Perceptions of Maternal Respiratory Syncytial Virus Recommendations in the United States

Abstract

Background:

Respiratory syncytial virus (RSV) is a leading cause of U.S. hospitalizations in infants. Current guidelines recommend vaccination during pregnancy or immunizing infants after birth to protect infants from RSV. While research has shown pregnant people are in favor of preventative measures for RSV, overall coverage remains relatively low. This study aimed to gather insight into RSV vaccine perceptions, preferred method of prevention, degree of health care providers (HCPs) recommendation, and timing for discussion and vaccination.

Methods:

A 10-minute online survey was administered to pregnant adults and new mothers in December 2024. Data on respondents’ preference for prevention, impact of the strength of HCP recommendation, and preferred timing and location for discussion were collected.

Results:

Among 800 respondents, 65% showed preference for vaccination during pregnancy over immunizing their baby post-birth. A strong HCP recommendation is associated with a higher maternal vaccination acceptance rate (56% “definitely” would vaccinate) compared with a lighter recommendation (47%). Preferred timing for this discussion is during an initial appointment (33%) or a few weeks before they would receive the vaccine (42%). About 84% of respondents prefer having the choice to vaccinate during pregnancy, even if their infants are born outside of the typical RSV season.

Conclusions:

The majority of respondents in our study believed that protecting their infants from RSV was important, and approximately two-thirds preferred vaccination during pregnancy. Higher vaccination uptake is achievable with a strong HCP recommendation, earlier HCP counseling during pregnancy, and flexible vaccination timing outside a typical RSV season.

Background

Respiratory syncytial virus (RSV) is a leading cause of U.S. hospitalizations in infants. In the absence of prevention products, 2%–3% of all infants aged <6 months are hospitalized for RSV each year. ¹ Currently, there are two types of RSV prevention options licensed by Food and Drug Administration and recommended by the Advisory Committee on Immunization Practices to the Centers for Disease Control and Prevention. This includes seasonal administration of either a maternal vaccination during 32 through 36 weeks of gestation or a monoclonal antibody administered to the infant after birth.^2–4

Several survey studies have reported that most pregnant people and health care providers (HCPs) are in favor of preventive measures for RSV.^5,6 In a survey study of adults who were pregnant or trying to become pregnant, Saper and colleagues also found that more than half those surveyed were very likely to get vaccinated during pregnancy, primarily driven by the belief that RSV could be a serious illness. ⁶ Other research to date among parents and HCPs in countries outside of the United States on attitudes toward RSV prevention also reported similar findings.^7–15

A recent study reported an estimated 55.8% of infants are protected against RSV, including a maternal RSV vaccination rate of 32.6%. ¹⁶ While these are meaningful coverage rates, there remains a gap between stated preference and actual coverage. Several barriers to vaccine uptake have been identified, including lack of prevention awareness among pregnant women and those with recent births. Lack of provider recommendation for vaccination may be another factor as well, with a recent study noting it to be the most frequently reported reason (16.9%) for eligible women not receiving the vaccination. ¹⁶

The current study sought to gain insight into the impact of an HCP recommendation on pregnant individuals’ willingness to receive the RSV vaccine during pregnancy and determine how this varies based on the strength of recommendation. Other potential barriers to vaccine uptake such as potential preferences for timing of discussion regarding RSV and the option to vaccinate outside of the viral season were explored.

Methods

This cross-sectional study consists of a 10-minute, self-paced online survey of individuals who were pregnant or recently had a pregnancy delivery at the time of survey administration, recruited from existing internet market research panels that reached a geographically and racially diverse population. Respondents could enter the survey via survey invitations from their panel provider or via the panel homepage of available studies. Interested participants could then access the screening survey to determine study eligibility. Details of the study topic were not disclosed to potential respondents at the time of survey invitation or screening beyond the broader category of health care. Respondents were blinded to the study sponsor until all questions had been answered, at which time participants were able to request details on the study sponsor, in line with local regulations, should they desire. Upon completion of the survey, participants were compensated through their panel with a $2 honorarium in line with current fair market values for survey-based research.

