BACKGROUND: Compared to other vaccines recommended for the elderly, the effectiveness of health education in improving the willingness to vaccinate the herpes zoster vaccine (HZV) in low-come residents remains unclear. METHODS: We recruited elderly participants from villages in Lingcheng District, and assigned each village to one of three health education interventions: oral health education, brochure-based health education, or video health education. The follow-up surveys were conducted immediately after each intervention. Baseline survey and the fifth follow-up were conducted at the beginning and end of the study, respectively. We assessed respondents' willingness to vaccinate the HZV under different pricing scenarios, as well as their reasons for accepting or refusing to vaccinate HVZ. Latent class growth analysis was used to identify potential similar trends in vaccination willingness. RESULTS: Of 1027 recruited, 946 completed 5 follow-ups. Data shows only when HZV was free, willingness to vaccinate could increase significantly across all interventions. Heterogeneity among population clusters has been identified on intervention effectiveness and comorbidity may be an important cause. Vaccine effectiveness and personal infection risk motivated acceptance, while accessibility and affordability were barriers. CONCLUSION: Health education improves HZV vaccination willingness, under free pricing scenario. Lowering HZV costs through health insurance or affordable options is necessary for successful education initiatives.