Assessment of physicians’ perception of pediatrics respiratory syncytial virus disease and preferences for immunization strategies in the United States

Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infection in infants and young children, placing substantial burden on patients, their families, and health systems. This observational, cross-sectional, web-based, survey study in the United States (during October - November 2023) assessed physicians' perceptions of RSV disease and new immunization strategies, including their preferences for monoclonal antibodies (mAbs) and maternal immunizations as RSV preventive measures. Immunization preferences were quantified through discrete choice experiment (DCE). Physicians aged ≥ 18 years, who spent at least 60% of their time in direct patient care and worked in a practice providing immunization to patients aged ≤ 2 years were recruited through online panels. Eighty pediatricians and 20 family practitioners participated. Mean (SD) age of physicians was 52.3 (12.7) years; majority were male (64.0%). Most physicians strongly agreed with supporting all types of recommended childhood immunizations (77.0%) and were aware of new RSV immunization strategies under development or recently approved (91.0%). A majority moderately/strongly agreed that maternal immunization and mAbs provide protection to the baby (77.0% and 87.0%, respectively). In DCE, physicians chose RSV immunization 96.1% of the time vs no immunization (3.9%). The most important attributes that drove physicians' preferences were: increasing durability of protection from 90 to 180 days (24.9%), increasing efficacy against RSV hospitalization from 57% to 80% (20.9%), and increasing efficacy against medically-attended RSV from 51% to 80% (20.2%). Understanding physicians' attitudes and preferences regarding RSV immunization strategies is important as new RSV prevention methods become available and are introduced into clinical practice.