Objective To investigate the vaccination rate and willingness for herpes zoster (HZ) among the elderly in Ningbo city, as well as the influencing factors.

Methods From March to June 2024 A multi-stage stratified cluster random sampling method was employed to select older adults aged ≥ 60 years from 10 districts/counties in Ningbo between March and June 2024 for a questionnaire survey. The awareness rates of HZ and its vaccine, vaccination rate, vaccination willingness, and influencing factors were analyzed.

Results A total of 4 619 older adults were included in the study. The HZ vaccination rate among the surveyed population was 1.04% (48/4619). The primary reason for non-vaccination was lack of awareness about the HZ vaccine (61.63%), followed by perceived lack of necessity (25.89%). Of the elderly, 33.54% (1 533/4 571) expressed willingness to consider HZ vaccination in the future. Multivariate logistic regression analysis revealed that higher HZ vaccination rates were associated with the male gender (OR = 7.063, 95%CI: 3.172–15.727), age ≥ 75 years (OR = 13.289, 95%CI: 5.371–32.878), education background of senior high school or above (OR = 4.022, 95%CI: 1.726–9.374), absence of underlying diseases (OR = 7.299, 95%CI: 3.175–16.949), self-rated health as "relatively good" (compared to "good", OR = 8.667, 95%CI: 2.690–27.924), knowledge score ≥ average (OR = 13.564, 95%CI: 3.120–58.958), and prior introduction of the vaccine by healthcare providers (OR = 3.892, 95%CI: 1.860–8.144). Among unvaccinated respondents, higher willingness for HZ vaccination was observed among residents aged ≥ 75 years (OR = 1.531, 95%CI: 1.323–1.773), with education background of junior high school or below (OR = 1.515, 95%CI: 1.206–1.901), no history of immune-related diseases (OR = 2.725, 95%CI: 1.517–4.902), knowledge score ≥ average (OR = 2.236, 95%CI: 1.943–2.572), and prior introduction of the vaccine by healthcare providers (OR = 3.476, 95%CI: 3.022–3.998).

Conclusions The vaccination rate and willingness for HZ among the elderly in Ningbo are generally low. It is recommended that efforts should be made to enhance health education to improve vaccine awareness and strengthen healthcare professionals' advocacy for vaccination. Additionally, proactive efforts should be made to promote vaccination for HZ among elderly individuals with underlying diseases.