{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T22:45:05Z","timestamp":1787870705029,"version":"build-2784847793"},"reference-count":47,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ashley Nicole Shellenberger SIDS Research Fund at The Penn State College of Medicine"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Reports"],"abstract":"<jats:p>Background\/Objectives: Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis and infant hospitalization in the US. RSV prevention evolved in 2023 as nirsevimab and maternal RSV pre-fusion vaccine became available for healthy newborns and infants. This study investigates sociodemographic characteristics associated with RSV immunoprophylaxis. Methods: A cross-sectional survey was conducted from November 2023 through March 2024 among a convenience sample of parents of infants aged &lt;8 months who received newborn care or pediatric ambulatory care at a single academic institution in Central Pennsylvania, USA. Logistic regression examined sociodemographic factors associated with RSV immunoprophylaxis uptake. Given the nirsevimab shortage during the 2023\u20132024 RSV season, a sensitivity analysis was completed for intended immunoprophylaxis. Results: Among 118 participants, 66.9% received RSV immunoprophylaxis while 74.5% intended to receive nirsevimab. Higher income, private insurance, out-of-home childcare, and an adult\/partner working in healthcare were associated with intended nirsevimab receipt. Participation in the Women, Infants and Children program was associated with lower rates of intended nirsevimab receipt. Out-of-home childcare was associated with both RSV immunoprophylaxis uptake and intended nirsevimab receipt. Conclusions: Sociodemographic factors significantly influence the intent to receive nirsevimab and RSV immunoprophylaxis uptake. Having an adult\/partner in healthcare was the most significant predictor for intent, suggesting that greater health literacy drives immunization intention. Enrollment in out-of-home childcare was the sole predictor of RSV immunoprophylaxis uptake. These findings highlight the importance of policy initiatives that promote equitable access to RSV immunoprophylaxis, including strategies to address socioeconomic barriers, improve health literacy, and ensure consistent availability of preventive agents for all infants.<\/jats:p>","DOI":"10.3390\/pediatric17050109","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T12:17:02Z","timestamp":1760617022000},"page":"109","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Sociodemographic Factors, Intent-Uptake Disparities, and Nirsevimab Availability in Infant RSV Immunoprophylaxis"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5978-5345","authenticated-orcid":false,"given":"Brody J.","family":"Lipsett","sequence":"first","affiliation":[{"name":"Pediatrics, Penn State College of Medicine, 500 University Dr, Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5388-1241","authenticated-orcid":false,"given":"Benjamin N.","family":"Fogel","sequence":"additional","affiliation":[{"name":"Pediatrics, Penn State College of Medicine, 500 University Dr, Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0306-6828","authenticated-orcid":false,"given":"Katherine E.","family":"Shedlock","sequence":"additional","affiliation":[{"name":"Pediatrics, Penn State College of Medicine, 500 University Dr, Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6344-8609","authenticated-orcid":false,"given":"Ian M.","family":"Paul","sequence":"additional","affiliation":[{"name":"Pediatrics, Penn State College of Medicine, 500 University Dr, Hershey, PA 17033, USA"},{"name":"Public Health Sciences, Penn State College of Medicine, 700 Crescent Rd, Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric W.","family":"Schaefer","sequence":"additional","affiliation":[{"name":"Public Health Sciences, Penn State College of Medicine, 700 Crescent Rd, Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0020-944X","authenticated-orcid":false,"given":"Ruth E.","family":"Gardner","sequence":"additional","affiliation":[{"name":"Pediatrics, Penn State College of Medicine, 500 University Dr, Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah D.","family":"Kaye","sequence":"additional","affiliation":[{"name":"Pediatrics, Penn State College of Medicine, 500 University Dr, Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9579-6798","authenticated-orcid":false,"given":"Steven D.","family":"Hicks","sequence":"additional","affiliation":[{"name":"Pediatrics, Penn State College of Medicine, 500 University Dr, Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S154","DOI":"10.1093\/infdis\/jiac120","article-title":"Respiratory Syncytial Virus Is the Leading Cause of United States Infant Hospitalizations, 2009\u20132019: A Study of the National (Nationwide) Inpatient Sample","volume":"226","author":"Suh","year":"2022","journal-title":"J. Infect. Dis."