Clinician recommendation may unlock RSV protection for hesitant families

Clinical takeaway: Discuss RSV prevention early in pregnancy, explain both available strategies clearly, address maternal and infant safety concerns directly, and make a strong recommendation tailored to eligibility, timing, and family preference.

RSV is a leading cause of infant hospitalization, and timely, confident counseling may help families choose between maternal vaccination and infant monoclonal antibody protection.

In 2 national cross-sectional surveys conducted in April 2024, researchers assessed RSV immunization intentions among 174 pregnant women and 1,765 parents of children aged 0 to 5 years. Among eligible pregnant respondents, 55.5% intended to receive or had received maternal RSV vaccination. Positive intention toward an infant RSV antibody shot was reported by 55.7% of pregnant women and 59.8% of parents.

Maternal vaccination was clearly preferred: 58.2% of pregnant women and 48.3% of parents selected vaccination during pregnancy, compared with 6.2% and 9.4%, respectively, who preferred an antibody shot for the infant.

Among respondents who were unsure or opposed, clinician counseling had measurable influence. A strong recommendation shifted 35.8% of pregnant women toward maternal vaccination and approximately 27% of pregnant women and parents toward accepting an infant antibody shot.

The most common barriers were insufficient information and safety concerns. About half of pregnant women with negative or uncertain maternal-vaccine intentions said they did not know enough to decide; concerns about safety for the infant and mother were also frequent. Among parents hesitant about the antibody shot, 40.0% cited long-term safety concerns and 38.6% cited inadequate information.

The authors concluded that an “information gap” was a key barrier and called for multipronged communication strategies beyond the clinical encounter. An accompanying commentary emphasized that acceptance alone may not ensure uptake because vaccine timing, product availability, practice policies, and reimbursement can also impede prevention.

Source: Porter RM, et al. (2026 July 24) JAMA Netw Open. Respiratory Syncytial Virus Immunization Intention During Pregnancy and Infancy