Prevention of respiratory syncytial virus bronchiolitis in infants with maternal immunization or monoclonal antibodies for the newborn: What do women choose?

OBJECTIVES

Maternal vaccination against respiratory syncytial virus (RSV) and nirsevimab administered to the newborn are the two strategies equally recommended in France for preventing lower respiratory tract infection caused by RSV in infants. Data about their respective uptake and factors influencing mother's choice are still lacking.

METHODS

We conducted a survey through an anonymous self-administered questionnaire that was proposed during post-partum hospitalization to all mothers who gave birth in January 2025 in a French university hospital maternity ward. We collected data to assess the respective administration rates of both methods and analyzed reasons underlying women's choice: previous knowledge of RSV prevention, information received during pregnancy, and factors associated with the choice of each preventive strategy.

RESULTS

Of the 401 mothers eligible during the survey period, 274 were included. In all, 73.7% (202 of 274) chose maternal vaccination, 19.3% (53 of 274) chose nirsevimab, and 6.9% (19 of 274) did not choose any prevention. Mothers who opted for maternal vaccination (n = 202) stated that their choice was guided by immediate protection at birth (81.2%), the absence of injection for their newborn (60.4%), and the advice of their gynecologist or midwife (49.5%). Mothers who opted for nirsevimab (n = 53) stated that their choice was guided by the lack of long-term safety data on the vaccine (39.6%) and fear of vaccine adverse effects (35.8%).

CONCLUSION

Within 1 year of its introduction in France, maternal RSV vaccination was the predominant chosen strategy for preventing bronchiolitis in this study population. This is likely due to the preventive advice they received from health care professionals and their desire to avoid an injection for their newborn.