Respiratory Syncytial Virus Immunization Intention During Pregnancy and Infancy

Importance: Respiratory syncytial virus (RSV) infection is the leading cause of infant hospitalizations in the US. Two immunization options are available to protect infants against hospitalization-maternal vaccination during pregnancy or RSV antibody shot administration for infants after birth. Gaps in immunization coverage suggest missed opportunities to protect infants against RSV-associated hospitalization. Objective: To describe RSV immunization intentions, behaviors, and preferences among pregnant women and parents of young children (ages 0-5 years). Design, Setting, and Participants: For this survey study, 2 concurrent national cross-sectional surveys were implemented in April 2024. Participants were recruited from a representative online survey panel of US adults. Participants were 18 years or older and either pregnant or the parent of a young child. Data were analyzed from May to November 2025. Main Outcomes and Measures: The outcomes of interest were prevalence of positive intention to receive RSV antibody shot for child among pregnant women and parents and prevalence of positive intention to receive RSV maternal vaccine among pregnant women. Results: Of 1765 parents and 174 pregnant women, most were aged 30 years or older (parent: 78.1% [95% CI, 76.2%-80.0%]; pregnant women: 64.0% [95% CI, 56.8%-71.1%]). Among pregnant women eligible for vaccination, 55.5% (95% CI, 47.7%-63.3%) reported a positive intention toward maternal RSV vaccination. Among pregnant women with negative or unsure intention, 35.8% (95% CI, 24.3%-47.3%) would probably or definitely accept RSV vaccination following a strong health care practitioner recommendation. Among parents, 59.8% (95% CI, 57.5%-62.1%) reported a positive intention toward RSV antibody shot administration for their child. Among parents with negative or unsure intention, 27.0% (95% CI, 23.7%-30.2%) would probably or definitely accept the RSV antibody shot for their child following a strong health care practitioner recommendation. More participants preferred maternal vaccination (parents: 48.3% [95% CI, 46.0%-50.6%]; pregnant women: 58.2% (95% CI, 50.9%-65.6%]) over infant RSV antibody shot administration (parents: 9.4% (95% CI, 8.1%-10.8%]; pregnant women: 6.2% (95% CI, 2.6%-9.8%). Top reasons for negative or unsure intentions in both groups included lack of information and safety concerns. Conclusions and Relevance: In this survey study, pregnant women and parents of young children preferred maternal RSV vaccination for protecting infants against RSV infection. For some participants with negative or unsure intentions about RSV immunization, a strong health care practitioner recommendation shifted intention toward accepting immunization. Future research efforts should design and evaluate novel communication strategies for providing information about RSV immunization options to eligible families, in addition to strengthening health care practitioner recommendation in favor of immunization.