The study (Protocol # 2024-0499) was deemed exempt according to 45 CFR 46.104(d)(2) Tests, Surveys, Interviews 45 CFR 46.104(d)(3)(i)(A) by Pearl Institutional Review Board (IRB). Informed consent was obtained from all participants prior to participating in the study. Respondents had the ability to remove themselves from study participation at any time without penalty. The survey was fielded from December 3, 2024, through December 27, 2024.

Study population and inclusion and exclusion criteria

This study surveyed pregnant adults and new mothers who met the following study inclusion criteria: (1) being female; (2) aged 18+ years; (3) has a child or children at less than 1 year of age or currently pregnant; (4) being primarily responsible, or shares responsibility, for making decisions about the health of their child(ren); (5) willing to provide informed consent; and (6) willing to consent to adverse event report provisions.

Participants were excluded if they completely opposed to vaccination (for themselves or their children) due to religious, political, or other beliefs or if they were, at the time of survey administration, employed or had a member in the household employed by an advertising agency or market research firm; marketing firm or marketing department in their own firm; a public relations company; a news media company; a pharmaceutical manufacturer, distributor, wholesaler, or retailer; or a medical professional.

Study measures

The survey collected data on sociodemographic factors and the participants’ awareness of various respiratory diseases. For their perceptions of the seriousness of RSV and the importance of protection from RSV, participants selected from a 5-point scale or “Don’t know.” They were then asked about their level of agreement/disagreement with statements related to the management and potential seriousness of RSV. For their willingness to receive maternal RSV vaccination overall and influence on their willingness based on HCP recommendation, the response options were “definitely would get,” “probably would get,” “might or might not get,” “probably would not get,” or “definitely would not get.” Participants were asked for their preference for RSV prevention method by selecting the options of “strongly prefer to receive vaccination during pregnancy,” “somewhat prefer to receive vaccination during pregnancy,” “somewhat prefer to immunize my baby after birth,” “strongly prefer to immunize my baby after birth,” or “I would not at all be open to considering either option.” Participants were then asked for the reasons for their stated preference. Finally, participants were asked about their level of agreement/disagreement using a 5-point scale on the choice to vaccinate during pregnancy regardless of timing of birth relative to the season, preference for timing of discussion of RSV preventives with the options of “initial appointment,” “a few weeks before vaccination,” “at the appointment of the vaccination,” or “I would not get any vaccines during pregnancy,” and the preferred location to receive vaccination with the options of “OB/GYN office,” “hospital,” “family physician’s office,” “pharmacy,” “work,” “health department,” or “other.”

Statistical analysis

Descriptive univariate statistics were used to examine study response. Continuous variables (e.g., age) were examined by mean and median. Categorical variables (e.g., gender, race) were examined with individual totals along with the respective percentages from the total sample size. Respondents were stratified into three subgroups: pregnant—first-time mother (has no other children), pregnant—experienced mother (already has one or more child), or new mother (had at least one pregnancy delivery in the prior 12 months).

Post hoc logistic regression analyses were performed to more clearly evaluate variation of findings by pregnancy status and other demographic covariates. Dependent variables were dichotomized, and all independent variables were included in the model.

The study was conducted in accordance with legal and regulatory requirements, as well as with scientific purpose, value, and rigor and followed generally accepted research practices described in Guidelines for Good Pharmacoepidemiology Practices (GPP) issued by the International Society for Pharmacoepidemiology (ISPE) and Good Practices for Outcomes Research issued by the International Society for Pharmacoeconomics and Outcomes Research.

Results

Among 800 respondents, 300 were first-time pregnant mothers, 300 were experienced pregnant mothers, and 200 were new mothers. Overall, the mean age was 30.4 years, the majority (82%) were married, lived in urban areas (58%), and were employed (54%). Full sample distribution is summarized in Table 1.

Table 1.

