Preferences of Dutch pregnant women for RSV immunisation - a mixed method study

Implementation of newly approved RSV preventive options is advancing rapidly. Therefore, we examined pregnant women's preferences regarding these RSV preventive options to optimise their implementation in immunisation programmes.

A mixed method study was conducted including a cross-sectional survey (March 2022 - March 2023) and a qualitative study (January-February 2024) at 15 antenatal clinics and the Wilhelmina Children's Hospital in the Netherlands. The questionnaire was created using the theoretical 5Cs framework about vaccine hesitancy. Utilizing a 10-point rating scale, the importance of several factors influencing preference for maternal or infant immunisation were evaluated and participants were asked which option they would prefer. To further explore factors that influence vaccine decision-making focus groups were performed and analysed using inductive thematic analysis.

A total of 412 women completed the questionnaire and 12 women participated in three focus groups. Majority of women (77.4%, 319/412) expressed a positive attitude to obtain either RSV preventive option. When asked for a definite decision, almost 90% of women preferred maternal vaccination. The most important influencing factors were protection against RSV disease and the safety of immunisation for the child before (i.e. in utero) and after birth. During the focus groups, advice of healthcare professionals was considered an important factor in decision making and all women referred to the balance between vaccine safety, prevention of the disease and duration of protection. Women would change their choice to the other option in case the other option has a greater protection against RSV.

We found that the majority of women have a positive attitude toward receiving either a maternal vaccine or infant immunisation. Therefore, it is likely that Dutch pregnant women would be positive to receive either RSV preventive option, provided they receive accurate and comprehensive information that specifically addresses the factors they consider most important.