What Form of RSV Protection Do Women Prefer: Maternal Vaccination or Infant Immunisation? A Cross-Sectional Survey in Europe
Abstract
1. Introduction
2. Methods
2.1. Study Design and Variables
2.2. Study Participants
2.3. Ethics
2.4. Data Analysis
3. Results
3.1. Demographics
3.2. Awareness and Knowledge of RSV
3.3. Likelihood to Initiate Conversations About RSV Immunisation
3.4. Likelihood to Accept Maternal RSV Vaccination
3.5. Preferences for Method of Immunisation
3.6. Factors Influencing Acceptance of Maternal Vaccination During Pregnancy
3.7. Factors Influencing Hesitancy Around Maternal Vaccination During Pregnancy
4. Discussion
Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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| Total (n = 740) | Finland (n = 47) | France (n = 116) | Germany (n = 100) | Italy (n = 144) | Spain (n = 126) | UK (n = 207) | |
|---|---|---|---|---|---|---|---|
| Age | |||||||
| Mean | 33 | 30 | 34 | 32 | 35 | 34 | 31 |
| 18–29 | 222 (30%) | 20 (43%) | 32 (28%) | 31 (31%) | 24 (17%) | 27 (21%) | 87 (42%) |
| 30–39 | 385 (52%) | 26 (55%) | 55 (47%) | 56 (56%) | 84 (58%) | 69 (55%) | 89 (43%) |
| 40+ | 133 (18%) | 1 (2%) | 29 (25%) | 13 (13%) | 36 (25%) | 30 (24%) | 31 (15%) |
| Pregnancy Status | |||||||
| Currently pregnant | 411 (56%) | 20 (43%) | 60 (52%) | 60 (60%) | 60 (42%) | 61 (48%) | 150 (73%) |
| Trying to conceive | 223 (30%) | 16 (34%) | 38 (33%) | 24 (24%) | 59 (41%) | 50 (40%) | 36 (17%) |
| Pregnant in past 12 months | 106 (14%) | 11 (23%) | 18 (16%) | 16 (16%) | 25 (17%) | 15 (12%) | 21 (10%) |
| Parental Status | |||||||
| Parent | 525 (71%) | 34 (72%) | 87 (75%) | 67 (67%) | 98 (68%) | 91 (72%) | 151 (73%) |
| Non-parent | 215 (29%) | 13 (28%) | 29 (25%) | 33 (33%) | 46 (32%) | 35 (28%) | 56 (27%) |
| Vaccines received in the last 12 months | |||||||
| Influenza | 407 (55%) | 24 (51%) | 51 (44%) | 58 (58%) | 79 (55%) | 78 (62%) | 128 (62%) |
| Tdap | 229 (31%) | 15 (32%) | 35 (30%) | 34 (34%) | 37 (26%) | 37 (29%) | 77 (37%) |
| COVID-19 | 348 (47%) | 16 (34%) | 53 (46%) | 44 (44%) | 60 (42%) | 71 (56%) | 118 (57%) |
| Education Status | |||||||
| University Graduate | 456 (62%) | 29 (62%) | 77 (66%) | 50 (50%) | 91 (63%) | 69 (55%) | 153 (74%) |
| Country | Number of respondents, n (%) | ||||||
|---|---|---|---|---|---|---|---|
| Total | Finland | France | Germany | Italy | Spain | UK | |
| Self-Reported Familiarity (n = 740) | |||||||
| RSV | 333 (45%) | 25 (53%) | 26 (22%) | 56 (56%) | 58 (40%) | 54 (43%) | 118 (57%) |
| COVID-19 | 636 (86%) | 41 (87%) | 90 (78%) | 85 (85%) | 132 (92%) | 101 (80%) | 193 (93%) |
| Influenza | 629 (85%) | 40 (85%) | 88 (76%) | 86 (86%) | 131 (91%) | 98 (78%) | 190 (92%) |
| Pneumonia | 474 (64%) | 33 (71%) | 58 (50%) | 71 (71%) | 76 (53%) | 79 (63%) | 153 (74%) |
| Bronchiolitis | 429 (58%) | 15 (32%) | 71 (61%) | 60 (60%) | 104 (72%) | 81 (64%) | 124 (60%) |
| Knowledge on RSV risk factors (n = 660) | |||||||
| Weakened immune system | 296 (45%) | 20 (50%) | 44 (42%) | 35 (38%) | 46 (38%) | 46 (43%) | 115 (58%) |
| Premature birth (before 32 weeks) | 240 (36%) | 13 (33%) | 40 (38%) | 36 (39%) | 31 (26%) | 37 (35%) | 93 (47%) |
