Quality Improvement Initiative to Increase Newborn RSV Immunization

Abstract

BACKGROUND: Respiratory syncytial virus (RSV) is a major cause of respiratory illness in infants. In 2023, the Food and Drug Administration approved 2 methods of RSV prevention: birthing parent bivalent RSVpreF vaccine and infant nirsevimab monoclonal antibody. During the 2023-2024 RSV season, 57.8% of newborns at Montefiore Medical Center Wakefield Division were immunized. This single-center quality improvement initiative aimed to increase RSV immunization rates by 10% in the following season. METHODS: Multidisciplinary teams implemented targeted interventions across preconception, prenatal, and postnatal periods. Strategies included posting RSV educational flyers, conducting staff education meetings, and incorporating mandatory RSV-related phrases into newborn discharge summaries. Weekly monitoring enabled real-time tracking and adjustments. Immunization rates were tracked using maternal records and newborn discharge data; engagement with educational materials was measured using quick-response code analytics. RESULTS: The average newborn RSV immunization rate increased to 75.9% during the 2024-2025 season. Maternal RSVpreF uptake significantly increased from 10.9 to 33.5% within the first month. The nirsevimab administration remained stable at 57.1% in the second season. Required documentation in the electronic medical record ensured that all newborns were assessed for immunization before discharge. Quick-response code flyers had moderate engagement, with higher click-through rates for Spanish-language materials. CONCLUSIONS: This quality improvement initiative exceeded its target, improving newborn RSV protection through provider education, documentation standardization, and patient outreach. These interventions streamlined workflow and advanced equitable immunization practices. Continued refinements and provider awareness will be essential to sustain high immunization rates amid evolving vaccine guidance and hesitancy.