Currently submitted to: JMIR Formative Research
Date Submitted: May 7, 2026
Open Peer Review Period: May 14, 2026 - Jul 9, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Decision-making around Respiratory Syncytial Virus (RSV) Immunization for infants in the United States: A qualitative interview study
ABSTRACT
Background:
Respiratory Syncytial Virus (RSV) is a leading cause of hospitalization among infants in the U.S., yet uptake of maternal RSV vaccination and infant RSV monoclonal antibody products remains low.
Objective:
This qualitative study examined behavioral and social drivers shaping RSV immunization decisions.
Methods:
Twelve interviews were conducted with pregnant and postpartum adults across the U.S. Participants were purposively sampled to reflect diverse RSV immunization intentions. The WHO’s Behavioral and Social Drivers of Vaccination Framework guided data collection and analysis. Interviews were analyzed using framework analysis and quantitative screening data were descriptively summarized to stratify intention.
Results:
RSV immunizations decisions were shaped by interacting emotional, social, and practical considerations. Positive-intention individuals reported greater trust in medical expertise, experiences with RSV illness, and confidence in vaccination. Unsure or negative-intention individuals emphasized concerns about vaccine novelty, side effects, and eligibility timing. Participants expressed preference for maternal vaccination due to perceived immediacy of protection, though practical barriers like vaccine availability created uncertainty. Trusted clinician communication was cited as essential for decision-making.
Conclusions:
RSV immunization decisions reflect intertwined motivational, social, and structural factors. Integrating maternal RSV vaccination into prenatal care and providing early, patient-centered education may strengthen confidence, reduce barriers, and improve timely uptake.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.