General practitioners' perceptions of the burden of RSV and views on RSV immunisation: a qualitative interview study

Abstract

Background: Respiratory syncytial virus (RSV) is a major cause of respiratory infections. With newly approved RSV immunisations for infants and older adults, understanding general practitioners' (GPs) perceptions is crucial for effective implementation of immunisation strategies. Methods: We conducted a qualitative study to explore GPs' perceptions of the RSV disease burden and their views on RSV immunisation. Thirteen GPs from the Netherlands participated in semi-structured remote interviews (May–October 2024). Interviews were video-recorded, transcribed verbatim and analysed using thematic and framework analysis, applying the Theoretical Domains Framework to identify behavioural influences. Results: GPs predominantly associate RSV with bronchiolitis in infants, recognizing a substantial disease burden in this population. GPs largely support infant RSV immunisation, though not universally as top priority. Contrary, GPs report limited clinical recognition of RSV in older adults and express significant uncertainty about its incidence and severity. This drives a general assumption of low disease burden in older adults and low perceived need for RSV immunisation. GPs stress the need for targeted education on RSV epidemiology and immunisation options to better guide (parental) decision-making. They also highlight the importance of public awareness campaigns and broader vaccine confidence initiatives to optimise uptake. Conclusions: GPs largely support RSV immunisation for infants, given the evident disease burden, but emphasise the need for RSV education to strengthen their advisory role. Uncertainty about the RSV burden in older adults limits their support for immunisation in this population, with GPs suggesting that a clearer understanding of the disease's impact is necessary first.