Pathogens
Maternal RSV Vaccination and Complementary Infant-Protection Strategies in Singapore: A Modified Nominal Group Technique Consensus Study
By Chia Yin Chong, Anne Goh, Anita Sugam Kale and 4 others.
Abstract
Background
Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract disease in infants and a major contributor to infant morbidity and mortality. A previous Singapore consensus addressed RSV disease burden and the role of the monoclonal antibody, nirsevimab, but did not extend to maternal RSV vaccination or its complementary use with long-acting monoclonal antibodies (mAbs). We sought structured expert consensus on positioning maternal RSV vaccination and a complementary prevention strategy in Singapore.
Methods
A modified nominal group technique (mNGT) was used. A multidisciplinary panel of seven Singapore-based experts in obstetrics, including maternal–fetal medicine and paediatrics (respiratory, infectious disease, immunisation, and immunology), reviewed a pre-circulated targeted evidence review and four draft statements across four themes (burden, preventive pathways, maternal RSV vaccination, and complementary strategy), with the opportunity to submit written comments in advance. At a live virtual meeting on 16 June 2026, facilitated by a medical communications agency, the panel first discussed the evidence underpinning each draft statement and then voted openly (non-anonymously) on each statement in sequence. Consensus was predefined as ≥70% agreement. Statements that did not reach consensus were refined collectively, with each expert contributing in turn, and re-voted.