Objectives: To investigate the perception and willingness of pregnant women and their partners to accept maternal vaccination or neonatal immunization against respiratory syncytial virus (RSV). Design: A cross-sectional survey study Setting: Pregnant women and their partners were recruited through healthcare professionals (midwives, gynaecologists, and Youth Health care), social media platforms (Instagram, LinkedIn, Facebook via institutions like the Spaarne Hospital), and the 9-Months Fair in the Netherlands. Main outcome measures: Willingness and motivation in decision-making for both maternal RSV vaccination or neonatal RSV immunization among pregnant women and their partners, including strategy preferences, and informational needs. Results: In total 1001 pregnant women (mean age: 31.1 years) and their partners (mean age: 33.2 years) completed the survey. On average, they were 24 weeks pregnant at the time, and 54.6% had no other children yet. The majority was Dutch-born (95.2% of women); with 68.3% of women having completed higher education and with overall strong pro-vaccination attitudes (93.9% of partners intended to vaccinate their expected newborn). The overall acceptability to vaccination and immunization was high, with 87% of respondents indicating they would (likely) accept both strategies. A positive attitude towards both methods was associated with previous experience with severity of RSV, intention to vaccinate the newborn and parental vaccination status during childhood and current pregnancy. When the choice was given, the majority of participants, in particular those with children and the intention to breastfeed, favoured maternal vaccination over passive immunization of infants (75.3% of the pregnant and 71.6% of the partners). A majority of the respondents cited optimal protection for the child and knowledge of RSV as important factors for accepting RSV prophylaxis. Conclusions: While most participants would accept both strategies for RSV protection of their infant, a majority, especially those with other children, favored maternal vaccination, due to concerns about infant safety and awareness of RSV severity.

The authors have declared no competing interest.

The research was supported by a research fund of the Spaarne Gasthuis Academy. No additional funding was received.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

A non-WMO (Medical Research Involving Human Subjects Act) declaration has been given by the Medical Ethics Committee of Leiden/The Hague/Delft (N23.094) and thereby waived ethical approval for this work.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

All data produced in the present work are contained in the manuscript