Respiratory Syncytial Virus (RSV) is a common respiratory infection that typically occurs between the late fall and early spring. Every year in the U.S., there are more than 2 million outpatient and emergency department visits and more than 80,000 hospitalizations related to RSV infection. Young infants, particularly those born prematurely or with chronic lung, heart, and neuromuscular diseases, are at increased risk for severe RSV illness because their respiratory and immune systems are underdeveloped.

Rates of RSV infection and severity of symptoms are often also influenced by one’s socioeconomic circumstances. Infants who live in low-income households are more likely to contract RSV infection because of crowded and inadequate housing conditions; and they often have worse access to the timely and high-quality medical care needed to manage their illnesses. Black and Latino infants more often experience these socioeconomic adversities as a result of longstanding discriminatory social policies and economic inequalities which contributes to the observed disparities in RSV outcomes. Preventing RSV infection has been challenging because there are no safe and effective vaccines for all infants. In 2023, the U.S. Food and Drug Administration approved two new medical products for preventing RSV infection in all infants: nirsevimab, a protective antibody injection given to infants at the start of the RSV season, and bivalent RSV prefusion F, a vaccine given at the end of pregnancy that transfers protective antibodies to the infant. These products represent an exciting new approach for preventing RSV illness; however, there is concern that infants who live in low-income households, and in particular Black and Latino infants, may have unequal access to these new immunizations, limiting their effectiveness.

This research aims to understand if the uptake of the new RSV immunizations is equal across socioeconomic and racial groups and if not, how this inequity influences disease outcomes. To do this, we will use birth and immunization information linked to health care claims. We will then use human-centered design, an approach aimed at creating solutions to complex problems based on people’s needs and experience, to design an intervention to help improve RSV immunization rates and reduce disparities.