Building on Vaccine Confidence in the Aftermath of the Pandemic: A Qualitative Study in Primary Care Physicians

Objectives: We aimed to document the impact of the COVID-19 pandemic on the public's attitudes and stances towards adult vaccination, as perceived by frontline primary care physicians (PCPs), as well as their proposed strategies to boost vaccine confidence and uptake. Methods: We conducted semi-structured interviews with 25 PCPs, recruited via purposive and snowball sampling from urban, semi-urban, rural and island regions of Greece. Interviews conducted from January to June 2025 were transcribed verbatim, anonymized and analyzed using thematic analysis. Results: PCPs' views on the impact of the pandemic were conflicting. The pandemic reportedly elevated the importance and necessity of adult immunization, brought immunizations into the patient-PCP agenda, and increased trust in PCPs as well as the uptake of other preventive services. Yet PCPs also underscored the increased difficulty in communicating vaccinations and the spillover hesitancy to vaccines. To strengthen vaccine confidence, PCPs proposed invigorating the public's health literacy, recommending vaccinations at any PCP-patient encounter, strengthening health workers' training regarding immunizations and introducing effective health policies on incentives, reinforced PHC services, digital health tools and vaccination sites. Conclusions: Despite heterogenous data on the impact of the pandemic on adult immunization, the urgency to address the challenges and seize the post-pandemic opportunities through public health strategies that reflect health workers' and communities' needs and values was underscored.