Information on Ontario's RSV Prevention Programs

- Sep 15, 2025

To: Ottawa Physicians, Nurse Practitioners, and Midwives
Date: September 15, 2025
From: Dr. Laura Bourns, Deputy Medical Officer of Health
Subject: Information on Ontario’s RSV prevention programs

Dear Colleagues,

The below communication provides information on Respiratory Syncytial Virus (RSV) prevention programs the 2025-2026 RSV season for:

  1. high-risk older adults, and
  2. infants and high-risk children

Please note: The RSV product order forms will be available at ottawapublichealth.ca/hcp later this month. A separate communication will be shared when product ordering is available.

1. Older Adult High Risk RSV Vaccine Prevention Program

For the 2025/2026 respiratory season, the Ontario Ministry of Health has announced that the Older Adult High Risk RSV Vaccine Prevention Program in Ontario has expanded eligibility to include all Ontario residents aged 75 years and older.

If an individual has previously received a dose of RSV vaccine, they do not need to receive another dose this season, as booster doses are not currently recommended.

Eligibility for the 2025/26 Older Adult High Risk RSV Vaccine Prevention program:

  • all individuals 75 years of age and older (new for the 2025-26 season)
  • individuals 60 to 74 years of age who are also:
    • residents of long-term care homes, Elder Care Lodges, or retirement homes including similar settings (e.g., co-located facilities).
    • patients in hospital receiving alternate level of care (ALC) including similar settings (for example, complex continuing care, hospital transitional programs)
    • Patients with glomerulonephritis (GN) who are moderately to severely immunocompromised
    • patients receiving hemodialysis or peritoneal dialysis
    • recipients of solid organ or hematopoietic stem cell transplants
    • individuals experiencing homelessness
    • individuals who identify as First Nations, Inuit, or Métis

Eligible Ontario residents can access publicly funded RSV vaccine through their primary care provider or in the setting in which they are eligible. OPH will support residents with barriers to access through select OPH clinics and information will be available on our website soon.

Vaccine Information

Both Arexvy and AbrysvoTM are Health Canada approved RSV vaccines that are indicated for the prevention of lower respiratory tract disease (LRTD) caused by respiratory syncytial virus in those 60 years of age and older. You may receive either of vaccines in your order depending on vaccine supply and availability.

For locations that have viable vaccine product on-hand, from the 2024-2025 Older Adult program, vaccination of eligible older adults can begin immediately.

RSV vaccine may be co-administered with other routine and seasonal immunizations for older adults.

2. Infant and High Risk Children Respiratory Syncytial Virus (RSV) Prevention Program

Starting October 1st, eligible infants or high risk children can receive publicly funded doses of Beyfortus® (Nirsevimab) monoclonal antibody (mAb):

Eligibility includes Ontario residents who meet one of the following criteria:

  • Infants born April 1, 2025 or after and who are less than 8 months of age
  • Children up to 24 months of age who remain vulnerable to severe RSV disease through their second RSV season due to specific health conditions, following a discussion with a healthcare provider:
    • Chronic lung disease (CLD), including bronchopulmonary dysplasia (BPD), defined by need for ongoing respiratory support and supplemental oxygen therapy at 36 weeks postmenstrual age (gestational age at birth plus chronological age) or discharged home, if earlier.
      • Note: Children who were < 12 months of age and approved for coverage in the previous RSV season for chronic lung disease and bronchopulmonary dysplasia remain eligible.
      • Hemodynamically significant cyanotic or acyanotic congenital heart disease (CHD) defined as infants requiring corrective surgery or are on cardiac medication for congestive heart failure or diagnosed with moderate to severe pulmonary hypertension.
      • Severe immunodeficiency
      • Down syndrome/Trisomy 21
      • Cystic fibrosis with recurrent pulmonary exacerbations requiring hospitalization, deteriorating pulmonary function and/or severe growth delay
      • Neuromuscular disease impairing clearing of respiratory secretions
      • Severe congenital airway anomalies impairing the clearing of respiratory secretions

Vaccination for pregnant people

Vaccination for pregnant people with AbrysvoTM, to provide their infant with passive immunity through maternal antibodies is option. The National Advisory Committee on Immunization (NACI) preferentially recommends the use of Beyfortus® for infant protection due to its effectiveness, long-lasting protection, and positive safety profile.

Eligibility is for pregnant individuals at 32-36 weeks pregnant who are Ontario residents and will deliver during RSV season, following a discussion with a health care provider.

AbrysvoTM is not to be administered to infants. This vaccine is only approved for those 18 and older. Please be extra cautious in separating these products to avoid a medication error.

Important notes:

  • Administration of both the vaccine and a monoclonal antibody is NOT recommended except under specific circumstances:
    • Infants born less than 14 days after administration of AbrysvoTM OR
    • Infants who meet the medical criteria for increased risk of severe RSV disease:
      • All premature infants (i.e., <37 weeks gestation)
      • Infants who meet any of the above high-risk criteria
      • Immunization of eligible infants, high risk children and pregnant patients should not begin until October 1st to ensure protection into the RSV season (November to late March).
      • Doses of AbrysvoTM ordered as part of the Infant and High Risk Children Program should be prioritized for pregnant individuals and not used for Older Adult immunization.

OPH will support families with infants with barriers to access through select OPH clinics and information will be available on our website soon.

Ordering Information

RSV products can be ordered through Ottawa Public Health’s Vaccine Distribution Centre for administration to eligible patients. The RSV product order forms will be available at ottawapublichealth.ca/hcp later this month.

A separate communication will be shared when product ordering is available.

Adverse Event Reporting

Resources

RSV prevention program information can be found on the Ministry of Health’s website; information for the 2025-2026 season to be posted on their website shortly.

For providers:

For your patients

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