High Acceptability of Nirsevimab for Decreasing Social Inequalities in Bronchiolitis Prevention at a Maternity Hospital in a Disadvantaged Suburb of Paris

Background: Respiratory syncytial virus (RSV) is the leading cause of bronchiolitis in infants and a major public health concern. In September 2023, nirsevimab, a new monoclonal antibody, was introduced in France to prevent RSV infections. Materials and Methods: A prospective, single-center, observational study was conducted between October and December 2023 at Jean Verdier Hospital in Seine-Saint-Denis, the most deprived department in mainland France, to assess parental acceptability of this immunization. Results: A total of 152 parents were included; 108 (71.1%; 95% CI=63%-78%) were in favor of nirsevimab use. Acceptance was not significantly influenced by most sociodemographic factors. However, lower acceptance was observed among parents with a higher French Deprivation Index (OR=1.47; 95% CI=1.07-2.08; P =0.02), parents of girls (OR=2.87; 95% CI=1.23-6.98; P =0.02), and those with infants of higher birth weight (OR=1.97; 95% CI=1.05-3.94; P =0.04). In contrast, acceptance was higher among parents covered by State Medical Aid (AME) (OR=0.10; 95% CI=0.01-0.59; P =0.04) and among those who considered bronchiolitis “possibly severe” (OR=0.20; 95% CI=0.06-0.69; P =0.01). Conclusion: The study shows that providing consistent information within the hospital setting facilitates high acceptance of nirsevimab and helps reduce social inequalities in bronchiolitis prevention. Differences in acceptance were mainly linked to sociocultural factors and perceptions of disease severity, underlining the importance of culturally adapted strategies.