Patients’ unmet expectations in the patient–provider relationship during vaccination consultations

In a context of infodemics and misinformation, consultations with healthcare professionals (HCPs) on vaccination represent critical opportunities to improve vaccine acceptance. However, such encounters can be tense, partly because patients and HCPs perceive vaccination from different perspectives and patients’ expectations are not always fully understood by providers. This study therefore aims to identify patients’ expectations regarding the patient-provider relationship during vaccination consultations and assess their fulfillment. We analyzed data from a nationally representative survey of 1,500 French adults. Participants completed an online questionnaire capturing their expectations regarding the patient–provider relationship when discussing vaccination, as well as their experiences during their most recent vaccination consultation within the last three years. We developed an algorithm to quantify expectation–experience gaps and performed multivariable Poisson analyses to identify factors associated with unmet expectations. 71% of patients considered it important to be listened to and 73% to receive answers to their questions. Overall, 34% had at least one unmet expectation. Unfulfillment ranged from 8% for receiving answers to 34% for being understood when having doubts about vaccination, with intermediate levels for feeling listened to (24%) and being treated as an equal (25%). Both vaccine hesitancy (adjusted RR = 1.80, p < 0.001) and distrust in physicians (aRR = 2.45, p < 0.001) independently increased the risk of having at least one unmet expectation, while older age (aRR = 0.50, p < 0.001) and higher educational level (aRR = 0.72, p = 0.007) decreased it. These results highlight the need for HCPs to better consider patients’ relational expectations in vaccination consultations, particularly among patients who are vaccine-hesitant, distrustful of physicians, young, or less educated— both in crisis and routine contexts.

Key messages

• In vaccination consultations, patients have important expectations. Over 70% expect to be listened to and have their questions answered, and around a third expect not to feel judged or infantilized.

• Unmet expectations are more common among patients who are vaccine-hesitant, distrustful of physicians, young, or less educated — calling for tailored patient-centered communication.