Parent Perspectives on Nirsevimab for Their Newborn

In 2023, nirsevimab, a monoclonal antibody against respiratory syncytial virus (RSV), was approved in the United States to be given to infants to prevent bronchiolitis, a leading cause of pediatric hospitalizations. We sought to better understand how parents of otherwise healthy newborns would respond to this recommendation.

We conducted semistructured interviews of purposefully sampled parents of newborns admitted to the well newborn unit between November 2023 and February 2024. Interviews were performed in a constant comparative manner until thematic sufficiency was reached using the Health Beliefs Model as a conceptual framework.

We conducted 28 interviews: 38% of participants planned to give nirsevimab to their newborn, 25% did not plan to, and 38% were unsure. Four major themes emerged: (1) Major knowledge gaps existed about RSV prophylaxis; (2) trust in pediatrician's recommendation and fear of RSV infection contributed to uptake; (3) parents deferring RSV prophylaxis were concerned about side effects, wanted more time to decide, felt the maternal RSV vaccine was sufficient, and trusted their own prevention measures; and (4) there was misinformation about nirsevimab among parents including a perception that nirsevimab is a new understudied vaccine with similarities to the COVID-19 vaccine. Application of the Health Beliefs Model highlighted actionable opportunities to positively influence decision making around perceived susceptibility and RSV disease severity, benefits, barriers, self-efficacy, and cues to action.

Increasing overall awareness of both nirsevimab and RSV in infants, starting conversations during pregnancy to combat misinformation, leveraging trusting relationships with pediatricians and prenatal clinicians can help with future uptake.