Attitudes of healthcare workers toward recommending vaccination against herpes zoster: a study based on the health belief model and theory of planned behavior.

Objective: To examine Chinese healthcare workers' (HCWs') attitudes toward promoting the herpes zoster (HZ) vaccine, using the Health Belief Model (HBM), the Theory of Planned Behavior (TPB), and dissemination theories. Methods: A cross-sectional survey was conducted among HCWs from multiple provinces and provincial-level municipalities in China between November 2023 and February 2024. The questionnaire assessed HZ-related knowledge, constructs derived from the Health Belief Model, subjective norms from the Theory of Planned Behavior, and dissemination- and organizational-level factors. Hierarchical multiple linear regression analyses were performed to examine associations with attitudes toward HZ vaccine promotion. Results: Healthcare workers' demonstrated an overall moderate level of knowledge regarding HZ and its vaccination. In regression analyses, perceived severity, perceived benefits, perceived barriers, and self-efficacy were significantly associated with attitudes toward HZ vaccine promotion, whereas perceived susceptibility was not. Subjective norms, leadership involvement, and perceived timelines for vaccination implementation were also positively associated with attitudes. The explanatory power of the models increased sequentially with the inclusion of TPB and organizational factors. Conclusion: While Chinese healthcare workers generally support HZ vaccine promotion, gaps remain in policy awareness and personal vaccination uptake. Using an integrated framework informed by the HBM, TPB, and dissemination theory, this study shows that HCWs' attitudes toward HZ vaccine promotion are shaped by both individual belief-based factors and organizational context. Interventions aiming to strengthen HZ vaccine promotion should address perceived benefits, barriers, and self-efficacy while fostering supportive institutional environments.