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Attitudes of Pregnant Women and Healthcare Professionals Toward Clinical Trials and Routine Implementation of Antenatal Vaccination Against Respiratory Syncytial Virus

A Multicenter Questionnaire Study

Wilcox, Christopher R. MBBCh*; Calvert, Anna MRCPH; Metz, Jane MBBS; Kilich, Eliz BM, BCh; MacLeod, Rachael MBChB; Beadon, Kirsten BSc§; Heath, Paul T. MRCPH, FRCPH; Khalil, Asma MD¶,‖; Finn, Adam PhD; Snape, Matthew D. MD§; Vandrevala, Tushna PhD**; Nadarzynski, Tom PhD††,‡‡; Coleman, Matthew A. MD§§; Jones, Christine E. PhD¶¶

The Pediatric Infectious Disease Journal: September 2019 - Volume 38 - Issue 9 - p 944–951
doi: 10.1097/INF.0000000000002384
Maternal-Neonatal Reports

Introduction: Respiratory syncytial virus (RSV) is a common cause of infant hospitalization and mortality. With multiple vaccines in development, we aimed to determine: (1) the awareness of RSV among pregnant women and healthcare professionals (HCPs), and (2) attitudes toward clinical trials and routine implementation of antenatal RSV vaccination.

Methods: Separate questionnaires for pregnant women and HCPs were distributed within 4 hospitals in South England (July 2017–January 2018).

Results: Responses from 314 pregnant women and 204 HCPs (18% obstetricians, 75% midwives, 7% unknown) were analyzed. Most pregnant women (88%) and midwives (66%) had no/very little awareness of RSV, unlike obstetricians (14%). Among pregnant women, 29% and 75% would likely accept RSV vaccination as part of a trial, or if routinely recommended, respectively. Younger women (16–24 years), those of 21–30 weeks’ gestation, and with experience of RSV were significantly more likely to participate in trials [odds ratio (OR): 1.42 (1.72–9.86); OR: 2.29 (1.22–4.31); OR: 9.07 (1.62–50.86), respectively]. White-British women and those of 21–30 weeks’ gestation were more likely to accept routinely recommended vaccination [OR: 2.16 (1.07–4.13); OR: 2.10 (1.07–4.13)]. Obstetricians were more likely than midwives to support clinical trials [92% vs. 68%, OR: 2.50 (1.01–6.16)] and routine RSV vaccination [89% vs. 79%, OR: 4.08 (1.53–9.81)], as were those with prior knowledge of RSV, and who deemed it serious.

Conclusions: RSV awareness is low among pregnant women and midwives. Education will be required to support successful implementation of routine antenatal vaccination. Research is needed to understand reasons for vaccine hesitancy among pregnant women and HCPs, particularly midwives.

From the *NIHR Clinical Research Facility, Southampton Centre for Biomedical Research, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom

Vaccine Institute, St George’s, University of London, London

Bristol Children’s Vaccine Centre, Education and Research Centre, University of Bristol, Bristol, United Kingdom

§Department of Paediatrics, Oxford Vaccine Group, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford

Department of Obstetrics and Gynaecology, Fetal Medicine Unit, St George’s University Hospitals NHS Foundation Trust

Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George’s University of London

**School of Social and Behavioural Sciences, Faculty of Business and Social Sciences, Kingston University, Kingston, London

††Department of Psychology, University of Southampton, Southampton

‡‡Department of Psychology, University of Westminster, London

§§Department of Fetal Medicine, Princess Anne Hospital, University Hospital Southampton NHS Foundation Trust

¶¶Faculty of Medicine and Institute for Life Sciences, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.

Accepted for publication April 23, 2019.

Supported by a grant from the British Paediatric Allergy Immunity and Infection Group. The British Paediatric Allergy Immunity and Infection Group had no role in the study design, data collection, data analysis/interpretation, report writing or the decision to submit the manuscript for publication.

C.R.W., A.C., J.M., K.B., P.T.H., A.K., A.F., M.D.S. and C.E.J. are investigators for clinical trials done on behalf of their respective institutions, sponsored by various vaccine manufacturers, but receive no personal funding for these activities. The other authors have no conflicts of interest to disclose.

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Address for correspondence: Christopher R. Wilcox, MBBCh, NIHR Clinical Research Facility, Southampton Centre for Biomedical Research, C Level West Wing, Mailpoint 218, Southampton General Hospital, Tremona Road, Southampton, SO16 6DY, United Kingdom. E-mail:

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