Patient Demographics

	Total(n = 800)		Pregnant first-time mother(n = 300)		Pregnant experienced mother(n = 300)		New mother, not pregnant(n = 200)
	Mean	Std. dev.	Mean	Std. dev.	Mean	Std. dev.	Mean	Std. dev.
Age	30.4	6.3	27.9	4.5	32.8	6.3	30.6	6.9
	N	% a	N	%	N	%	N	%
Region
Northeast	125	16%	49	16%	46	15%	30	15%
Midwest	170	21%	62	21%	62	21%	46	23%
South	332	42%	111	37%	132	44%	89	45%
West	173	22%	78	26%	60	20%	35	18%
Urbanicity
Urban	463	58%	246	82%	154	51%	63	32%
Suburban	253	32%	48	16%	110	37%	95	48%
Rural	84	11%	6	2%	36	12%	42	21%
Employment status
Full time	431	54%	137	46%	203	68%	91	46%
Part time	94	12%	44	15%	27	9%	23	12%
Unemployed	46	6%	11	4%	18	6%	17	9%
Unable to work due to health reasons	29	4%	21	7%	6	2%	2	1%
Student	10	1%	2	1%	4	1%	4	2%
Homemaker	186	23%	85	28%	39	13%	62	31%
Retired/Other	3	0%	0	—	2	1%	1	1%
Prefer not to answer	1	0%	0	—	1	0%	0	—
Household income
$49,999 or less (net)	192	24%	13	4%	76	25%	103	52%
$50,000–$99,999 (net)	304	38%	123	41%	118	39%	63	32%
$100,000–$149,999	211	26%	109	36%	84	28%	18	9%
$150,000 or more	86	11%	52	17%	22	7%	12	6%
Prefer not to answer	7	1%	3	1%	0	—	4	2%
Education status
Some high school or less	14	2%	0	—	2	1%	12	6%
High school graduate	194	24%	30	10%	81	27%	83	42%
2-year college/Technical school	127	16%	32	11%	53	18%	42	21%
4-year college	173	22%	60	20%	69	23%	44	22%
Some postgraduate work	99	12%	74	25%	21	7%	4	2%
Postgraduate degree	193	24%	104	35%	74	25%	15	8%
Marital status
Married or living with partner	658	82%	285	95%	235	78%	138	69%
Single, never married	113	14%	12	4%	52	17%	49	25%
Divorced or separated	21	3%	1	0%	10	3%	10	5%
Widowed	3	0%	0	—	2	1%	1	1%
Prefer not to answer	5	1%	2	1%	1	0%	2	1%
Has children
Yes	500	63%	0	0%	300	100%	200	100%
Current trimester
First trimester	241	40%	158	53%	83	28%	N/A	—
Second trimester	258	43%	91	30%	167	56%	N/A	—
Third trimester	101	17%	51	17%	50	17%	N/A	—

a

Percentages may not sum exactly to 100% due to rounding to the nearest full percentage point.

N/A, not applicable; Std. dev., standard deviation.

Awareness and perception of RSV

Overall, 90% of respondents were aware of RSV as a childhood disease with comparable awareness to influenza (89%). New mothers and experienced pregnant mothers reported a high level of awareness of RSV as a childhood disease (93% and 94%, respectively), with slightly lower rates of awareness among pregnant first-time mothers (83%), as shown in Figure 1. A majority (62%) of first-time pregnant mothers believed most RSV cases in babies were easy to treat, as shown in Table 2. However, there is potential for misinterpretation by survey respondents due to the absence of widely approved antivirals and the recent introduction of immunization strategies for RSV, suggesting caution in the interpretation of this finding. In general, there is a trend of first-time pregnant mothers differing from experienced mothers on RSV perceptions, such as being less likely to agree that RSV can cause serious complications in babies (58% compared with 77% of pregnant experienced mothers and 87% of new mothers who are not pregnant), that RSV can be life-threatening in babies (50% compared with 72% and 91%), and that it is important to protect babies from RSV immediately from the moment they are born (55% compared with 74% and 85%). RSV was perceived as a serious condition by more than 90% of respondents across all categories, with similar rates of respondents agreeing that protection from RSV was important to protect babies against such an infection, as shown in Table 3.

