RSV Prophylaxis in Neonates: Implementation and Parental Acceptance during the First RSV Season in Germany

RSV is the leading cause of lower respiratory tract infections (LRTI) in infants. Since 2024, STIKO recommends immunising all neonates with nirsevimab prior to or during their first RSV season. This study aims to assess parental acceptance and uptake of RSV immunisation during the first implementation season in Germany.

All neonates born at our hospital between 11 November 2024 and 31 January 2025 were included in this study. Parents received an antenatal information leaflet; counselling was part of the U2 medical checkup. The immunisation rate was assessed using data from electronic medical records. In addition, an online questionnaire surveyed parental satisfaction with the information provided.

Of 1030 neonates, 76% received nirsevimab, 6% were protected by maternal RSVpreF vaccination (overall immunisation rate: 82%). Children of multiparous mothers were immunised less often than children of primiparous mothers (OR = 0.52; p < 0.001). Mothers aged ≥ 30 years were more likely to consent to vaccination (30-34: OR = 1.75; ≥ 35: OR = 1.72). 68% of parents had already made their decision prior to delivery. Of 153 respondents, 17% requested more detailed information on safety, duration of vaccination protection, and availability of the vaccine.

Maternal age and parity appear to be associated with nirsevimab uptake. Early prepartum counselling and transparent communications regarding product safety could further increase acceptance.