Written by Kimiko Dunbar
Spoon Feed
Hesitancy around receipt of nirsevimab in infants stems from knowledge gaps about RSV and the injection broadly. Early prenatal education and existing relationships with providers can help to offset hesitancy.
How bad is RSV, anyway?
We recently covered RSV disease burden and nirsevimab effectiveness during the first respiratory season following its release and learned there was low uptake of RSV prophylaxis and no significant change in RSV disease burden overall. Was this due to limited supply or lack of parental buy-in?
This qualitative study explored parental perspectives on nirsevimab for RSV prevention in newborns through semi-structured interviews with 28 parents. Participants were selected between Nov. 2023 – Feb. 2024 on the well-baby unit after delivering healthy, term infants. Only 38% planned to administer nirsevimab, while 25% declined, and 38% were unsure. Themes included knowledge gaps about RSV and nirsevimab, trust in pediatricians, needing more time to decide, concerns about side effects, and misinformation likening nirsevimab to COVID-19 vaccines. Findings suggest that early prenatal education and leveraging provider relationships may improve uptake and reduce hesitancy surrounding RSV prophylaxis. The sample size of this single-center study is small: 28 interviews with insured, English-speaking parents. It’s hard to know if these findings hold true for a broader population. Further, this institution recommended nirsevimab to all infants regardless of maternal vaccination status. Some parents declined newborn administration because they felt that maternal administration (>14 days prior) was sufficient, which is consistent with CDC recommendations.
How will this change my practice?
Discussions around vaccination/injections for babies can be tricky. It’s helpful to understand the perspectives of those who are hesitant about RSV prophylaxis. The authors offer helpful talking points about nirsevimab administration – namely, nirsevimab is an antibody, not a vaccine, and is similar to the antibody that has been used and tested for safety for many years previously (palivizumab). We should also leverage long-standing relationships with families in discussions, acknowledging we may not be as successful if prophylaxis is only mentioned by hospitalists in the newborn nursery who have known the family for 24-48 hours.
Source
Parent Perspectives on Nirsevimab for Their Newborn. Pediatrics. 2024 Dec 1;154(6):e2024067532. doi: 10.1542/peds.2024-067532. PMID: 39587878
