Respiratory syncytial virus (RSV) is a common yet potentially severe virus that affects the respiratory system. It poses a significant risk to infants, pregnant women, older adults, and those with chronic conditions, often leading to serious complications such as bronchiolitis and pneumonia. RSV infection can occur at any age, and repeated infections are common throughout life as natural infection does not confer long-lasting immunity. Currently, RSV activity in Australia varies by region, with Queensland and Western Australia experiencing a notable increase in cases, while New South Wales and South Australia report relatively stable numbers. RSV-related hospitalisations are rising in the Northern Territory, further emphasising the urgency of prevention measures (Immunisation Coalition, 2025; NCIRS, 2019; NCIRS, 2024).
To combat this public health concern, the Australian Government has announced that, from 3 February 2025, the maternal RSV vaccine will be added to the National Immunisation Program (NIP) Schedule, providing free access to eligible pregnant women.
What is RSV?
RSV is a highly contagious virus that causes infection of the lungs and respiratory tract. While most healthy individuals experience mild, cold-like symptoms, RSV can be particularly dangerous for newborns and infants due to their underdeveloped immune systems. Older adults face a heightened risk of hospitalisation due to age-related immune decline. Additionally, individuals with chronic conditions such as COPD, CHF, diabetes and CKD are more vulnerable to severe RSV complications (Woodward & Jones, 2024a).
Conditions associated with increased risk of severe RSV disease in adults
Individuals with medical conditions associated with an increased risk of RSV complications, such as asthma, chronic obstructive pulmonary disease, congestive heart failure, diabetes, and chronic kidney disease, should be strongly encouraged to receive RSV vaccination. Vaccination can help prevent severe outcomes and reduce the burden on healthcare systems.
Older adults and individuals with chronic conditions are at heightened risk of severe RSV disease, including:
- Cardiac conditions – such as congestive heart failure (CHF) and coronary artery disease (CAD)
- Chronic respiratory conditions – including chronic obstructive pulmonary disease (COPD), emphysema, bronchiectasis, and severe asthma
- Immunocompromising conditions – such as HIV, malignancy, solid organ transplants, and those receiving immunosuppressive therapy
- Chronic metabolic disorders – including diabetes and mitochondrial disorders
- Chronic kidney disease – particularly those with Stage 4 or Stage 5 kidney disease
- Chronic neurological conditions – including degenerative central nervous system diseases and neuromuscular disorders
- Obesity – individuals with a body mass index (BMI) ≥30 kg/m²
These groups should be prioritised for RSV vaccination to mitigate the risk of severe disease and hospitalisation (Woodward & Jones, 2024b).
RSV vaccination: Essential protection for pregnant women, infants, and older adults
The inclusion of the maternal RSV vaccine in the NIP Schedule is a significant step toward reducing the burden of RSV in Australia. The vaccine provides passive immunity to newborns by transferring protective antibodies from the mother to the baby during pregnancy, offering protection during the critical first few months of life. From 3 February 2025, the RSV vaccine will be available free of charge under the NIP Schedule for pregnant women between 28 and 36 weeks gestation. This initiative aims to safeguard both expectant mothers and their newborns, reducing the risk of severe RSV-related complications. Additionally, RSV vaccines for older adults aged 60 and above are now available via private prescription. Studies indicate that RSV infection in older adults can be as severe as influenza, leading to prolonged hospital stays, pneumonia, ICU admission, and increased mortality.
Currently, two vaccines — Arexvy and Abrysvo — are registered in Australia to prevent RSV-related lower respiratory tract disease. At this stage, Abrysvo is the only one approved for pregnant women to provide passive immunity to newborns. Meanwhile, Arexvy is only indicated for older adults aged 60 and above to reduce the risk of severe RSV-related lower respiratory disease (Australian Government Department of Health and Aged Care, 2025b).
RSV vaccine co-administration and timing
To improve uptake and reduce vaccine fatigue, RSV vaccines can be co-administered with other respiratory vaccines, such as those for influenza, COVID-19, pneumococcal, and shingles. Clinical trials have shown that RSV vaccines given alongside influenza vaccines did not compromise immune response and had similar safety profiles. Healthcare providers should discuss co-administration with clients to increase RSV vaccination uptake and ensure optimal protection.
RSV vaccines for older adults can be administered at any time of the year but are ideally given before the RSV season. In Australia, RSV peaks between May and July in temperate regions, while in tropical areas, it coincides with the rainy season.
Conclusion
The inclusion of the RSV vaccine in the NIP Schedule for pregnant women and the availability of RSV vaccines for older adults represents significant advancements in Australia’s immunisation strategy. Given the current rise in RSV cases across Australia, expectant parents and older adults at risk are encouraged to consult their healthcare provider about RSV vaccination to ensure protection against this potentially life-threatening virus.
It is important to always check the most current NIP Schedule to stay informed about RSV vaccination eligibility. The latest details can be found on the Australian Government Department of Health and Aged Care website.
References
Australian Government Department of Health and Aged Care. (2023, August 14). National immunisation program. Australian Government Department of Health and Aged Care. https://www.health.gov.au/our-work/national-immunisation-program
Australian Government Department of Health and Aged Care. (2025a, January 7). Immunisation for pregnancy. https://www.health.gov.au/topics/immunisation/when-to-get-vaccinated/immunisation-for-pregnancy
Australian Government Department of Health and Aged Care. (2025b, January 17). Respiratory syncytial virus (RSV). The Australian Immunisation Handbook. https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/respiratory-syncytial-virus-rsv#
CDC. (2024, August). RSV. CDC. https://www.cdc.gov/rsv/about/index.html
Immunisation Coalition. (2025, January 20). Respiratory Syncytial Virus (RSV) statistics. https://www.immunisationcoalition.org.au/news-data/respiratory-syncytial-virus-rsv-statistics/
NCIRS. (2019, May 27). National data on Respiratory Syncytial Virus (RSV) released. https://ncirs.org.au/national-data-respiratory-syncytial-virus-rsv-released
NCIRS. (2024, November 11). Respiratory syncytial virus (RSV) FAQs | NCIRS. https://ncirs.org.au/ncirs-fact-sheets-faqs-and-other-resources/respiratory-syncytial-virus-rsv-frequently-asked
Woodward, M., & Jones, L. (2024a). Protecting your older patients from RSV – A common respiratory virus. In Immunisation Coalition.
Woodward, M., & Jones, L. (2024b). RSV vaccination in older adults: A new era in prevention. In Immunisation Coalition.