Maternal and infant immunizations for respiratory diseases, United States, may 2025

To assess end-of-season coverage with influenza, tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap), and COVID-19 vaccines among pregnant women, and respiratory syncytial virus (RSV) immunization among pregnant women and their infants, during the 2024-25 respiratory illness season.

Data from an Internet panel survey conducted during March 26-May 8, 2025, were analyzed. The study included 2738 currently and recently pregnant women; analysis of each immunization product was restricted to a subsample of participants eligible for the specific product (influenza: 1788; Tdap: 885; COVID-19: 2125; maternal RSV: 721; nirsevimab: 1416). Coverage was assessed for individual vaccines, along with demographic characteristics, provider recommendation for immunization, and attitudes, including perceptions on safety and effectiveness of vaccines. Differences in vaccination coverage between groups were assessed using t-tests.

Among eligible participants, 51.0% reported receiving influenza vaccine before or during pregnancy, 52.6% reported receiving Tdap vaccine during pregnancy, 32.3% reported receiving the 2024-25 COVID-19 vaccine before or during pregnancy, and 49.3% reported receiving an RSV vaccine during pregnancy. Among 1416 women with eligible infants, 62.2% reported their infant received nirsevimab; overall, 70.4% of infants were protected by maternal RSV vaccine, nirsevimab, or both. Vaccination coverage was higher among women with a provider recommendation compared to those without for influenza (65.6% vs. 12.2%), Tdap (69.5% vs. 2.9%), and COVID-19 (56.4% vs. 4.4%) vaccines. Prevalence of provider recommendation for Tdap vaccination was lower among non-Hispanic Black (66.4%) and Hispanic women (60.1%) compared with non-Hispanic White women (83.2%). Women reporting being very/somewhat hesitant about a given vaccine were less likely than non-hesitant women to have received that vaccine.

Provider recommendation and vaccine hesitancy were associated with maternal vaccine uptake. Because providers have been found to be trusted information sources for patients, efforts supporting informative vaccine conversations between providers and pregnant women could help increase the proportion of pregnant women and infants protected against severe respiratory illnesses.