662 - Demographic Characteristics that Influence the Uptake of Neonatal RSV Prophylaxis in a Single Military Treatment Facility

Publication Number: 662.4068

Richelle Roelandt L. Homo, Brooke Army Medical Center, San Antonio, TX, United States; Megan Donahue, Brooke Army Medical Center, San Antonio, TX, United States; Andrew J. Groberg, Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine, San Antonio, TX, United States; Dustin Halverson, Brooke Army Medical Center, Fort Sam Houston, TX, United States; Anna C. Wooten, Brooke Army Medical Center, Fort Sam Houston, TX, United States; Adharsh Ponnapakkam, Brooke Army Medical Center, San Antonio, TX, United States

Background: Two RSV prevention measures were approved in 2023: a monoclonal antibody administered to the infant (nirsevimab) and a parental vaccine given between 32-36 weeks of pregnancy and confers passive immunity to the infant (RSVPreF). Medical services are issued at no cost to United States servicemembers and their beneficiaries. Our group demonstrated >85% uptake of RSV prophylaxis at birth hospitalization in a military treatment facility; however, demographic characteristics were not extensively explored.

Objective: Our goal was to characterize maternal/infant demographics in this population. We also explored the demographic information of infants who did not receive adequate RSV prophylaxis at birth hospitalization but eventually received nirsevimab in outpatient visits.

Design/Methods: The electronic medical record was queried for in-hospital births between October 2023 – March 2024. Neonates admitted to the mother-baby-unit and the neonatal intensive care unit were included. Neonates who died or were transferred prior to their discharge from birth hospitalization were excluded. Maternal and infant demographics were obtained. Descriptive statistics and chi-squared tests were performed.

Results: 571 of 583 infants met inclusion criteria. 455 (~80%) had adequate RSV prophylaxis by discharge of their birth hospitalization (Table 1). There was more uptake of RSV prophylaxis in infants whose mothers were active duty/reserve/guard versus dependent/retiree status (84% vs. 77%, p=0.05) (Table 2). There were no differences in uptake between commissioned officer (83%), senior non-commissioned officer (81%), non-commissioned officer (88%), and junior enlisted members (70%) (p=0.45). There were no differences in uptake amongst self-reported race (Table 2, p=0.89). Of the 116 (20%) newborns who did not receive adequate RSV prevention by discharge of their birth hospitalization, 7 (6%) received it at an outpatient follow-up visit at a mean age of 18 days of life (range = 13 – 27 days of life).

Conclusion(s): Infants whose mothers have active duty/similar status had a higher uptake compared to those infants whose mothers were dependents/retirees, though interpretation may be limited to sample size. There were no significant differences in uptake by maternal race or military rank. Of the infants who did not receive prophylaxis during birth hospitalization, a small percentage received nirsevimab in outpatient follow between 2-3 weeks of life, which may inform future immunization campaigns. Qualitative studies that reveal parental perceptions towards pediatric immunizations could elucidate differences in uptake.

Table 1. Demographics of mother-infant-dyads admitted to the mother-baby-unit and neonatal intensive care unit between October 16, 2023 – March 31, 2024.


Table 2. RSV prevention uptake at birth hospitalization according to demographics in infants admitted to the mother-baby-unit and neonatal intensive care unit between October 16, 2023 – March 31, 2024.


Table 1. Demographics of mother-infant-dyads admitted to the mother-baby-unit and neonatal intensive care unit between October 16, 2023 – March 31, 2024.


Table 2. RSV prevention uptake at birth hospitalization according to demographics in infants admitted to the mother-baby-unit and neonatal intensive care unit between October 16, 2023 – March 31, 2024.