Respiratory syncytial virus (RSV) vaccine choices during pregnancy

OBJECTIVES: Respiratory Syncytial Virus (RSV) is the leading cause of bronchiolitis and pneumonia in infants and can lead to fatal respiratory distress, especially in very young infants. New maternal RSV vaccines and infant monoclonal antibodies are now available. This study aims to understand RSV vaccine attitudes in Australian pregnant women. STUDY DESIGN: The cross-sectional online survey employed a discrete choice experiment (DCE) design to quantify trade-offs and investigate decision-making patterns among pregnant women regarding the maternal RSV vaccine. A mixed-methods approach was used, with results from focus group discussions informing the development of the DCE survey. METHODS: Any pregnant women aged ≥18 years in Australia were eligible to participate in the survey. During the survey, respondents were asked to choose between hypothetical scenarios, or optout option. Survey data were analysed using mixed logit and latent class models. RESULTS: In total, 440 pregnant women participated and demonstrated a strong preference for a free RSV maternal vaccine with a lower risk of serious side effects and higher vaccine effectiveness. Latent class analysis revealed two distinct preference groups: "accepters/deliberators" and "rejecters". Compared to rejecters (31.7 %), accepters/deliberators (68.3 %) were more likely to be older, haver high household income and had received a pertussis vaccine, and were less likely to receive an influenza vaccine. Incentives to encourage vaccination were not supported by either group. Among rejecters, cost did not influence their vaccine preference, but text message reminders were more preferred. In contrast to accepters/deliberators, rejecters expressed a strong dislike for video advertisements. Participants showed a significantly higher preference for RSV maternal vaccination (54.8 %) versus infant monoclonal antibody injection (16.8 %) in a general preference question (p < 0.001). CONCLUSIONS: Maternal RSV vaccination at no cost was generally well received and preferred by pregnant women in this study, though preferences for promotion strategies varied.