Why Are Some Parents Still Hesitant to Vaccinate Their Child Against RSV?

Most parents have never refused any recommended vaccines and trust their child’s physician, but vaccine hesitancy still poses a challenge to immunization programs.¹ While many factors influence parental decision-making when it comes to vaccinating their child against respiratory syncytial virus (RSV), research suggests that increased awareness of the diseases can reduce vaccine hesitancy and improve trust in health care providers.

The researchers believe the study found that many parents are supportive of RSV vaccination, with informed and aware parents being more likely to vaccinate their children with the new RSV vaccine. | MargJohnsonVA - stock.adobe.com

This survey study published in Vaccine aimed to investigate vaccine hesitancy within the context of new RSV vaccines and increased virus activity in 2022 and 2023.

“Overall, parental acceptance of immunizations is related to the perceived risk and severity of the disease,” wrote the researchers of the study. “This was supported by our data showing that well-informed parents tend to be more concerned about RSV infection, and consequently are more willing to vaccinate their children.”

RSV is the most common viral pathogen identified in young children with acute lower respiratory infections. Moreover, a substantial proportion of RSV-associated morbidity occurs within the first year of life. A study of 1262 children hospitalized for RSV infection found that about 70% of cases were for children under 1 year of age, with the majority (69.9%) of children being under 3 months of age.²

In the present study, the researchers included parents or caregivers of infants aged 0 to 36 months using personal approach methods or flyers distributed in children’s hospitals, pediatric practices, and child-care facilities in Regensburg, Germany, between February to June 2023. The survey included questions pertaining to demographics, socioeconomic status, mental well-being, knowledge of RSV and perceptions of the disease, and attitudes to general childhood and RSV vaccines.

A total of 191 parents and caregivers completed the survey, with a high proportion of participating mothers (88%). The mean (SD) age of participants was 35 (4) years, with most responses coming from families with 1 child (48%) being older than 6 months (86%).

Of the participants, 84% reported they had never refused any recommended vaccinations, and 91% reported they trusted their child’s pediatrician. However, 11% of participants said they felt children should have fewer vaccinations or be able to get over the illness on their own.

Additionally, parents who were supportive or undecided about RSV vaccination were less likely to be vaccine hesitant in general (OR, 0.03; P < .001; OR, 0.13; P = .003).

Furthermore, 58% reported having good or basic knowledge of RSV, which correlated with a higher socioeconomic status index (P = .049). While 24% were undecided about RSV vaccination, all parents rated its benefit high in the first year of life.

Parents who refused the RSV vaccination were less concerned about the infection compared with those who support vaccinations (OR, 0.44; P < .001), while those previously hospitalized children (OR, 3.88; P = .017) or preterm-born children (OR, 5.12; P = .026) were generally more concerned.

However, the researchers acknowledged some limitations to the study, including potential participation bias, a small sample size, and potential overestimation of participant knowledge through self-reported answers. Additionally, the study excluded vaccine hesitancy among pregnant individuals.

Despite these limitations, the researchers believe the study found that many parents are supportive of RSV vaccination, with informed and aware parents being more likely to vaccinate their children with the new RSV vaccine.

“Now that RSV has become a vaccine-preventable disease, providing the unique opportunity to substantially reduce illness and deaths in the coming season 2023/2024, it is essential that especially the “target group” of parents who are hesitant but accessible receive all the information on the new vaccines they need to make an informed decision in due time,” wrote the researchers.

References

1. Langer S, Holzapfel S, August L, et al. Parental knowledge and attitudes to infant immunization in the context of RSV: All about confidence? Vaccine. Published online June 19, 2024. doi:10.1016/j.vaccine.2024.06.018

2. Steinzor P. How COVID-19 has impacted RSV epidemiology among children in a hospital setting. June 7, 2024. Accessed June 26, 2024. https://www.ajmc.com/view/how-covid-19-has-impacted-rsv-epidemiology-among-children-in-a-hospital-setting