialists; n = 24)
GP/ Family medicine/ Internal medicine		3	3	4	3
Infectious disease specialist		1	1	1	1
Geriatrician		1	1	-	1
Dermatologist		1	1	1	1

^aMild HZ was defined as having symptoms including mild skin irritation/itching and rash, mild pain and burning, tingling, numbness in a small area on one side of the body, fever, low energy, headaches, chills, feeling unwell, aching muscles, nausea, vomiting, and diarrhea; ^bModerate HZ was defined as having symptoms including painful rash, fluid-containing blisters on one side of the body, and stronger pain that is sharp, stabbing, and intense. Sensitivity of skin to touch may significantly impact daily living (e.g., pain while putting on clothes or having anything touch the skin, such as bed linen). Severe HZ was defined as having symptoms that may last for long periods (e.g., many months) as well as spread to other parts of the body, or reoccur, resulting in inflammatory relapses. In addition to the painful rashes and blisters, there may be severe pain which impacts daily living, lasts three months or more after the initial rash, other conditions such as insomnia, weight loss, depression, and disability. Eye infections and vision loss (if HZ is in or near the eye), eye-related disease and disorders, hearing or balance problems, weakness of muscles on the affected side of the face (if HZ is within or near the ear), as well as brain-related infections, diseases and disorders may also occur. GP: general practitioner; HZ: herpes zoster; ZVL: zoster vaccine live.

Figure 1. Study flowchart.

COM-B: Capability, Opportunity, Motivation and Behavior; IRB: Institutional Review Board; HZ: herpes zoster.

Data availability statement

The datasets generated and/or analyzed during the current study are not publicly available due to maintaining participant confidentiality in qualitative interview recordings.