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Understanding parental decisions to decline or delay infant RSV immunisation, nirsevimab, in Western Australia in
Shevaun Drislane1, Hannah Moore2, Katie Attwell1
1School of Social Sciences, Political Science and International Relations, University of Western Australia, Australia.
Insights
Parental concerns about safety, disease risk, and alternative strategies influenced decisions to decline or delay nirsevimab (monoclonal antibody) for respiratory syncytial virus (RSV) protection in infants.
Area of Science:
- Immunology
- Public Health
- Pediatrics
Background:
- Respiratory syncytial virus (RSV) poses a significant health risk to infants.
- Nirsevimab, a monoclonal antibody, was introduced in Western Australia in 2024 to protect eligible infants from RSV.
- Understanding parental vaccine decision-making is crucial for public health initiatives.
Purpose of the Study:
- To explore parental reasons for declining or delaying nirsevimab immunisation for their infants.
- To investigate parental knowledge and perceptions of RSV infection.
- To understand broader parental attitudes towards infant immunisation.
Main Methods:
- Qualitative study employing semi-structured interviews with eleven parents.
- Interviews explored rationales for nirsevimab decisions, RSV knowledge, and general immunisation attitudes.
- Inductive and deductive coding and analysis of interview responses.
Main Results:
- Key factors influencing decisions included safety concerns and potential side effects of nirsevimab.
- Lack of knowledge or underestimation of RSV disease risk and burden was a significant factor.
- Alternative risk mitigation strategies and healthcare provider advice also shaped parental choices.
Conclusions:
- Parental hesitancy towards nirsevimab is influenced by a complex interplay of safety perceptions, risk assessment, and external advice.
- This study provides novel qualitative insights into nirsevimab vaccine hesitancy in Australia.
- Findings can inform strategies to improve RSV immunisation program rollout and uptake in Australia and globally.
Purpose:
In 2024, the government of Western Australia introduced 'nirsevimab', a monoclonal antibody offering protection from respiratory syncytial virus (RSV), for eligible infants. This study explores why parents of infants who were eligible to receive nirsevimab opted to decline or delay the immunisation.
Methods:
Semi-structured, qualitative interviews were conducted with eleven parents to understand rationales for their decline or delay decision, their knowledge and understanding of RSV infection, and their broader attitudes to immunisation. Interview responses were inductively and deductively coded and analysed.
Findings And Conclusion:
Factors shaping parents' decline or delay decisions included concerns as to the safety and potential side effects of nirsevimab, lack of knowledge or under-estimation of disease risk and burden of RSV, reasoning based on alternative risk mitigation strategies and conditions, and following healthcare provider advice. This study is one of few globally, and the first if its kind in Australia, to use qualitative methods to deeply explore parental decline or delay of infant RSV immunisation. Its significant contribution to knowledge can aid strategic improvements in rollout and maintenance of infant RSV immunisation programs in Australia and globally.
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