Assessing the willingness and preference of pregnant and postpartum women regarding RSV immunization for newborns in western China: A mixed-methods study.

Respiratory syncytial virus (RSV) is a leading cause of pediatric lower respiratory tract infections, yet evidence on vaccine acceptance among Chinese pregnant and postpartum women remains limited. This study examines the willingness, preference and factors influencing neonatal RSV immunization among this population in Lanzhou City, China. The study used a convergent mixed-methods approach, including cross-sectional questionnaires and in-depth interviews, and data were processed through multiple regression analysis and thematic analysis. The results showed that the respondents‘ knowledge of RSV was generally low, with 56.5% indicating that they had never heard of the virus, and only 40.1% expressing willingness to be vaccinated, with most of them preferring monoclonal antibody after the birth of infants to maternal vaccination during pregnancy. The key factors influencing immunization willingness included education level, occupation, experience of vaccine side effects, health status during pregnancy, previous vaccination history during pregnancy, and RSV knowledge level, while the factors influencing immunization preference included annual per capita household income, RSV understanding level and RSV knowledge level. Qualitative interviews further revealed participants‘ general concerns about the safety and efficacy of vaccination during pregnancy, with national immunization policy and vaccine cost also being important influencing factors. Pregnant and postpartum women demonstrated limited RSV awareness and generally low willingness for immunization, with a clear preference for infant monoclonal antibody administration over maternal vaccination. Comprehensive interventions in terms of health education, service accessibility, financial subsidies and precise communication are recommended to increase immunization rates and reduce the burden of RSV-related diseases.