FIG. 1.

Awareness of childhood diseases—percent of respondents aware of each disease. (Percentages may not sum exactly to 100% due to rounding to the nearest full percentage point.) RSV, respiratory syncytial virus.

Table 2.

Agreement with Statements About Respiratory Syncytial Virus

	Total(n = 800)		Pregnant first-time mother(n = 300)		Pregnant experienced mother(n = 300)		New mother, not pregnant(n = 200)
	N	% a	N	% a	N	% a	N	% a
Most RSV cases in babies are easy to treat
Strongly agree	168	21%	93	31%	60	20%	15	8%
Somewhat agree	213	27%	94	31%	77	26%	42	21%
Neither agree nor disagree	142	18%	29	10%	64	21%	49	25%
Somewhat disagree	152	19%	45	15%	56	19%	51	26%
Strongly disagree	87	11%	34	11%	27	9%	26	13%
Don’t know	38	5%	5	2%	16	5%	17	9%
RSV can cause serious complications in babies
Strongly agree	577	72%	174	58%	230	77%	173	87%
Somewhat agree	160	20%	93	31%	50	17%	17	9%
Neither agree nor disagree	44	6%	29	10%	12	4%	3	2%
Somewhat disagree	4	1%	1	0%	3	1%	0	—
Strongly disagree	1	0%	0	—	0	—	1	1%
Don’t know	14	2%	3	1%	5	2%	6	3%
RSV can be life-threatening in babies
Strongly agree	549	69%	150	50%	217	72%	182	91%
Somewhat agree	201	25%	127	42%	61	20%	13	7%
Neither agree nor disagree	32	4%	17	6%	13	4%	2	1%
Somewhat disagree	5	1%	4	1%	1	0%	0	—
Strongly disagree	1	0%	0	—	0	—	1	1%
Don’t know	12	2%	2	1%	8	3%	2	1%
Babies under 2 months are at the highest risk of hospitalization due to RSV-related infections, but the risk remains high through the first 6 months of life
Strongly agree	500	63%	158	53%	196	65%	146	73%
Somewhat agree	229	29%	115	38%	76	25%	38	19%
Neither agree nor disagree	46	6%	23	8%	18	6%	5	3%
Somewhat disagree	4	1%	0	—	3	1%	1	1%
Strongly disagree	2	0%	0	—	0	—	2	1%
Don’t know	19	2%	4	1%	7	2%	8	4%
RSV can be a danger all year round, particularly to newborns
Strongly agree	523	65%	164	55%	199	66%	160	80%
Somewhat agree	219	27%	111	37%	78	26%	30	15%
Neither agree nor disagree	39	5%	22	7%	12	4%	5	3%
Somewhat disagree	7	1%	1	0%	4	1%	2	1%
Strongly disagree	3	0%	0	—	1	0%	2	1%
Don’t know	9	1%	2	1%	6	2%	1	1%
It is important to protect babies from RSV immediately from the moment they are born
Strongly agree	555	69%	164	55%	222	74%	169	85%
Somewhat agree	192	24%	110	37%	59	20%	23	12%
Neither agree nor disagree	40	5%	21	7%	15	5%	4	2%
Somewhat disagree	4	1%	2	1%	1	0%	1	1%
Strongly disagree	0	—	0	—	0	—	0	—
Don’t know	9	1%	3	1%	3	1%	3	2%
I would do everything possible to give my baby the best protection against RSV
Strongly agree	576	72%	161	54%	226	75%	189	95%
Somewhat agree	180	23%	109	36%	65	22%	6	3%
Neither agree nor disagree	34	4%	24	8%	5	2%	5	3%
Somewhat disagree	7	1%	5	2%	2	1%	0	—
Strongly disagree	0	—	0	—	0	—	0	—
Don’t know	3	0%	1	0%	2	1%	0	—
RSV infection in infancy may cause long-term breathing problems for children
Strongly agree	462	58%	139	46%	190	63%	133	67%
Somewhat agree	251	31%	137	46%	74	25%	40	20%
Neither agree nor disagree	48	6%	18	6%	21	7%	9	5%
Somewhat disagree	6	1%	2	1%	4	1%	0	—
Strongly disagree	2	0%	0	—	0	—	2	1%
Don’t know	31	4%	4	1%	11	4%	16	8%

a

Percentages may not sum exactly to 100% due to rounding to the nearest full percentage point.

