Maternal views on the RSVpreF Vaccine: Thematic analysis of survey data from the first season of implementation in England and Scotland

Background: Respiratory syncytial virus (RSV) is a leading cause of infant hospitalisation due to lower respiratory tract infections. Until 2022, prevention in the United Kingdom (UK) was limited to the costly monoclonal antibody palivizumab. In August 2024, the RSVpreF (Abrysvo, Pfizer) maternal vaccine was introduced into the national immunisation schedule. Programme success depends on vaccine effectiveness as well as maternal access, acceptance and uptake. <br/>Objective: To explore maternal perspectives on the RSVpreF vaccine and identify barriers and facilitators to vaccine uptake, in order to inform antenatal education and public health strategies.<br/><br/>Methods: Qualitative analysis of maternal survey responses was conducted using an interpretive approach, following Braun and Clarke’s thematic analysis methodology. NVivo software supported the coding process. Free-text responses were obtained from 388 vaccine-eligible mothers of infants hospitalised with bronchiolitis, lower respiratory tract infection, or acute wheeze, collected prospectively between September 2024 and March 2025 across 30 sites, as part of the BronchStop vaccine effectiveness study.<br/><br/>Results: Four key themes were identified: 1. access-related barriers to vaccination; 2. insufficient RSV awareness and information to support informed decision-making; 3. vaccine safety concerns and hesitancy; and 4. perceived benefits and protective value of the maternal RSV vaccine. These themes were consistent across sociodemographic groups. <br/><br/>Conclusion: Uptake of the maternal RSV vaccine was influenced by access barriers, informational gaps and perceived safety concerns. Improved vaccine delivery, enhanced awareness and personalised antenatal counselling are essential to increase uptake. Addressing structural inaccessibility and tailoring antenatal education are critical for future RSV seasons. Ongoing qualitative research is needed to guide targeted public health interventions.