Background and Aim: Maternal immunisation protects pregnant women and infants from vaccine-preventable diseases. Despite strong evidence and national recommendations, uptake in Australia remains suboptimal and inequitable. To reduce access barriers, a nurse-led, hospital-based antenatal immunisation clinic was established in April 2025 in Melbourne, Australia.

Methods and Analysis: A mixed-methods service evaluation was conducted from April 2025 to January 2026. Quantitative measures included clinic activity, vaccine delivery, and patient experience surveys. Free-text responses were analysed using reflexive thematic analysis. Implementation outcomes were mapped to RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework to identify contextual enablers, barriers and opportunities for sustained improvement and scalability.

Outcomes: Over the first 10 months, the clinic delivered approximately 2,500 vaccinations to about 1,500 pregnant women. 510 survey responses were analysed. RE-AIM mapping demonstrated:
Reach: Strong service utilisation across a highly diverse catchment with substantial uptake by patients.
Effectiveness: High patient-reported experience with a median satisfaction score 10/10 [IQR 9–10] and 99.2% stating they would recommend the service.
Adoption: Successful integration into routine antenatal workflows, with most respondents (90.8%) hearing about the clinic through their antenatal clinician. Adoption was supported by a walk-in, no-referral, no cost, co-located “one-stop” model.
Implementation: Key enablers were supportive staff (kind, reassuring, professional staff), clear vaccine communication and education (questions welcomed, supported decision-making), and efficient delivery (accessible “one-stop” service, minimal waiting). Key barriers were operational and modifiable, including wayfinding difficulties and occasional capacity constraints at peak times.
Maintenance: Sustained high service volume and consistently positive feedback across the evaluation period supported ongoing delivery.

Conclusion and Future actions: A nurse-led, hospital-based antenatal immunisation clinic provided an accessible and acceptable vaccination pathway, minimising missed vaccination opportunities. Implementation outcomes demonstrate strong feasibility and scalability, offering a practical model for maternity services aiming to improve vaccination coverage and reduce access barriers.

Background and Aim
The burden of Respiratory Syncytial Virus (RSV) disease is highest in children under 2 years, especially in infants under 6 months. Two effective RSV therapeutics, a maternal RSV vaccine ‘Abryvso’ and a long-acting monoclonal antibody ‘Nirsevimab’ were introduced in Australia in 2025 in a hybrid program, in a bid to reduce RSV infections and hospitalisations. In the year prior to the program introduction, the RSVChoice study explored acceptability and maternal preferences of RSV therapeutics, with secondary outcomes exploring maternal awareness and knowledge of RSV disease and provider delivery preference.
Methods and Analysis
Data was collected from 13 Australian women who had a child < 2 years through 4 semi-structured qualitative focus groups, which informed a national Discrete Choice Experiment (DCE). Key themes from the focus groups included effectiveness, cost, safety, timing, provider administration, information delivery, vaccine manufacturer and disease risk perception. The final DCE was completed by 1500 pregnant people and mothers with a child <2 years and the attributes effectiveness, cost, safety, timing, and risk perception of the disease.
Outcomes
This study found that knowledge of the monoclonal antibody and perception of disease severity were low and that maternal vaccine decision-making and acceptability of therapeutics was strongly influenced by cost, effectiveness and safety. Overall, mothers preferred the maternal vaccine (51.4%) and 24.3% preferred the monoclonal antibody or were ‘not sure’. The preferred provider for therapeutic delivery was for General practitioners (GPs).
Conclusion and Future Actions
The RSVChoice study highlights the need for clear implementation strategies for introducing new vaccines including pre-emptive education for health professionals and parents to improve knowledge and awareness. A harmonised, Commonwealth-funded RSV program is needed order to optimise equitable uptake in Australia.

Objectives:
Respiratory Syncytial Virus (RSV) is the leading cause of bronchiolitis and pneumonia in infants and can lead to fatal respiratory distress, especially in very young infants. New maternal RSV vaccines and infant monoclonal antibodies are now available. This study aims to understand RSV vaccine attitudes in Australian pregnant women.

Study Design:
The cross-sectional online survey employed a discrete choice experiment (DCE) design to quantify trade-offs and investigate decision-making patterns among pregnant women regarding the maternal RSV vaccine. A mixed-methods approach was used, with results from focus group discussions informing the development of the DCE survey.

Methods:
Any pregnant women aged ≥ 18 years in Australia were eligible to participate in the survey. During the survey, respondents were asked to choose between hypothetical scenarios, or optout option. Survey data were analysed using mixed logit and latent class models.

Results:
In total, 440 pregnant women participated and demonstrated a strong preference for a free RSV maternal vaccine with a lower risk of serious side effects and higher vaccine effectiveness. Latent class analysis revealed two distinct preference groups: “accepters/deliberators” and “rejecters”. Compared to rejecters (31.7%), accepters/deliberators (68.3%) were more likely to be older, haver high household income and had received a pertussis vaccine, and were less likely to receive an influenza vaccine. Incentives to encourage vaccination were not supported by either group. Among rejecters, cost did not influence their vaccine preference, but text message reminders were more preferred. In contrast to accepters/deliberators, rejecters expressed a strong dislike for video advertisements. Participants showed a significantly higher preference for RSV maternal vaccination (54.8%) versus infant monoclonal antibody injection (16.8%) in a general preference question (p<0.001).

Conclusions:
Maternal RSV vaccination at no cost was generally well received and preferred by pregnant women in this study, though preferences for promotion strategies varied.

