(831) Quality Improvement Initiative for Respiratory Syncytial Virus Vaccination In Pregnancy- How Can We Do Better?

Objective:
This study was undertaken to evaluate patterns of perinatal respiratory syncytial virus (RSV) vaccination and to identify strategies to increase vaccine uptake through an institutional quality improvement (QI) initiative.

Study

Design:
We evaluated rates of perinatal RSV vaccination during the most recent season of vaccine eligibility from October 2023 to February 2024 among patients seeking prenatal care between 32 to 36 weeks gestation at a single academic tertiary medical center. Maternal demographic characteristics, gestational age at vaccination, and number of prenatal visits during eligibility period were abstracted from electronic records and compared across patients who accepted and refused vaccination. Student’s t test and chi2 tests were used to compare continuous and categorical data, respectively. We then administered a structured survey at the end of the RSV season among patients who were previously eligible for vaccination to examine reasons for vaccine hesitancy and identify strategies for enhancing vaccine education.

Results:
Of 548 eligible patients, 200 (36%) accepted RSV vaccination while 348 (63.5%) did not. Unvaccinated patients were more likely to be Black (p=.002), have public insurance (p=.007) and attend fewer prenatal visits during eligibility period (p < .001). Evaluation of vaccination patterns demonstrated increase in vaccination rates throughout the RSV season with highest rates attained at earlier gestational ages (Figures 1 and 2). Of the 278 patients compliant through postpartum follow up – 90 completed the survey (response rate = 32.3%). Primary reasons for vaccine hesitancy were identified as – lack of understanding about vaccine efficacy (40%) and concerns about fetal (30%) and maternal (30%) side effects. Respondents identified handouts (44.1%) and text-based messaging (37.3%) as their preferred approach for receiving vaccine education.

Conclusion:
Vaccine education using text-based messaging and handouts with content focused on the clinical benefit and safety of vaccination has the potential to address RSV vaccine hesitancy and enhance perinatal vaccination.