RSV, respiratory syncytial virus.

Table 3.

Seriousness of and Importance to Protect from Respiratory Syncytial Virus—Among Respondents Aware of Respiratory Syncytial Virus

	Total(n = 716)		Pregnant first-time mother(n = 249)		Pregnant experienced mother(n = 282)		New mother, not pregnant(n = 185)
	N	% a	N	% a	N	% a	N	% a
Seriousness of RSV disease for babies
Extremely serious	477	67%	154	62%	186	66%	137	74%
Very serious	194	27%	76	31%	78	28%	40	22%
Somewhat serious	40	6%	18	7%	15	5%	7	4%
Not very serious	2	0%	1	0%	1	0%	0	—
Not at all serious	0	—	0	—	0	—	0	—
Don’t know	3	0%	0	—	2	1%	1	1%
Importance of protection from RSV for babies
Extremely important	561	78%	165	66%	228	81%	168	91%
Very important	125	17%	64	26%	48	17%	13	7%
Somewhat important	26	4%	17	7%	5	2%	4	2%
Not very important	2	0%	1	0%	1	0%	0	—
Not at all important	0	—	0	—	0	—	0	—
Don’t know	2	0%	2	1%	0	—	0	—

a

Percentages may not sum exactly to 100% due to rounding to the nearest full percentage point.

RSV prevention

More than 80% of survey respondents expressed willingness to get an RSV vaccine during pregnancy to protect their baby from RSV, as shown in Figure 2. If given the option of a maternal RSV vaccination or immunizing their baby after birth, approximately two-thirds (65%) of respondents opted for vaccination during pregnancy, as shown in Figure 3. Preference for maternal vaccination was highest among new mothers (75%) and lowest among pregnant first-time mothers (58%) but still represented the majority preference for all groups.

FIG. 2.

Willingness to receive RSV vaccine during pregnancy, overall and based on strength of HCP recommendation. (Percentages may not sum exactly to 100% due to rounding to the nearest full percentage point. Full survey wording: Strongest Recommendation = “RSV is very serious and I strongly recommend you get vaccination,” Moderate Recommendation = “RSV vaccine is recommended and I think it is a good idea to get vaccinated,” Lightest Recommendation = “RSV vaccinate is recommended, here is some information for you, think about it and let me know if you want to get the vaccine.”) HCP, health care provider; RSV, respiratory syncytial virus.

FIG. 3.

Preference for maternal RSV vaccination versus immunizing baby after birth. (Percentages may not sum exactly to 100% due to rounding to the nearest full percentage point).

Impact of HCP recommendation

Overall, a strong doctor recommendation was associated with greater willingness and intent (56% “definitely” would receive a vaccination) compared with a lighter recommendation (47%). New mothers were most likely to “definitely” receive vaccination based on a strong recommendation (61%), while pregnant first-time mothers saw the greatest increase in likelihood to vaccinate based on the strength of recommendation (13 percentage point increase from lightest to strongest recommendation), as shown in Figure 2.

Post hoc logistic regression analysis

Post hoc regression analyses elucidated few trends across the key metrics measured. New mothers who were not pregnant at the time of the survey were more likely to consider RSV “extremely” serious if contracted by babies (odds ratio [OR] = 1.92, 95% confidence interval [CI]: 1.17–3.15) and more likely to consider protecting babies from RSV to be “extremely” important (OR = 3.74, 95% CI : 2.12–6.58). Those working full or part time were more likely to receive maternal RSV vaccination after an HCP recommendation, no matter the strength (strong recommendation: OR = 2.16, 95% CI: 1.38–3.40; moderate recommendation: OR = 2.02, 95% CI: 1.33–3.09; light recommendation: OR = 2.39, 95% CI: 1.54–3.72). Similarly, those employed full or part time were more likely to receive maternal vaccination over immunization after birth if given the choice to decide (OR = 2.35, 95% CI: 1.65–3.35). Full findings from the regression analysis can be found in Supplementary Table S3.