| Age 6 months or younger | 223 (34%) | 20 (50%) | 26 (25%) | 34 (37%) | 37 (31%) | 27 (25%) | 69 (35%) |
| Children with chronic lung disease | 195 (30%) | 12 (30%) | 40 (38%) | 25 (27%) | 25 (21%) | 27 (25%) | 71 (36%) |
| Children with heart disease (present at birth) | 195 (30%) | 12 (30%) | 35 (34%) | 19 (21%) | 36 (30%) | 28 (26%) | 71 (36%) |
| Children who have neuromuscular disorders | 149 (23%) | 10 (25%) | 24 (23%) | 12 (13%) | 22 (18%) | 25 (24%) | 63 (32%) |
| Children exposed in daycare or to sick adults | 260 (39%) | 23 (58%) | 32 (31%) | 31 (34%) | 42 (35%) | 42 (40%) | 75 (38%) |
| Child with a genetic disorder | 128 (19%) | 7 (18%) | 21 (20%) | 17 (18%) | 18 (15%) | 21 (20%) | 50 (25%) |
| I don’t know | 106 (16%) | 3 (8%) | 23 (22%) | 14 (15%) | 23 (19%) | 19 (18%) | 28 (14%) |
| Factor | Number of Respondents, n (%) by Country | ||||||
|---|---|---|---|---|---|---|---|
| Total (n = 578) | Finland (n =35) | France (n = 86) | Germany (n = 73) | Italy (n = 105) | Spain (n = 102) | UK (n = 177) | |
| Safety * | 377 (65%) | 28 (80%) | 53 (62%) | 41 (56%) | 69 (66%) | 61 (60%) | 119 (67%) |
| Safe for baby | 261 (45%) | 22 (63%) | 38 (44%) | 25 (34%) | 46 (44%) | 38 (37%) | 87 (49%) |
| Safe during pregnancy | 252 (44%) | 19 (54%) | 30 (35%) | 28 (38%) | 44 (42%) | 44 (43%) | 89 (50%) |
| Safe for me | 210 (36%) | 15 (43%) | 33 (38%) | 20 (27%) | 38 (36%) | 36 (35%) | 69 (39%) |
| Efficacy ** | 353 (61%) | 26 (74%) | 55 (64%) | 42 (58%) | 53 (50%) | 54 (53%) | 119 (67%) |
| Vaccine protects baby immediately at birth | 230 (40%) | 18 (51%) | 29 (34%) | 27 (37%) | 35 (33%) | 42 (41%) | 76 (43%) |
| Prevents serious complications/symptoms | 230 (40%) | 18 (51%) | 34 (40%) | 24 (33%) | 36 (34%) | 38 (37%) | 78 (44%) |
| Prevents hospitalizations | 173 (30%) | 17 (49%) | 23 (27%) | 17 (23%) | 24 (23%) | 29 (28%) | 53 (30%) |
| Prevents transmission to others | 148 (26%) | 12 (34%) | 19 (22%) | 22 (30%) | 20 (19%) | 20 (20%) | 51 (29%) |
| Others | |||||||
| Recommendation from healthcare provider | 211 (37%) | 15 (43%) | 22 (26%) | 18 (25%) | 41 (39%) | 36 (35%) | 90 (51%) |
| Multi-year protection | 145 (25%) | 12 (34%) | 22 (26%) | 17 (23%) | 22 (21%) | 27 (26%) | 35 (20%) |
| Advice from government bodies | 137 (24%) | 9 (26%) | 10 (12%) | 27 (37%) | 27 (26%) | 16 (16%) | 44 (25%) |
| Advice from pregnancy support groups | 124 (22%) | 8 (23%) | 12 (14%) | 23 (32%) | 17 (16%) | 17 (17%) | 48 (27%) |
| Insurance covers cost | 108 (19%) | — | 16 (19%) | 21 (29%) | 13 (12%) | 12 (12%) | 37 (21%) |
| Believe baby will be at risk for RSV | 100 (17%) | 7 (20%) | 14 (16%) | 16 (22%) | 11 (10%) | 16 (16%) | 35 (20%) |
| Advice from friends/family | 87 (15%) | 6 (17%) | 10 (12%) | 11 (15%) | 7 (7%) | 18 (18%) | 37 (21%) |
| Nothing would influence decision | 22 (4%) | — | 5 (6%) | 3 (4%) | 2 (2%) | 3 (3%) | 7 (4%) |
| Country | Number of Respondents, n (%) | ||||||
|---|---|---|---|---|---|---|---|
| Total (n = 78) | Finland (n = 1) | France (n = 17) | Germany (n = 12) | Italy (n = 19) | Spain (n = 12) | UK (n = 17) | |
