The RSV vaccine is making a difference

Don't be afraid to show your support for a successful public health initiative with a new vaccine.

Social media is full of negative information on the value of immunisations. It can be particularly severe when it involves a new vaccine. Too often we allow celebrity sceptics and self-interested politicians to influence public discourse on vaccination. We need to applaud success stories when they occur.

In 2024, Australia experienced a record-breaking surge in RSV (Respiratory Syncytial Virus) infections. More than 170,000 cases were notified with almost 50% under the age of 4 years. RSV can lead to bronchiolitis and pneumonia in infants. RSV outbreaks also place an enormous burden on the hospital system and can lead to fatalities in those most vulnerable.

An initiative to reduce the burden of disease was started in February 2025. It involved the use of an RSV vaccine (Abrysvo) in pregnancy (after 28 weeks and at least 2 weeks before the expected date of delivery) and the use of a monoclonal antibody (Nirsevimab) in infants. Only the infants of unvaccinated mothers would receive the antibody.

In both situations the newborn would receive short-lasting protection from the disease during a vulnerable period of life. (It is inevitable that the child will be exposed to the disease during childhood but at least it can be delayed until it is better able to mount a good defence.)

According to a recent research letter in the Medical Journal of Australia, the 2025 NSW RSV Prevention Program achieved more than a 40% reduction in RSV notifications and hospitalisations among infants aged younger than 6 months.

The fatality rate is also highest in this age group with preterm babies as high as 5%.

The results are preliminary but follow on the findings of a large study undertaken in the UK during 2024/25 where more than 300,000 babies were followed. The findings of this program were presented earlier this year and showed the vaccine was highly protective if given at least 4 weeks before birth. According to the report, the vaccination reduced hospitalisations by up to 85%.

The vaccine was found to be highly beneficial for infants born prematurely even if the interval was less than 4 weeks. Maternal RSV vaccine uptake is on the rise in the UK.

Why it matters for carers and travellers

Given the success of the maternal vaccination program, it is easy to understand why the Australian government has added the adult RSV vaccine to the National Immunisation Program for those over 75 years. It makes economic sense (for the government).

This shouldn't be lost on those younger than 75 years who are carers of young children who also attend childcare centres or travellers undertaking a cruise where RSV outbreaks may occur.

Vaccination might be considered common sense in this case rather than good economic sense.

The latter might apply when the individual is a carer under 75 years who also loves to travel!

RSV in Australia right now

Respiratory Syncytial Virus is a notifiable disease in Australia.

Just under 65,000 cases have been reported to June 21 this year with the majority in the past quarter (cooler months). A similar pattern with young children is being observed and it will be interesting to see whether the reduction in hospitalisations is maintained.

Who is at risk of serious RSV disease?

Most people will experience a mild illness with RSV disease. Those most at risk of serious disease include very young children (under 5 years), older individuals (> 65 years), and people who might be immune suppressed.

Approximately 2-3% of infants with RSV will require hospitalisation.

In the older population, co-morbidities such as asthma, chronic lung disease and heart failure may also contribute to more serious disease and hospitalisation.

How is RSV prevented?

Non-vaccination

Most respiratory viruses can be avoided by simple measures.

• Hand washing
• Avoiding close contact with sick people, particularly children
• Avoid touching your face with unwashed hands
• Keeping surfaces clean

Vaccination

Two RSV vaccines are currently available in Australia.

Arexvy (GSK) The vaccine is approved for use in those over 60 years.

It is recommended for:

• All individuals over 75 years (now funded under the NIP)
• Individuals 60-74 years with medical conditions which increase the risk of severe RSV disease.
• First Nations adults aged 60-74 years (now funded under the NIP)
• Anyone over 60 years who feels at high risk of exposure (grandparents, childcare workers, teachers etc).

Abrysvo (Pfizer)

Approved for use in:

• • Pregnancy (between 24 and 36 weeks gestation)
  • Individuals older than 60 years

When is the best time to be immunised?

It is best to have the vaccine before the season of risk (autumn and winter).