This report presents findings from a survey of 198 pediatric healthcare professionals that examines why children go unvaccinated in mixed-income communities. It distinguishes outright vaccination refusal driven by mistrust, sociocultural beliefs, and low health literacy from adherence issues such as missed appointments, which stem from logistical and economic barriers. The report closes with targeted recommendations for healthcare systems and practices to improve equity.

This report presents findings from a survey of primary care providers and pediatricians, examining the burden of RSV across diagnosis, treatment, and prevention. It reveals rising case severity compared with prior seasons, underuse of diagnostic testing, and inconsistent vaccination recommendations. The report closes with recommendations to strengthen diagnostic capacity, standardize treatment protocols, and expand education for frontline providers.

The report brings together evidence, policy perspectives, and practical experience from leading experts across public health, clinical practice, social science, civil society, and policy, all focused on a critical question: why do vaccination inequities persist, and what will it take to fix them? The answer that emerged is clear: Vaccination inequities are not accidents. They are predictable, patterned, and preventable outcomes of how systems are designed, measured, and experienced.

This policy report presents a comprehensive, evidence-based review and policy recommendations for RSV prevention in infants and young children. It draws on epidemiological data, clinical trial results, real-world effectiveness studies and the lived experiences of families affected by RSV to present a comprehensive picture of the burden this virus imposes and the strategies available to reduce it, also addressing the important and under-recognized interaction between RSV and pneumococcal disease.