The acceptability of and willingness to pay for a herpes zoster vaccine: A systematic review

Abstract

Patients, predominantly the elderly, with Herpes Zoster (HZ) not only suffer symptoms of the disease but also bear considerable expenses. This study systematically reviewed the acceptability of and willingness to pay for the HZ vaccine. This review was registered in PROSPERO 2023 (CRD42023403062). We used “acceptance”, “willing to pay”, and “HZ vaccine” (and variations thereof) as keywords in a systematic search for original English research articles published up to April 7, 2023. The search was conducted over Scopus, PubMed, ScienceDirect, Cochrane, and Google Scholar in accordance with PRISMA 2020 guidelines. The inclusion criteria were as follows: studies (1) that mentioned HZ vaccination, (2) related to acceptability or willingness to pay, and (3) with full texts available and peer-reviewed prior to final publication. Grey literature, letters to editors, commentaries, case reports or series, systematic reviews, meta-analyses, articles of poor quality, and articles with ambiguously defined and measured outcome variables were excluded. The Joanna Briggs Institute (JBI) critical appraisal checklist was used to evaluate the methodological quality of the studies. Finally, the search yielded 24 studies, of which 9 were conducted in Asia, 8 in Europe, and 7 in America. General adults or patients aged 50 or older were often the target populations, for whom treatments were accompanied by healthcare providers’ recommendations. The willingness to pay and willingness to accept the vaccine ranged from $8 to $150 and 16.6% to 85.8%, respectively. Compared to the US, Asia and Europe had higher acceptance rates for HZ immunization. The most frequent excuses given for not being vaccinated are side effects, cost, lack of recommendations, anti-vaccination views, ignorance about the HZ vaccine, and the belief that one is not at risk for the disease. National campaigns should be developed to increase public awareness of HZ, and more international research should be conducted to understand the WTA and WTP for HZ immunizations.