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Poster Session 4

Category: Infectious Diseases

Poster Session 4

(1037) The First Two Seasons of Maternal RSV Immunization: Patients’ Acceptance, Satisfaction, and Costs

Thursday, February 12, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Audra C. Fain, MD (she/her/hers)

Resident Physician
Department of Obstetrics and Gynecology, David Geffen School of Medicine at University of California, Los Angeles (UCLA)
Los Angeles, California, United States

Coauthor(s)

TN

Tina A. Nguyen, MD

Associate Professor
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, David Geffen School of Medicine at University of California, Los Angeles (UCLA)
Los Angeles, California, United States
NS

Neil S Silverman, MD

Professor
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, David Geffen School of Medicine at University of California, Los Angeles (UCLA)
Los Angeles, California, United States

Objective:
The respiratory syncytial virus (RSV) vaccine’s efficacy to reduce infant RSV–related morbidity has been established, yet low rates of prenatal RSV vaccination were seen in the first 2 seasons of vaccine availability: 18% in 2023-24 and 38% in 2024-25 (CDC RSV Vaxview). We sought to explore potential vaccine acceptance barriers, as well as identify factors impacting differences in patients’ attitudes and costs between the 2 seasons.

Study Design:
An IRB-approved protocol identified all patients in our health system receiving an RSV vaccine during either RSV seasons from 2023-25. RSV vaccination is available on-site in all outpatient obstetric clinical areas in our system. Patients received an invitation to participate via their electronic patient portal. Data collected included demographics, other vaccinations, satisfaction metrics, billing and payment requests, and selected pregnancy outcomes.

Results:
Among eligible patients, RSV vaccine acceptance rates surpassed national rates across seasons and showed a significant increase between the 2023 and 2024 season (Table 1). Satisfaction with on-site vaccine availability was consistently high (4.5-4.7/5.0), with low rates of reported side effects (6-8%). Acceptability of future RSV vaccination was uniformly high across seasons. For out-of pocket costs, 5-12% of patients received a bill after their vaccine; required payment decreased from 79% to 46% between seasons. When payment was required, 54% were responsible for > $100, similar between seasons. Preterm delivery rates were low and stable between seasons (5.8% vs 7.0%, p = 0.57), and were unrelated to interval between vaccination and delivery. Reported infant RSV infections declined between seasons (11.9% vs 6.6%, p = 0.04) but occurred significantly sooner after birth in 2024-25 (p < 0.001) and were more likely to result in hospitalization.

Conclusion:
High rates of RSV vaccine acceptance and satisfaction were identified, with on-site vaccine availability a strong factor in acceptance. Persistence of billing and insurance concerns across seasons highlights coverage as a key barrier for vaccination.