P3.J195: Parental Perspectives and Decision Making on Nirsevimab Administration in Otherwise Healthy Newborns

Background: Respiratory syncytial virus (RSV) is the leading cause of bronchiolitis and a major cause of pediatric hospitalizations in the U.S. In July 2023, nirsevimab, a monoclonal antibody against RSV, was approved by the FDA and later recommended by the CDC to be given to infants. Given this recent approval, we sought to better understand how parents of otherwise healthy newborns would respond to this recommendation.

Methods: Using qualitative methodology, we conducted semi-structured interviews of purposefully sampled parents of otherwise healthy term and late preterm newborns admitted to the maternity and well newborn unit between November 2023-February 2024. Interviews were performed in a constant comparative matter until thematic sufficiency was reached.

Results: We conducted 24 interviews including 27 participants. 38% of participants planned to give nirsevimab to their newborn, 25% did not plan to, and 38% were unsure. The following four major themes emerged: (1) Parents of healthy newborns had some knowledge about RSV and had only very recently heard about RSV prophylaxis being available for their newborn; (2) Parents planning to give RSV prophylaxis to their newborn trusted their pediatrician’s recommendation and feared RSV infection for their newborn; (3) Parents choosing to defer RSV prophylaxis were concerned about potential side effects, wanted more time to make an informed decision on a new recommendation, felt adequately protected by maternal RSV vaccine alone, and felt confident in their own infection prevention measures; (4) There was misinformation about nirsevimab among parents including a perception that nirsevimab is a vaccine and a new understudied intervention like the COVID-19 vaccine. Participants shared that major sources of information on nirsevimab included physicians, popular media, online (CDC), social media (including TikTok), family, other parents, and work colleagues.

Conclusion: Uncertainty existed among parents in our study regarding plans for administering nirsevimab for their newborns. Increasing overall awareness of both nirsevimab and RSV in infants and combating existing misinformation about nirsevimab can help with future uptake. Our findings underscore the importance of trust with clinicians when parents face decisions about preventive injections.