Maternal preferences for infant respiratory syncytial virus (RSV) preventives: an Australian discrete choice experiment.

OBJECTIVES

Two RSV preventatives, a maternal RSV vaccine and a long-acting monoclonal antibody, were introduced in Australia in 2025. In the year prior to program introduction, we explored maternal acceptability, preferences, awareness and knowledge of disease and provider delivery preferences.

DESIGN

Discrete Choice Experiment (DCE).

SETTING

Qualitative data from online focus groups informed a national DCE survey.

PARTICIPANTS

Qualitative data from Australian mothers with a child <2 years was collected through focus groups, identifying key themes for decision-making. The final attributes for the DCE survey included effectiveness, cost, safety, timing, and risk perception of the disease and was administered to 1500 pregnant people and mothers with a child <2 years.

MAIN OUTCOME MEASURES: The primary outcomes were acceptability and maternal preferences for RSV preventatives and secondary outcomes were maternal awareness/knowledge of RSV and provider delivery preference.

RESULTS

We found knowledge of the monoclonal antibody and perception of disease severity were low and maternal vaccine decision-making and acceptability of preventatives is strongly influenced by cost, effectiveness and safety. Overall, 51.4% of mothers preferred the maternal vaccine and 24.3% preferred the monoclonal antibody or were 'not sure' and general practitioners (GPs) were the preferred provider for delivery.

CONCLUSION

Prior to the introduction of the hybrid RSV prevention program for infants in Australia in February 2025, we found that awareness of disease and RSV preventatives was low and that decision-making was influenced by cost, effectiveness and safety concerns. This study highlights the need for a national RSV implementation strategy and harmonised, Commonwealth-funded RSV program to optimise equitable uptake.