Misinformation, patient hesitancy raise alarm ahead of respiratory season

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As flu, RSV and COVID-19 prepare to collide once again this fall and winter, a new global survey shows overwhelming concern among health care providers. According to Sermo’s 41^st Real Time Barometer, 95% of 607 global survey respondents across health care specialties said they are worried about the upcoming respiratory season. Nearly nine in ten said misinformation about vaccines and respiratory illness has had a moderate or significant impact on their practice.

The Sermo Barometer 41 survey was fielded August 12-13, 2025, including responses from physicians across specialties, advanced practice providers (APPs) and pharmacists.

The misinformation problem

Clinicians reported that vaccine misinformation remains the top reason patients delay or refuse shots. Safety concerns and perceptions that vaccines are unnecessary followed closely behind. In response, clinicians are increasingly focused on direct education: 79% said they prioritize conversations during consultations, while half provide printed resources and 40% of clinicians point patients to trusted websites.

“Misinformation about vaccines, especially for respiratory illnesses like COVID, continues to be a significant challenge we face in protecting our communities,” said Nat Fondell, M.D., FAAFP, FASAM, medical director at La Clinica’s Birch Grove Health Center and a member of Sermo’s Medical Advisory Board. “Our role as medical providers is to provide clear, evidence-based guidance to help patients make informed decisions about their health. When they make vaccine decisions, I want them to remember me saying: ‘I’ve gotten this vaccine myself and wouldn’t hesitate to have my family members get it.’”

Vaccine uptake predictions

Survey respondents expect flu to be the biggest driver of patient volume this year, with 77% of clinicians — and 90% of nurse practitioners — planning to more strongly recommend flu shots.

Still, expectations for other vaccines remain mixed.

• Flu vaccine: 72% of clinicians believe most patients will get it.
• COVID-19 booster: 36% expect majority uptake.
• RSV vaccine (adults): 37% predict strong uptake, despite hospitalization risks among older adults.
• RSV vaccines (pediatrics): 51% expect strong uptake, with 86% of responding pediatricians planning to push the vaccine harder this year.
• Pneumococcal vaccine: About half predict majority uptake in both adults (53%) and children (54%).

Pharmacists on the frontline

Another shift noted in the survey is the growing role of retail pharmacists. More than half of clinicians (58%) said patients increasingly turn to pharmacists first for advice on respiratory symptoms.

“The pharmacy is often the first stop for a concerned patient or parent,” said Petra Bobovcan, a community pharmacist in Zagreb and a member of Sermo’s pharmacist group. “We have become the frontline for respiratory care — providing immediate access to trusted advice and effective triage. We are performing rapid tests for flu, strep, and, of course, strongly advocating for preventative vaccinations … This proactive guidance is essential for both patient well-being and managing strain on the health care system during busy respiratory seasons. It’s a pivotal shift in care, and we’re ready for it.”

Clinicians also cited challenges from updated guidelines and worsening environmental conditions. Although more than a third said new guidelines heavily influence care decisions, patient noncompliance remains the most persistent obstacle.

Nearly all respondents (96%) said real-time respiratory surveillance data is vital, even as governments scale back on COVID-19 and flu reporting.

Seventy-seven percent acknowledged climate change as a factor worsening respiratory illness, pointing to air pollution (36%) and rising allergens (27%) as top contributors.

Looking forward, 83% believe climate-related factors will significantly increase respiratory illness cases within five years.