Parent Perspectives on Nirsevimab for Their Newborn

Abstract

Background: In 2023, nirsevimab, a monoclonal antibody against respiratory syncytial virus (RSV), was approved in the United States to be given to infants to prevent bronchiolitis, a leading cause of pediatric hospitalizations. We sought to better understand how parents of otherwise healthy newborns would respond to this recommendation.

Methods: We conducted semistructured interviews of purposefully sampled parents of newborns admitted to the well newborn unit between November 2023 and February 2024. Interviews were performed in a constant comparative manner until thematic sufficiency was reached using the Health Beliefs Model as a conceptual framework.

Results: We conducted 28 interviews: 38% of participants planned to give nirsevimab to their newborn, 25% did not plan to, and 38% were unsure. Four major themes emerged: (1) Major knowledge gaps existed about RSV prophylaxis; (2) trust in pediatrician's recommendation and fear of RSV infection contributed to uptake; (3) parents deferring RSV prophylaxis were concerned about side effects, wanted more time to decide, felt the maternal RSV vaccine was sufficient, and trusted their own prevention measures; and (4) there was misinformation about nirsevimab among parents including a perception that nirsevimab is a new understudied vaccine with similarities to the COVID-19 vaccine. Application of the Health Beliefs Model highlighted actionable opportunities to positively influence decision making around perceived susceptibility and RSV disease severity, benefits, barriers, self-efficacy, and cues to action.

Conclusions: Increasing overall awareness of both nirsevimab and RSV in infants, starting conversations during pregnancy to combat misinformation, leveraging trusting relationships with pediatricians and prenatal clinicians can help with future uptake.