Timing of vaccination and provider discussion

Most respondents (84%) expressed a desire to be given the choice to receive maternal vaccination, even if their due date was outside of the typical RSV season (Fig. 4). Regarding maternal vaccination, protection immediately from birth was the top reason for preferring this form of RSV vaccination (55%, noticeably higher among new mothers), followed by the vaccine’s safety for the mother, baby, and the pregnancy (45%–48%), and recommendation from their HCPs (44%). Full distribution of these results can be found in Supplementary Tables S1 and S2.

FIG. 4.

Agreement with desiring the choice to receive maternal RSV vaccination for birth in non-respiratory season. (Percentages may not sum exactly to 100% due to rounding to the nearest full percentage point).

Finally, mothers expressed a preference to discuss recommended vaccines either at their initial appointment after confirming that they are pregnant or a few weeks prior to administration. Only 23% of respondents would prefer to first discuss vaccination on the day they would receive the vaccine. Mothers also prefer to receive vaccination at their OB/GYN’s office or a hospital if it is their first pregnancy. Notably, adding the stipulation that they would need to go to a pharmacy to receive the vaccine did not have a detrimental impact on vaccine willingness. Full distribution of preferred timing and location can be found in Table 4.

Table 4.

Preference on the Timing of Discussion and Location of Vaccination

	Total(n = 800)		Pregnant first-time mother(n = 300)		Pregnant experienced mother(n = 300)		New mother, not pregnant(n = 200)
	N	% a	N	% a	N	% a	N	% a
Preferred timing for HCP to discuss recommended vaccines
At my initial appointment after confirming I am pregnant	260	33%	79	26%	117	39%	64	32%
A few weeks before I get the vaccine	338	42%	163	54%	97	32%	78	39%
At the appointment when I would get the vaccine	183	23%	54	18%	80	27%	49	25%
I would not get any vaccines during pregnancy	19	2%	4	1%	6	2%	9	5%

	Total(n = 781)		Pregnant first-time mother(n = 296)		Pregnant experienced mother(n = 294)		New mother, not pregnant(n = 191)
Locations preferred for receiving a vaccine during pregnancy
At my OB/GYN or midwife’s office	416	53%	59	20%	195	66%	162	85%
At my hospital	405	52%	202	68%	146	50%	57	30%
At my family or other physician’s office	207	27%	61	21%	83	28%	63	33%
At my pharmacy (e.g., drug store, supermarket)	125	16%	40	14%	53	18%	32	17%
At work	12	2%	2	1%	7	2%	3	2%
At the health department	173	22%	89	30%	58	20%	26	14%
Other location	0	—	0	—	0	—	0	—

a

Percentages may not sum exactly to 100% due to rounding to the nearest full percentage point.

HCP, health care provider; OB/GYN, obstetrician/gynecologist.

Discussion

In our study, pregnant people expressed an overwhelming desire to protect their infants against RSV, and the majority preferred vaccination during pregnancy as the prevention approach. The study findings are consistent with a prior U.S.-based survey study that found that nearly two-thirds would accept RSV protection, either by vaccine or immunization, with side effects being the most notable concern among participants. ¹⁷ There is a notably higher rate of interest for vaccination during pregnancy in our study than prior study by Saper and colleagues. ⁶ This difference may be at least partially attributable to the current study clearly outlining both potential options and soliciting a preference, as opposed to asking about general likelihood without a comparator. This difference clearly highlights the importance of ensuring pregnant adults and new mothers are sufficiently informed of the choices currently available to them.