},{"key":"ref_2","first-page":"543","article-title":"Risk of Primary Infection and Reinfection with Respiratory Syncytial Virus","volume":"140","author":"Glezen","year":"1986","journal-title":"Am. J. Dis. Child."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1038\/s41467-023-44275-y","article-title":"Incidence and transmission of respiratory syncytial virus in urban and rural South Africa, 2017\u20132018","volume":"15","author":"Cohen","year":"2024","journal-title":"Nat. Commun."},{"key":"ref_4","unstructured":"Kimberlin, D. (2018). Red Book: 2018 Report of the Committee on Infectious Diseases, American Academy of Pediatrics. [31st ed.]. Respiratory Syncytial Virus."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1128\/CMR.00010-16","article-title":"Respiratory Syncytial Virus: Infection, Detection, and New Options for Prevention and Treatment","volume":"30","author":"Griffiths","year":"2016","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e1474","DOI":"10.1542\/peds.2014-2742","article-title":"Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis","volume":"134","author":"Ralston","year":"2014","journal-title":"Pediatrics"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"The IMpact-RSV Study Group (1998). Palivizumab, a Humanized Respiratory Syncytial Virus Monoclonal Antibody, Reduces Hospitalization from Respiratory Syncytial Virus Infection in High-risk Infants. Pediatrics, 102, 531\u2013537.","DOI":"10.1542\/peds.102.3.531"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1056\/NEJMoa0804877","article-title":"The Burden of Respiratory Syncytial Virus Infection in Young Children","volume":"360","author":"Hall","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1093\/infdis\/jiaa752","article-title":"Respiratory Syncytial Virus\u2013Associated Hospitalization Rates among US Infants: A Systematic Review and Meta-Analysis","volume":"225","author":"McLaughlin","year":"2020","journal-title":"J. Infect. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e220527","DOI":"10.1001\/jamanetworkopen.2022.0527","article-title":"Mortality Associated with Influenza and Respiratory Syncytial Virus in the US, 1999\u20132018","volume":"5","author":"Hansen","year":"2022","journal-title":"JAMA Netw. Open"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1001\/jama.289.2.179","article-title":"Mortality Associated with Influenza and Respiratory Syncytial Virus in the United States","volume":"289","author":"Thompson","year":"2003","journal-title":"JAMA"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"D\u00edez-Domingo, J., P\u00e9rez-Yarza, E.G., Melero, J.A., S\u00e1nchez-Luna, M., Aguilar, M.D., Blasco, A.J., Alfaro, N., and L\u00e1zaro, P. (2014). Social, economic, and health impact of the respiratory syncytial virus: A systematic search. BMC Infect. Dis., 14.","DOI":"10.1186\/s12879-014-0544-x"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.15585\/mmwr.mm7241e1","article-title":"Use of the Pfizer Respiratory Syncytial Virus Vaccine During Pregnancy for the Prevention of Respiratory Syncytial Virus\u2013Associated Lower Respiratory Tract Disease in Infants: Recommendations of the Advisory Committee on Immunization Practices\u2014United States, 2023","volume":"72","year":"2023","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e2023065425","DOI":"10.1542\/peds.2023-065425","article-title":"Disparities in the Availability and Acceptance of Nirsevimab in Massachusetts","volume":"154","author":"Abraham","year":"2024","journal-title":"Pediatrics"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e2024067532","DOI":"10.1542\/peds.2024-067532","article-title":"Parent Perspectives on Nirsevimab for Their Newborn","volume":"154","author":"Hinderstein","year":"2024","journal-title":"Pediatrics"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.ypmed.2019.03.037","article-title":"Disparities and reverse disparities in HPV vaccination: A systematic review and meta-analysis","volume":"123","author":"Spencer","year":"2019","journal-title":"Prev. