Respiratory syncytial virus (RSV) prevention: perception and willingness of expectant parents in the Netherlands

Objectives: To investigate the perception and willingness of pregnant women and their partners to accept maternal vaccination or neonatal immunization against respiratory syncytial virus (RSV). Design: A cross-sectional survey study Setting: Pregnant women and their partners were recruited through healthcare professionals (midwives, gynaecologists, and Youth Health care), social media platforms (Instagram, LinkedIn, Facebook via institutions like the Spaarne Hospital), and the 9-Months Fair in the Netherlands. Main outcome measures: Willingness and motivation in decision-making for both maternal RSV vaccination or neonatal RSV immunization among pregnant women and their partners, including strategy preferences, and informational needs. Results: In total 1001 pregnant women (mean age: 31.1 years) and their partners (mean age: 33.2 years) completed the survey. On average, they were 24 weeks pregnant at the time, and 54.6% had no other children yet. The majority was Dutch-born (95.2% of women); with 68.3% of women having completed higher education and with overall strong pro-vaccination attitudes (93.9% of partners intended to vaccinate their expected newborn). The overall acceptability to vaccination and immunization was high, with 87% of respondents indicating they would (likely) accept both strategies. A positive attitude towards both methods was associated with previous experience with severity of RSV, intention to vaccinate the newborn and parental vaccination status during childhood and current pregnancy. When the choice was given, the majority of participants, in particular those with children and the intention to breastfeed, favoured maternal vaccination over passive immunization of infants (75.3% of the pregnant and 71.6% of the partners). A majority of the respondents cited optimal protection for the child and knowledge of RSV as important factors for accepting RSV prophylaxis. Conclusions: While most participants would accept both strategies for RSV protection of their infant, a majority, especially those with other children, favored maternal vaccination, due to concerns about infant safety and awareness of RSV severity.