Background/Objectives: Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis and infant hospitalization in the US. RSV prevention evolved in 2023 as nirsevimab and maternal RSV pre-fusion vaccine became available for healthy newborns and infants. This study investigates sociodemographic characteristics associated with RSV immunoprophylaxis. Methods: A cross-sectional survey was conducted from November 2023 through March 2024 among a convenience sample of parents of infants aged <8 months who received newborn care or pediatric ambulatory care at a single academic institution in Central Pennsylvania, USA. Logistic regression examined sociodemographic factors associated with RSV immunoprophylaxis uptake. Given the nirsevimab shortage during the 2023–2024 RSV season, a sensitivity analysis was completed for intended immunoprophylaxis. Results: Among 118 participants, 66.9% received RSV immunoprophylaxis while 74.5% intended to receive nirsevimab. Higher income, private insurance, out-of-home childcare, and an adult/partner working in healthcare were associated with intended nirsevimab receipt. Participation in the Women, Infants and Children program was associated with lower rates of intended nirsevimab receipt. Out-of-home childcare was associated with both RSV immunoprophylaxis uptake and intended nirsevimab receipt. Conclusions: Sociodemographic factors significantly influence the intent to receive nirsevimab and RSV immunoprophylaxis uptake. Having an adult/partner in healthcare was the most significant predictor for intent, suggesting that greater health literacy drives immunization intention. Enrollment in out-of-home childcare was the sole predictor of RSV immunoprophylaxis uptake. These findings highlight the importance of policy initiatives that promote equitable access to RSV immunoprophylaxis, including strategies to address socioeconomic barriers, improve health literacy, and ensure consistent availability of preventive agents for all infants.

New respiratory syncytial virus (RSV) immunizations for infants and pregnant mothers recently became available to prevent severe RSV disease in infants. We aimed to determine the primary reasons for parental RSV immunization decisions. We further sought to evaluate the associations between vaccine receipt and source of health care information and trust in one's health care provider. A convenience sample of parents and guardians of infants were surveyed during the 2023-2024 RSV season in one newborn nursery and three affiliated clinics that are part of an academic health system. Among the 118 respondents, 79 (66.9%) chose to receive an RSV vaccine themselves (n = 42) or consented for infant immunization (n = 37). Thirty-nine (92.9%) parents who consented to maternal vaccination and 35 (87.5%) who consented to infant immunization stated a primary reason was protection for their infant. Among those that did not receive the maternal vaccine, the most common reasons were nonavailability (39.7%) or no provider immunization offer (22.2%). Infant immunoprophylaxis was most commonly refused due to the immunization being too new (66.7%). There were no significant associations between vaccine receipt and reported source of health information or between vaccine receipt and degree of trust in the health care provider. The desire to protect their infant from illness was the primary reason for parental RSV immunization intent, while the primary reasons for not immunizing were lack of availability, lack of provider recommendation, and the perception that the immunizations are too new. Ensuring availability and strong recommendations may improve immunization uptake.

Background: Nirsevimab, a monoclonal antibody for respiratory syncytial virus (RSV), reduces medically attended RSV infections. It was introduced in the 2023–24 RSV season. This study examined the association between caregiver vaccination (seasonal influenza vaccine (SIV), COVID-19, and boosters) and intent to immunize infants against RSV. Methods: Data from 118 caregivers with infants ≤ 8 months were analyzed. Chi-squared tests and logistic regression assessed the relationship between caregiver vaccination and intent to immunize against RSV. Results: In total, 74.6% of caregivers intended to immunize their infants against RSV. Intent was positively associated with caregiver receipt of a seasonal influenza vaccine (p < 0.001), COVID-19 vaccine (p < 0.001), and COVID-19 booster (p < 0.001). Intent was also associated with older child seasonal vaccination. Caregiver receipt of both COVID-19 vaccinations and boosters had a strong relationship with RSV immunization intent (OR 7.91 (1.90–33.0, p = 0.004)). Conclusions: Caregiver vaccination behaviors are linked to RSV immunization intent, helping physicians identify hesitant families and prepare for immunization conversations.