Physician knowledge, attitudes, and perceptions of respiratory syncytial virus in older adults: A cross-sectional survey in Germany and Italy

Respiratory syncytial virus (RSV) causes substantial morbidity and mortality among older adults and individuals with chronic diseases, putting pressure on healthcare systems. RSV vaccines became available in 2023, however, physicians' knowledge and attitudes regarding RSV and RSV vaccines may hinder uptake. We aimed to understand physicians' knowledge, attitudes, and perceptions of respiratory infections, including RSV, and vaccination. A pre-tested cross-sectional survey was fielded with physicians who commonly administer or recommend respiratory vaccines in Germany and Italy. Regression models assessed physicians' characteristics associated with knowledge and perceptions of RSV. Overall, 307 physicians (Germany: n = 152; Italy: n = 155) completed the survey. Physicians had good mean RSV disease knowledge scores (Germany: 3.8/5; Italy: 3.3/5). Most (Germany: 68%; Italy: 72%) indicated wanting further information on RSV, versus <35% for other respiratory diseases. Most considered RSV an important burden, especially for adults aged ≥50 years with immunocompromising conditions (Germany: >96%; Italy: >92%) and ≥60 years with chronic conditions (Germany: >95%; Italy: >87%). Physicians seeing >100 versus ≤100 patients weekly, and general practitioners versus other specialists, perceived RSV burden as more important. Perceived barriers to RSV vaccination included lack of national recommendation and reimbursement (Germany: 92%; Italy: 89%), and patients not being informed on getting vaccinated (Germany: 71%; Italy: 59%). In conclusion, physicians generally considered RSV an important pathogen for older adults and those with chronic conditions at risk of severe infection. Most wanted more information on RSV, thus medical education is important to address knowledge gaps and enable physicians to guide patients in making informed vaccination decisions.