Background and Aim: Australian guidelines recommend multiple vaccines during pregnancy to protect pregnant women and their infants, with the addition of further vaccines anticipated. This growth poses a challenge to implementation and already sub-optimal uptake. To address low uptake and increasingly complex guidelines, new initiatives are required. One component to more successful implementation may be a co-designed “maternal immunisation schedule”. The co-design process would ground this resource in the preferences and priorities of health-care professionals and pregnant women.

Methods and Analysis: Qualitative interviews were undertaken with health-care professionals (n = 8) and pregnant/recently pregnant women (n = 8). Discussion covered topics such as timing, co-administration, prioritisation, factors to consider when designing a schedule, and the information that should accompany a vaccine schedule. Data analysis was conducted using NVivo.

Three themes emerged from the interviews: 1) maintaining flexibility 2) safety, and 3) preserving women’s autonomy. Additionally, four concepts raised conflicting opinions 1) co-administration, 2) vaccine timing, 3) when to give/receive vaccine information, and 4) format of the schedule.

Outcomes: Findings provide an evidence base about what matters to stakeholders and highlight the importance of co-design methodology. These have helped develop priority areas for discussion at co-design workshops, which will in turn inform the development of maternal vaccination guidance in this increasingly complex and crowded space.

Conclusion and Future actions: In keeping with best practice of co-design, key stakeholders will continue to be engaged iteratively, to provide feedback on the relevance, utility and implementation of a maternal vaccine schedule. Implementation and evaluation will occur with the plan to upscale nationally.

Background and Aim
Infants too young to be vaccinated are at highest risk of severe pertussis. Following the COVID-19 pandemic, reduced circulation of Bordetella pertussis raised concern of an immunity debt. Therefore, Norway introduced routine maternal pertussis vaccination in May 2024 to protect newborns from severe pertussis. We describe programme implementation, uptake, and a new method for timely surveillance.

Methods and Analysis
The vaccine was included free-of-charge in the national childhood immunisation programme and recommended in gestational week 24. Implementation focused on addressing regulatory barriers, integration into existing antenatal care pathways to optimize access and effectiveness, and consultation with healthcare professional associations. We held tailored educational webinars for healthcare workers in antenatal care and developed communication materials for pregnant women.

Official vaccination uptake during the period 01.05.2024-30.04.2025 was calculated using post-birth data from the Medical Birth Registry of Norway (MBRN) linked with the Norwegian Immunisation Registry (SYSVAK). To generate more timely estimates of uptake, we identified ongoing pregnancies using second-trimester ultrasound procedure codes in the Norwegian Patient Registry (NPR) and linked these to SYSVAK.

Outcomes
Official coverage statistics showed 72.9% (51,962/71,286) of eligible pregnant women were vaccinated during the programme’s first year. Uptake increased steadily over time with a clear peak around the recommended gestational week. There was little regional variation and a continued effort to vaccinate later in pregnancy.

Timely uptake estimates using NPR second-trimester ultrasound codes gave a cumulative coverage of 73.5% (48,754/66,373). Monthly NPR-based estimates were slightly lower compared to MBRN coverage (maximum 2.0% lower).

Conclusion and Future Actions
High maternal pertussis vaccination coverage was facilitated by early stakeholder engagement, integration into existing care pathways, and targeted education and information. Linkage of high-quality national registries enabled timely surveillance of uptake and earlier evaluation of the newly implemented programme.

Background and Aim:
Maternal immunisation protects pregnant women and infants from vaccine-preventable diseases, however coverage remains low and inequitable. To address access issues, a hospital-based antenatal immunisation clinic was introduced in April 2025 within a metropolitan health service in Melbourne, Australia. We assessed determinants of being up to date (UTD) with recommended antenatal vaccines.
Methods and Analysis:
Retrospective analysis of pregnant women with a finalised pregnancy outcome in July 2025 was performed. The primary outcome was UTD at pregnancy outcome, defined as receipt of influenza, pertussis, and respiratory syncytial virus vaccines. Determinants included clinic attendance, country of birth, interpreter requirement, Medicare eligibility, hospital campus, and documented vaccination counselling were recorded. Univariate logistic regression estimated odds ratios (OR) with 95% confidence intervals (CI).
Outcomes:
Among 319 women, 167 (55.9%) were UTD and 213 (67.2%) were born overseas. Attendance at antenatal immunisation clinic was strongly associated with UTD status (OR 10.69 (5.24-21.81), p<0.0001; Table 1). Overall, there was no statistically significant difference in UTD rates between women born overseas relative to Australian-born individuals (OR 1.19 (0.73-1.93), p=0.48), however significantly lower odds were observed for women born in Iraq (OR 0.18 (0.06- 0.55), p<0.01) and Syria (OR 0.12 (0.03- 0.50), p<0.01). Antenatal care at a campus without on-site immunisation clinic was associated with lower UTD (OR 0.53 (0.30-0.94), p= 0.03). Neither number of documented vaccination discussions (OR 1.16 (0.99- 1.37), p=0.07) nor gestational age at first discussion (OR 1.00 (0.97-1.04), p=0.83) were significantly associated with UTD.
Conclusion and Future actions:
In this highly diverse cohort, attendance at a hospital-based antenatal immunisation clinic was the strongest determinant of UTD status, highlighting its role in reducing access barriers. Lower uptake in specific country-of-birth subgroups and at sites without on-site vaccination capability indicates persistent equity gaps and supports integrated and accessible vaccination pathways within antenatal care.