Abstract

This cross-sectional study assessed varicella zoster virus (VZV) immunity and vaccination uptake among 180 children and adolescents aged 1–18 years in urban and rural areas of Northern Lebanon. Overall IgG seroprevalence was 79.4%, indicating prior infection or vaccination, while recent infection (IgM positivity) was detected in 5% of participants. IgG seropositivity was substantially higher among those who completed the two-dose vaccination schedule (89.5%) compared with those who received one dose (63.6%), confirming the superior immunogenicity of the complete regimen. Parental history of varicella was a highly reliable predictor of seropositivity. Despite this, vaccination coverage remained suboptimal, with major barriers including preference for natural infection, perceived lack of necessity, and cost. Regular pediatric follow-up strongly predicted vaccine uptake, whereas low parental awareness reduced it. These findings highlight persistent susceptibility to VZV and support the urgent inclusion of varicella vaccination in Lebanon’s national immunization program, alongside targeted parental education and strengthened pediatric healthcare engagement.