For maternal RSV vaccine, provider recommendation mattered

Maternal RSV vaccine was first recommended by CDC last year during the 2023 to 2024 season. In a new MMWR report from CDC, the agency found that provider recommendation for that immunization in particular was associated with higher coverage.

According to the CDC survey findings, 33% of eligible pregnant women reported receiving an RSV vaccination to protect their infants from RSV—one of the most common reasons for infant hospitalization. CDC recommends a single dose of RSV vaccine at 32 to 36 weeks’ gestation during September to January. Among women with a live birth, 45% reported that their infant received nirsevimab. CDC also recommends nirsevimab, an RSV antibody, for infants who are less than 8 months old and born during or entering their first RSV season from October to March for most parts of the United States. Overall, 56% of infants were protected against severe RSV disease by either vaccination product or both.

Approximately one-half of pregnant women who responded to the survey did not report receiving a provider recommendation for maternal RSV vaccination or nirsevimab for their infants, indicating missed opportunities to protect infants from severe RSV disease. These findings further underscore the importance of a strong provider recommendation for immunization, noted researchers.

Not receiving a recommendation for vaccination from a physician, nurse, or other medical professional was the most frequently reported reason for nonreceipt of the maternal RSV vaccine followed by not knowing that RSV vaccination was needed during pregnancy, and patients having concerns about possible safety risks to the infant.

Among unvaccinated pregnant and recently pregnant women with a live birth whose infant did not receive nirsevimab, the main reasons for not getting nirsevimab for their infants included 1) concerns about the long-term safety of nirsevimab for the infant; 2) not planning to get the infant any vaccines; and 3) not wanting the infant to receive too many vaccines.

Authors of the report said that multiple challenges in rolling out the new RSV immunization products might have resulted in lower than anticipated coverage. These challenges included timing of recommendations and product availability, differing recommendations in terms of timing of vaccine and nirsevimab administration, complex clinical considerations and nuanced communications, limited time to improve awareness of the new recommendations for both health care providers and pregnant women, cost and reimbursement issues, access issues, and concerns about safety and efficacy of the products.