The awareness levels of RSV reported in this study are notably higher than those in similar studies conducted in the past.^18,19 This increase in observed awareness levels could be driven by increased media coverage and advertising over the past few years that accompanied the introduction of new interventions for RSV. Nonetheless, this limits the ability in the current study to evaluate the role of various awareness campaign efforts in enhancing public knowledge of RSV. Additional research that assesses these key efforts may inform future public health education. Similarly, further research should explore the role that prior RSV knowledge may have in the acceptance rates of preventative options for RSV.

The current study builds upon past research by noting the importance of a strong HCP recommendation in patient willingness to accept RSV preventative measures. This highlights the role of HCPs in furthering the protection of infants from RSV infection from birth. Our study results also highlighted the ongoing need for education and awareness among new, or soon-to-be, parents regarding the potential seriousness of an RSV infection. This is consistent with past research showing higher levels of vaccine uptake intention among those who recognize the seriousness of RSV infection,^6,10 further supporting that education could increase understanding of disease severity, vaccine interest, and intention to be treated whether during pregnancy or as a new mother.

Finally, parental autonomy emerged as an important factor in vaccine preferences and uptake intentions. In addition to an overall preference for the maternal vaccine as opposed to immunizing infants at birth, respondents also expressed a clear desire for the ability to choose for themselves between the available immunization methods, including the opportunity to opt for the maternal vaccine even if their expected delivery date occurs outside of the typical RSV season to ensure protection for their baby. Similarly, mothers expressed a desire to discuss vaccination with their HCP before the day they would receive the vaccination, affording them time to weigh their options and not feel rushed to decide.

Strengths and limitations

Strengths of the current study include surveying a large sample of respondents across the country and understanding the potential implications regarding HCP practice behaviors on vaccination uptake. The study adds to existing research that already showed people generally agree that HCPs are trusted and reliable sources for RSV information, ¹⁷ with our results now suggesting that how this message is delivered may also be crucial.

This study has several limitations. Research questions were descriptive in nature and employed self-report methodology, limiting the certainty with which these study results can be extrapolated to a broader population. Although standard quantitative survey tactics like the inclusion of Likert and gradation scales were used widely, there remains potential for differing interpretation of scale points from respondent to respondent. The current study also relied upon the willingness of respondents to be enrolled in a research panel, which invites the possibility of selection bias, or aligned in some fashion with a patient advocacy group, which invites the possibility of information bias. As the objective of the survey was to explore preferences among those who would consider vaccination, respondents who self-reported opposition to any vaccination were excluded from the study, which may introduce potential selection bias. However, studies estimate this represents less than 10% of potential U.S. respondents. ²⁰ There is also potential for seasonality to impact responses, such as RSV awareness. The study was fielded in December, which coincides with a potential increase in discussions with HCPs about RSV and media exposure stemming from new RSV vaccination brand launches. Furthermore, the study may not collect all pertinent information that influences the participants’ awareness and perception, such as the number of prenatal visits that survey respondents may have had prior to study participation. The absence of this information limits our ability to determine to what extent, if any, participants may be biased toward higher awareness of RSV based on HCP counseling during prenatal visits.

Conclusions

The majority of respondents in our study believed that protecting their infants from RSV was important, and approximately two-thirds preferred vaccination during pregnancy. Higher vaccination coverage is achievable with a strong HCP recommendation, earlier HCP counseling during pregnancy, and flexible vaccination timing outside a typical RSV season.

Writing Support

Medical writing support was provided by E.J.P., MD, at Ipsos Insight LLC and was funded by Pfizer.

Ethics Approval

This study was conducted in full conformance with the Guidelines for GPP published by the ISPE, the Helsinki Declaration of 1964, and the laws and regulations of the countries in which the research was conducted. Informed consent was collected from all participants prior to participating in the study. No identifiable data were collected during the course of this research or are included in this article. The study (Protocol #2024-0499) was approved by the Pearl IRB of Indianapolis, Indiana, on November 26, 2024.

Authors’ Contributions

A.W.L.: Conceptualization, methodology, writing, visualization, and supervision. M.J.H.: Methodology, analysis, investigation, writing, visualization, and project administration. S.J.P.: Writing, visualization, and supervision.