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/s10900-006-9031-7","article-title":"Health Disparities and Prevention: Racial\/ethnic Barriers To Flu Vaccinations","volume":"32","author":"Chen","year":"2006","journal-title":"J. Community Health"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1001\/jamapediatrics.2021.1682","article-title":"Pediatric COVID-19 Disparities and Prioritizing Equity\u2014Children Are Not Spared","volume":"175","author":"Shah","year":"2021","journal-title":"JAMA Pediatr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e2022056597","DOI":"10.1542\/peds.2022-056597","article-title":"Human Papillomavirus Vaccination Trends Among Adolescents: 2015 to 2020","volume":"150","author":"Lu","year":"2022","journal-title":"Pediatrics"},{"key":"ref_20","unstructured":"Centers for Disease Control and Prevention (2025, July 03). Limited Availability of Nirsevimab in the United States\u2014Interim CDC Recommendations to Protect Infants from Respiratory Syncytial Virus (RSV) During the 2023\u20132024 Respiratory Virus Season, Available online: https:\/\/emergency.cdc.gov\/han\/2023\/han00499.asp."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Akaike, H. (1974). New look at statistical-model identification. Selected Papers of Hirotugu Akaike, Springer. Available online: https:\/\/link.springer.com\/chapter\/10.1007\/978-1-4612-1694-0_16.","DOI":"10.1007\/978-1-4612-1694-0_16"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1959","DOI":"10.1542\/peds.113.S5.1959","article-title":"Insurance Status and Vaccination Coverage Among US Preschool Children","volume":"113","author":"Santoli","year":"2004","journal-title":"Pediatrics"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2338","DOI":"10.1016\/j.vaccine.2017.03.060","article-title":"Predictors of influenza vaccination in the U.S. among children 9\u201313 years of age","volume":"35","author":"Imburgia","year":"2017","journal-title":"Vaccine"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1016\/j.acap.2023.02.010","article-title":"Influenza Vaccinations Among Privately and Publicly Insured Children with Asthma","volume":"23","author":"Geissler","year":"2023","journal-title":"Acad. Pediatr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e2520440","DOI":"10.1001\/jamanetworkopen.2025.20440","article-title":"Nirsevimab Uptake in a Pediatric Primary Care Network During the 2023\u20132024 RSV Season","volume":"8","author":"DeRoo","year":"2025","journal-title":"JAMA Netw. Open"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"837","DOI":"10.15585\/mmwr.mm7338a2","article-title":"Maternal Respiratory Syncytial Virus Vaccination and Receipt of Respiratory Syncytial Virus Antibody (Nirsevimab) by Infants Aged <8 Months\u2014United States, April 2024","volume":"73","author":"Razzaghi","year":"2024","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e2025070790","DOI":"10.1542\/peds.2025-070790","article-title":"Disparities in Nirsevimab Uptake Across a Pediatric Primary Care Network","volume":"156","author":"Ahmed","year":"2025","journal-title":"Pediatrics"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e2460735","DOI":"10.1001\/jamanetworkopen.2024.60735","article-title":"Respiratory Syncytial Virus Vaccine and Nirsevimab Uptake Among Pregnant People and Their Neonates","volume":"8","author":"Blauvelt","year":"2025","journal-title":"JAMA Netw. Open"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"844","DOI":"10.15585\/mmwr.mm7338a3","article-title":"Decline in Vaccination Coverage by Age 24 Months and Vaccination Inequities Among Children Born in 2020 and 2021\u2014National Immunization Survey-Child, United States, 2021\u20132023","volume":"73","author":"Hill","year":"2024","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2828","DOI":"10.1016\/j.vaccine.2022.03.028","article-title":"Disparities in human papillomavirus vaccination coverage in the United States, National Health and Nutrition Examination Survey, January 2017\u2013March 2020","volume":"40","author":"Lewis","year":"2022","journal-title":"Vaccine"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"126139","DOI":"10.1016\/j.vaccine.2024.07.040","article-title":"Parental hesitancy about COVID-19, influenza, HPV, and other childhood vaccines","volume":"42","author":"Santibanez","year":"2024","journal-title":"Vaccine"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Villarroel, M.A., Galinksy, A.M., Lu, P.