| Safety and Side Effects * | 37 (47%) | - | 6 (35%) | 9 (75%) | 12 (63%) | 3 (25%) | 6 (35%) |
| I think the vaccine could harm my baby | 21 (27%) | - | 4 (24%) | 6 (50%) | 8 (42%) | 1 (8%) | 2 (12%) |
| I think the vaccine could harm me | 15 (19%) | - | 1 (6%) | 4 (33%) | 6 (32%) | 1 (8%) | 3 (18%) |
| I think the vaccine could put my pregnancy at risk | 21 (27%) | - | 3 (18%) | 6 (50%) | 6 (32%) | 2 (17%) | 3 (18%) |
| I am worried about the long-term side effects with the vaccine | 29 (37%) | 1 (100%) | 4 (24%) | 4 (33%) | 5 (26%) | 3 (25%) | 2 (12%) |
| I am worried about the short-term side effects with the vaccine | 14 (18%) | - | 2 (12%) | 4 (33%) | 4 (21%) | 1 (8%) | 3 (18%) |
| Lack of knowledge ** | 24 (31%) | - | 7 (41%) | 4 (33%) | 7 (37%) | 2 (17%) | 5 (29%) |
| I do not know enough about RSV vaccine(s) | 21 (27%) | - | 6 (35%) | 4 (33%) | 4 (21%) | 2 (17%) | 5 (29%) |
| I do not know enough about RSV as an illness | 14 (18%) | - | 2 (12%) | 2 (17%) | 5 (26%) | - | - |
| Concerns on Efficacy *** | 13 (17%) | - | 1 (6%) | 1 (8%) | 5 (26%) | 3 (25%) | 3 (18%) |
| I am concerned that the vaccine(s) will not offer protection for a long enough period of time | 6 (8%) | - | 1 (6%) | 1 (8%) | 1 (5%) | - | 2 (12%) |
| I am concerned about how well the vaccine works | 10 (13%) | - | 1 (6%) | 1 (8%) | 4 (21%) | 3 (25%) | 1 (6%) |
| Others | |||||||
| I don’t believe my baby is at risk for RSV | 9 (11%) | - | 2 (12%) | 2 (17%) | 1 (5%) | - | - |
| It has not been recommended by my healthcare provider (HCP)/pharmacist | 17 (21%) | - | 3 (18%) | 4 (33%) | 4 (21%) | 2 (17%) | 3 (18%) |
| I am focused on getting other vaccines right now | 7 (9%) | - | 1 (6%) | 1 (8%) | - | 1 (8%) | 2 (12%) |
| I am tired of receiving vaccinations | 7 (8%) | - | 1 (6%) | 1 (8%) | 2 (11%) | - | - |
| I am against vaccinations in general | 7 (9%) | - | 3 (18%) | 1 (8%) | 1 (5%) | - | 1 (6%) |
| I am concerned about cost / affordability of a vaccine | 8 (10%) | - | 1 (6%) | 1 (8%) | 1 (5%) | 2 (17%) | 2 (12%) |
| I am concerned because the vaccine(s) are new | 15 (19%) | - | 5 (29%) | - | 3 (16%) | 1 (8%) | 4 (24%) |
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Mendes, D.; Kang, M.; Law, A. What Form of RSV Protection Do Women Prefer: Maternal Vaccination or Infant Immunisation? A Cross-Sectional Survey in Europe. Vaccines 2026, 14, 238. https://doi.org/10.3390/vaccines14030238
Mendes D, Kang M, Law A. What Form of RSV Protection Do Women Prefer: Maternal Vaccination or Infant Immunisation? A Cross-Sectional Survey in Europe. Vaccines. 2026; 14(3):238. https://doi.org/10.3390/vaccines14030238
Chicago/Turabian StyleMendes, Diana, Malvin Kang, and Amy Law. 2026. "What Form of RSV Protection Do Women Prefer: Maternal Vaccination or Infant Immunisation? A Cross-Sectional Survey in Europe" Vaccines 14, no. 3: 238. https://doi.org/10.3390/vaccines14030238
APA StyleMendes, D., Kang, M., & Law, A. (2026). What Form of RSV Protection Do Women Prefer: Maternal Vaccination or Infant Immunisation? A Cross-Sectional Survey in Europe. Vaccines, 14(3), 238. https://doi.org/10.3390/vaccines14030238

