Timing is everything: optimizing maternal RSV immunization through ANC attendance patterns and timing in Viet Nam

Area of Science:

• Immunology
• Public Health
• Maternal and Child Health

Background:

• Maternal immunization against respiratory syncytial virus (RSV) is a vital strategy to protect infants from severe respiratory infections.
• Successful implementation hinges on aligning vaccine administration with antenatal care (ANC) visit schedules, particularly in resource-limited settings like Vietnam.

Purpose of the Study:

• To assess the alignment of antenatal care (ANC) visit patterns with respiratory syncytial virus (RSV) vaccine eligibility windows across different levels of healthcare facilities in Vietnam.
• To inform strategies for optimizing maternal RSV immunization program delivery.

Main Methods:

• A retrospective cross-sectional study analyzed ANC register data from 7,349 women across 15 health facilities in Vietnam in 2023.
• Gestational age at ANC visits, visit frequency, and attendance within Vietnam's (24-36 weeks) and WHO's (≥28 weeks) RSV vaccine eligibility windows were evaluated.

Main Results:

• ANC attendance and frequency varied significantly by facility level, with primary facilities showing earlier and more frequent visits.
• Maternal RSV vaccination coverage potential increased substantially under the WHO-recommended eligibility window (≥28 weeks) compared to Vietnam's current window (24-36 weeks) across all facility levels.
• Primary facilities demonstrated higher potential for RSV vaccine delivery due to earlier and more frequent ANC engagement.

Conclusions:

• Aligning maternal RSV immunization strategies with existing ANC attendance patterns is critical for effective program rollout in Vietnam.
• Primary healthcare facilities are pivotal for maternal vaccination success due to their consistent engagement with pregnant individuals.
• Adopting the broader WHO eligibility window, enhancing early ANC counseling, and improving healthcare data continuity are essential for equitable vaccine access.