Pregnant women's perceptions of RSVpreF vaccine and Nirsevimab for infant RSV prevention.

Background: Respiratory syncytial virus (RSV) is the most common cause of infant hospitalization. Following the introduction of a prefusion F protein vaccine (RSVpreF) for pregnant women and a monoclonal antibody (nirsevimab) for infants aged <8 months in 2023, we aimed to understand public perceptions about RSV immunization to inform targeted health strategies to improve uptake.

Methods: We conducted two nationally representative web-based surveys of pregnant women to understand maternal RSV immunization attitudes and intentions (Wave 1: 9/20/2023-10/3/2023; N = 198; Wave 2: 5/24/2024-6/14/2024; N = 216). We used thematic analysis to identify themes and sub-themes in pooled data across both waves (N = 414).

Results: Motivators for immunization included concerns about the disease's risks, recognized benefits of immunization, and recommendations by healthcare professionals and the Center for Disease Control and Prevention (CDC). Participants reported hesitation to immunize due to insufficient immunization information, low perceived disease risk, lack of trust in vaccine due to product novelty and vaccine-makers, limited availability of RSVpreF vaccine, and concerns about vaccine safety and potential side effects. Individuals who reported hesitancy shared that information needed to encourage immunization should include narratives from parents who chose immunization, research, and evidence underscoring the effectiveness and safety of the immunization, and information about access and availability of the products. Trusted sources of immunization information among all participants included (1) healthcare providers, (2) family/relatives, and (3) research.

Conclusion: Our findings suggest that efforts to promote RSV immunization should focus on engaging healthcare providers to improve pregnant women's knowledge and awareness related to RSV and using vaccine narratives to build confidence in RSV immunization.