Pregnant persons perceptions and uptake of prenatal RSV vaccine - Minnesota, 2023-2024

Background: Respiratory syncytial virus (RSV) vaccine was recommended for use during pregnancy in September 2023. Objective: To assess pregnant persons' intentions to receive and evaluate factors associated with RSV vaccine intentions and uptake. Study Design: We invited 1999 pregnant persons >= 18 years, between 12 and 30 weeks gestation who had received prenatal care at HealthPartners to complete an online survey during September-November 2023. Our primary outcome was intention to receive RSV vaccine. We also asked respondents about reasons to or not to receive RSV vaccine and intentions to receive other vaccines during pregnancy. We assessed RSV vaccine uptake for patients 32-36 weeks gestation between 10/12/23 (first RSV vaccine in study population) and 2/1/24. We estimated adjusted prevalence ratios (aPR) and 95 % confidence intervals (CI) between responses and intention to receive RSV vaccination and, for those eligible to receive RSV vaccine, adjusted rate ratios (aRR) and 95 % CIs for RSV vaccine uptake. We adjusted aPRs and aRRs for age, race, ethnicity, Medicaid, living with children <= 5 years, and work in healthcare and weighted by inverse probability of survey participation using Poisson regression with robust variance. Results: 455 patients participated (23 % response), 26 % were non-white and/or Hispanic, 46 % lived with children <= 5 years, and 30 % work in healthcare; 65 % intended to receive RSV vaccine during pregnancy. Among 427 eligible respondents, 51 % received RSV vaccine. Factors associated with RSV vaccination intention and uptake included perceived vaccine effectiveness (aPR: 19.47, 95 % CI: 5.82, 65.12; aRR 3.06, 95 % CI: 1.70, 5.51) and a provider recommendation (aPR: 8.04, 95 % CI: 4.23, 15.29; aRR 3.30, 95 % CI: 1.99, 5.48). Among those not planning to receive RSV vaccine, responses suggested safety concerns. Conclusion: Strong recommendations for receiving RSV vaccine during pregnancy from a healthcare provider incorporating information about RSV vaccine safety and effectiveness may increase vaccine uptake.