Respiratory Syncytial Virus Immunization Disparities in Mothers and Infants at the Birth Hospitalization: A Cross-Sectional Study.

Abstract

To review rates of nirsevimab immunization for respiratory syncytial virus (RSV) among mother-newborn dyads admitted to a single tertiary medical center system. A retrospective study examined RSV immunization rates across admitted mother-infant dyads between November 2024 and February 2025. Other collected data included gestational age, sex, delivery type, newborn medication receipt/declination, and maternal demographics. We analyzed specifically the relationship between RSV immunization and race and ethnicity, language, and other patient characteristics. Of 1156 mothers, 854 (74%) received the RSV vaccine during pregnancy. There were statistically significant differences in race and RSV vaccine receipt, with rates highest among Asian mothers (85%) and lowest among non-Hispanic Black mothers (59%). Among 302 newborns, 135 (55%) received nirsevimab during hospitalization. Differences in race and nirsevimab receipt were statistically significant, with uptake highest among Asian newborns (83%) and lowest among non-Hispanic White infants (47%). Secondary analyses showed significant associations between maternal and newborn RSV immunization and newborn medication acceptance, and between maternal RSV vaccination and maternal age, insurance type, and religion. Our study found substantial disparities in RSV immunization by race for mothers and infants. Some disparities were mitigated during the birth hospitalization, suggesting that the inpatient setting can effectively reduce health disparities. Given the effectiveness of RSV immunization addressing these disparities should be prioritized.