Information on Ontario’s Respiratory Syncytial Virus (RSV) prevention program

To: Ottawa Physicians and Nurse Practitioners 
Date:  October 1, 2026
From:  Dr. Laura Bourns, Deputy Medical Officer of Health
Subject: Information on Ontario’s Respiratory Syncytial Virus (RSV) prevention program 

Dear Colleagues,

The below communication provides information on Ontario’s Respiratory Syncytial Virus (RSV) prevention programs for the 2026-2027 RSV season for:

1. High-risk older adults
2. Infants and high-risk children

1. Older Adult RSV Vaccination Program

As communicated earlier this year, the Older Adult RSV Vaccine Prevention Program is available year-round for eligible individuals. A single dose of RSV vaccine can be given to eligible older adults at any time during the year. 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 at this time.

Older Adult High Risk RSV Vaccine Prevention program eligibility:

• All individuals 75 years of age and older
• 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)
• Individuals on home oxygen or requiring chronic oxygen therapy, regardless of residence
• 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 within the past two years or with ongoing immunosuppression
• 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. RSV vaccination is not available through pharmacies. OPH will support residents with barriers to access through select OPH clinics. More information will be available on our website. 

Vaccine Information

Both Arexvy and Abrysvo^TM are Health Canada approved RSV vaccines that are indicated for the prevention of lower respiratory tract disease (LRTD) caused by RSV in those 60 years of age and older. RSV vaccine may be co-administered with other routine and seasonal immunizations for older adults.

Depending on vaccine supply and availability, healthcare providers may receive either product in their vaccine order.

2. Infant and High-risk Children RSV Prevention Program

Immunization of eligible infants, high-risk children, and pregnant patients can begin on October 1^st, 2026.

a) Monoclonal Antibody (mAb) for Infants and High-risk Children

Starting October 1^st, 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:

• Infant program
• Infants born April 1, 2026 or after and who are less than 8 months of age
• High-risk children program:
• 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:

o   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.

o   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.

o   Severe immunodeficiency

o   Down syndrome/Trisomy 21

o   Cystic fibrosis with recurrent pulmonary exacerbations requiring hospitalization, deteriorating pulmonary function and/or severe growth delay

o   Neuromuscular disease impairing clearing of respiratory secretions

o   Severe congenital airway anomalies impairing the clearing of respiratory secretions

b) Abrysvo^TM vaccination for pregnant people

Vaccination for pregnant people with Abrysvo^TM, to provide their infant with passive immunity through maternal antibodies, can help to protect infants against RSV.

Abrysvo^TM 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. Eligibility is for pregnant individuals at 28-36 weeks pregnant who are Ontario residents and will deliver during RSV season, following a discussion with a health care provider.

While RSVpreF (Abrysvo®) is authorized by Health Canada for use in pregnant persons between 32 and 36 weeks gestation, the National Advisory Committee on Immunization (NACI) recommends that RSVpreF may be administered between 28 and 36 weeks gestation. This recommendation is supported by available safety and efficacy data, supports broader access and opportunities for immunization, and aligns with recommendations by the World Health Organization. Administration before 32 weeks gestation is considered off-label and is subject to the clinical judgment of the health care provider.

Important notes:

• Administration of both the vaccine and a monoclonal antibody is NOT recommended except under the following specific circumstances:
  • Infants born less than 14 days after administration of Abrysvo^TM in pregnancy OR
  • Infants at increased risk of severe RSV disease:
    • All premature infants (<37 weeks gestational age)
    • Infants who meet any of the above high-risk criteria
    • OPH will support families with infants with barriers to access through select OPH clinics and information will be available on our website.

Ordering Information

RSV products, including RSV vaccines and monoclonal antibody for infants, are available for order through our Vaccine Distribution Centre. Orders can be placed at any time using our online RSV vaccine order form

For locations that have viable (non-expired) vaccine product on-hand, from the 2025-2026 RSV prevention programs, that product should be used first.

Adverse Event Reporting

• Beyfortus® is a monoclonal antibody, as such, reports of suspected side effects should be submitted through the Health Canada Side Effect Reporting Form
• Abrysvo^TM and Arexvy adverse event reports can be reported using the Adverse Event Following Immunization Form.

Resources

RSV prevention program information can be found on the Ministry of Health’s website; information for the 2026-2027 season to be posted on their website shortly.

For health care providers:

• Older Adult High-Risk Respiratory Syncytial Virus (RSV) Vaccine Program Fact Sheet - Health Care Providers
• Infant and High-risk Children Respiratory Syncytial Virus (RSV) Prevention Program Factsheet for Health Care Providers
• Letter from the Office of the Chief Medical Officer of Health re Ontario’s RSV prevention programming for the 2026-2027 season

For your patients (These pages are currently under review and will be updated in the coming days)

• Ministry of Health’s RSV prevention program page for the general public: ontario.ca/rsv
• Ottawa Public Health’s RSV website: ottawapublichealth.ca/rsv