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Objectives: To identify the main challenges in public communication encountered by representatives in Swiss health institutions during the first two waves of the COVID-19 pandemic., Methods: In-depth qualitative interviews were conducted with representatives of key public health institutions (N = 25) across Switzerland. Participants were asked to identify barriers, facilitators, problems, and solutions in their public communication. The interviews were analyzed thematically., Results: Swiss institutional communication faced internal challenges (e.g., lack of human resources and training, rigid organizational structure), external challenges related to the public (e.g., low health and scientific literacy, low levels of trust), and environmental challenges related to the broader context (e.g., infodemics). At the same time, institutions developed best practices to foster collaboration, promote transparency, and address misinformation., Conclusion: Health organizations need a cultural shift to account for the increasing complexity of crisis communication. Their awareness of the importance of communication should match the implementation of enhanced dedicated infrastructures and processes., Practice Implications: Institutions need mechanisms allowing innovation and adaptation to prepare for future pandemics. Emphasis should be placed on training communication professionals who can design, develop, deliver, and evaluate texts that meet the information needs of the public, enhance health and scientific literacy, and counter mis/disinformation., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)