Introduction Vaccines formed the core of Australia's National COVID-19 Plan in combination with other public health measures. Vaccine rates varied geographically, and lower uptake was seen in some regional and remote areas.

Objective Explore barriers and enablers to implementing COVID-19 vaccine programs and recommendations for improvement from a vaccine provider perspective in rural and regional Queensland (QLD).

Design Participants included eleven healthcare personnel (HCP) from rural (45%) and regional (55%) settings in the Wide Bay region, QLD, Australia. Semi-structured interviews were conducted to identify barriers and enabling factors HCP experienced implementing COVID-19 programs, in addition to their recommendations to optimise ongoing implementation of vaccine programs. Braun and Clarke's reflexive thematic analysis of interview transcripts was performed, and over-arching themes were identified.

Findings Four barrier themes were identified: 1. operational barriers, 2. communication issues, 3. financial constraints, and 4. leadership and coordination. Four enabler themes were also identified: 1. adaptability; 2. prior experience and knowledge; 3. collaboration and teamwork; and 4. community engagement. Recommendations for optimising ongoing vaccine rollout included reducing the administrative burden on providers, increasing involvement of primary care and the private sector in planning and decision making, improving communication methods, reviewing financial remuneration for private providers, and decentralising decision-making.

Discussion There were multiple barriers and enablers to implementation of COVID-19 programs experienced by rural and regional HCP in the Wide Bay region of QLD which were consistent with existing literature.

Conclusion A range of actionable recommendations were identified that could optimise the COVID-19 vaccine program and future vaccine programs in rural and regional areas.