RSV Immunization Rates and Vaccine Hesitancy: Practical Strategies for Clinicians

Episode 14 directly addresses the challenging environment in which RSV immunization is being implemented, with significant misinformation affecting parental decision-making. Dr. Tan notes that the broader vaccine landscape has been disrupted by widespread misinformation from public health officials and regulatory bodies, leading to declining immunization rates across all vaccines and fueling measles and pertussis outbreaks. Within this climate, RSV maternal vaccination and monoclonal antibody prophylaxis have seen relatively good acceptance — but gaps persist, particularly in some regions and communities.

Dr. Simões shares his direct clinical experience in multiple practices: approximately 20% of families in his network decline both RSV maternal vaccination and monoclonal antibody prophylaxis. He attributes higher acceptance in part to practice policies that require vaccination for continued enrollment — an approach that creates community-wide protection. He also highlights a specific concern unique to this moment: a significant decline in hepatitis B birth-dose administration (down roughly 30%) suggests that broader vaccine-hesitant attitudes are reshaping birth-hospitalization protocols. Dr. Simões advocates a pragmatic, frank communication style that places the risks of remaining unprotected in concrete, real-world terms — including travel risks, disease reemergence, and catastrophic complications.

Dr. Tan emphasizes the fundamental role of the pediatrician as vaccine advocate, recommending motivational interviewing — asking what concerns families have, listening empathetically, and responding with strong, science-based information. The panel agrees that the distinction between monoclonal antibodies (human proteins, no adjuvants) and traditional vaccines offers a useful communication bridge for hesitant families.

In the next episode, "RSV Prevention and Vaccine Hesitancy: Building Long-Term Communication Strategies," Dr. Creech presents a framework based on moral foundation theory for understanding why parents resist vaccines — and how to tailor conversations accordingly.