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Infant Respiratory Syncytial Virus Immunization Through Maternal Vaccination and Nirsevimab
Karen P Acker1, Kevin Strobino2, Jessica M DeAngelis1
1Department of Pediatrics, Weill Cornell Medicine, New York, New York.
JAMA Network Open
|February 16, 2026
Summary
Respiratory syncytial virus (RSV) immunization uptake in infants increased from the 2023-2024 to the 2024-2025 season. However, infants with public insurance had lower receipt rates for maternal RSV vaccine and nirsevimab.
Area of Science:
- Pediatrics
- Immunology
- Public Health
Background:
- Two novel respiratory syncytial virus (RSV) prevention methods, maternal RSV vaccination and nirsevimab, became available for infants in 2023.
- Factors influencing the uptake of these RSV prevention strategies during their initial seasons remain incompletely understood.
Purpose of the Study:
- To determine the rate of RSV immunization via maternal vaccination or nirsevimab in infants during the 2023-2024 and 2024-2025 RSV seasons.
- To identify demographic and socioeconomic factors associated with the receipt of these RSV immunizations.
Main Methods:
- A cohort study was conducted at a New York quaternary care hospital from October 2023 to March 2025, including infants under 8 months.
- Primary outcomes included receipt of maternal RSV vaccine (≥14 days pre-delivery) or nirsevimab.
- Multinomial logistic regression analyzed factors associated with immunization, controlling for age, sex, season, insurance, and race/ethnicity.
Main Results:
- Overall RSV immunization coverage increased from 57.6% in 2023-2024 to 75.3% in 2024-2025.
- Maternal RSV vaccine uptake was 21.1% (2023-2024) and 36.2% (2024-2025); nirsevimab uptake was 36.5% (2023-2024) and 39.1% (2024-2025).
- Public insurance was associated with lower odds of receiving maternal RSV vaccine (AOR=0.18) and nirsevimab (AOR=0.80) compared to private insurance.
Conclusions:
- RSV immunization rates in infants significantly improved between the 2023-2024 and 2024-2025 seasons.
- Persistent disparities exist, with infants holding public insurance being less likely to receive either RSV prevention method.
- Targeted interventions are necessary to address these inequities and improve broad access to RSV immunization.
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