(299) Pregnant persons' perceptions of RSV vaccination during pregnancy

Background: In the United States, the RSVpreF vaccine was recommended for use during pregnancy in September 2023. Little is known about pregnant individuals’ intentions to receive this vaccine.

Objectives: To assess awareness of and intention to receive a prenatal RSV vaccine via survey.

Methods: We used electronic health records (EHR) to identify pregnant persons age ≥18 years, who were between 12–30 weeks gestation and were receiving care within one health system in the Upper Midwest, United States. We mailed potential participants an invitation to complete an online survey. We performed follow-up recruitment with one phone call for non-respondents without an EHR-recorded pregnancy outcome (e.g., pregnancy loss, delivery). The survey was available September–November 2023 and included questions related to RSV vaccine awareness, intentions to receive the RSV vaccine during pregnancy, perceived barriers and benefits, and demographic information. We estimated adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) between participant responses and intention to receive RSV vaccination (definitely or probably receive vaccine) adjusted for age, race and ethnicity, Medicaid, living with children ≤5 years, and experience working in healthcare using Poisson regression with robust variance.

Results: Of the 455 patients who participated in the survey (23% of invited), 26% were non-white and/or Hispanic, 46% lived with children ≤5 years, 41% currently or previously worked in healthcare, and 77% had a bachelor’s or graduate degree. A majority (55%) were aware of the RSV vaccine and 73% reported they would probably or definitely receive it during pregnancy if available. Of the 124 respondents who did not intend to receive the RSV vaccine, 57% were worried the vaccine could harm their baby, 54% were worried about vaccine side effects, and 23% did not think the vaccine would be effective. Factors associated with intention to receive RSV vaccination included perceived infant susceptibility to RSV infection (aPR: 1.51 (95% CI: 1.22, 1.87), perceived vaccine safety (aPR: 6.60, 95%CI: 4.11, 10.58), recommendation from provider to receive RSV vaccine (aPR: 7.36, 95% CI: 4.14, 13.08), and plans to receive other vaccines during the current pregnancy (aPR: 1.32, 95% CI:1.14, 1.55 for Tdap; aPR: 2.56, 95% CI: 1.95, 3.37 for influenza; aPR: 1.77, 95% CI: 1.14, 1.55 for COVID-19).

Conclusions: In this population, more than 70% of patients intended to receive the RSV vaccine if available. Safety concerns were the primary reason for not intending to receive the vaccine. Findings from this study may be used to help design patient-level interventions to increase vaccine uptake during pregnancy.