-J., Pingali, C., and Valenzuela, C. (2024, February 14). Human Papillomavirus Vaccination Coverage in Children Ages 9\u201317 Years: United States, 2022, Available online: https:\/\/stacks.cdc.gov\/view\/cdc\/145593.","DOI":"10.15620\/cdc:145593"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.mm7201a1","article-title":"Racial and Ethnic Differences in COVID-19 Vaccination Coverage Among Children and Adolescents Aged 5\u201317 Years and Parental Intent to Vaccinate Their Children\u2014National Immunization Survey\u2013Child COVID Module, United States, December 2020\u2013September 2022","volume":"72","author":"Valier","year":"2023","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"183","DOI":"10.15585\/mmwr.mm7207a4","article-title":"COVID-19 Vaccination Coverage and Demographic Characteristics of Infants and Children Aged 6 Months\u20134 Years\u2014United States, June 20\u2013December 31, 2022","volume":"72","author":"Murthy","year":"2023","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e101592","DOI":"10.1136\/bmjopen-2025-101592","article-title":"Perinatal outcomes and uptake of RSV vaccine during pregnancy in South London: A cross-sectional study","volume":"15","author":"Razai","year":"2025","journal-title":"BMJ Open"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1111\/apa.17127","article-title":"Parental awareness and attitudes towards prevention of respiratory syncytial virus in infants and young children in Australia","volume":"113","author":"Holland","year":"2024","journal-title":"Acta Paediatr."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"126541","DOI":"10.1016\/j.vaccine.2024.126541","article-title":"Respiratory syncytial virus (RSV) prevention: Perception and willingness of expectant parents in the Netherlands","volume":"44","author":"Harteveld","year":"2025","journal-title":"Vaccine"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"127716","DOI":"10.1016\/j.vaccine.2025.127716","article-title":"Immunization Acceptance after Broad Recommendation for Respiratory Syncytial Virus Prophylaxis: Results from a Cross-Sectional Study in Germany","volume":"64","author":"Wetzke","year":"2025","journal-title":"Vaccine"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"127434","DOI":"10.1016\/j.vaccine.2025.127434","article-title":"Exploring the knowledge and attitude toward respiratory syncytial virus vaccine and associated factors among pregnant women in Japan during the early post-marketing phase","volume":"61","author":"Machida","year":"2025","journal-title":"Vaccine"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1016\/j.amepre.2014.06.017","article-title":"Assessing Immunization Interventions in the Women, Infants, and Children (WIC) Program","volume":"47","author":"Thomas","year":"2014","journal-title":"Am. J. Prev. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"4291","DOI":"10.1016\/j.vaccine.2021.06.041","article-title":"Early influenza vaccination rates decline in children during the COVID-19 pandemic","volume":"39","author":"Fogel","year":"2021","journal-title":"Vaccine"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1002\/ppul.26664","article-title":"Environmental risk factors for respiratory infection and wheeze in young children: A multicentre birth cohort study","volume":"59","author":"Ruffles","year":"2023","journal-title":"Pediatr. Pulmonol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"200153","DOI":"10.1016\/j.jpedcp.2025.200153","article-title":"Factors Influencing Parental Decisions on Respiratory Syncytial Virus Immunoprophylaxis","volume":"17","author":"Shedlock","year":"2025","journal-title":"J. Pediatr. Clin. Pract."},{"key":"ref_44","first-page":"181","article-title":"Impact of requiring influenza vaccination for children in licensed child care or preschool programs--Connecticut, 2012\u20132013 influenza season","volume":"63","author":"Hadler","year":"2014","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e269","DOI":"10.1016\/j.amepre.2021.01.026","article-title":"Pneumococcal Vaccination Mandates for Child Care: Impact of State Laws on Vaccination Coverage at 19\u201335 Months","volume":"60","author":"Hair","year":"2021","journal-title":"Am. J. Prev. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1720","DOI":"10.1001\/jama.1992.03490130108039","article-title":"Infectious diseases and injuries in child day care. Opportunities for healthier children","volume":"268","author":"Thacker","year":"1992","journal-title":"JAMA"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e2024070240","DOI":"10.1542\/peds.2024-070240","article-title":"Infant Respiratory Syncytial Virus Immunization Coverage in the Vaccine Safety Datalink: 2023\u20132024","volume":"155","author":"Irving","year":"2025","journal-title":"Pediatrics"}],"container-title":["Pediatric Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2036-7503\/17\/5\/109\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T13:43:37Z","timestamp":1760622217000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2036-7503\/17\/5\/109"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,16]]},"references-count":47,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["pediatric17050109"],"URL":"https:\/\/doi.org\/10.3390\/pediatric17050109","relation":{},"ISSN":["2036-7503"],"issn-type":[{"value":"2036-7503","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,16]]}}}