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Respiratory Syncytial Virus (RSV)

Respiratory Syncytial Virus, or RSV, is a virus that usually causes mild cold-like symptoms in most people. However, it can be serious for certain groups, including older adults, young children, people with weak immune systems, those with lung or heart problems, and premature babies. RSV tends to circulate more between October and April each year.

Anyone can get RSV, but many babies catch it in their first year. Even if you've had RSV before, you can still get it again later in life.

 
 

Signs and Symptoms

Signs and symptoms of RSV can range from mild cold symptoms to severe respiratory distress and can include:

  • fever
  • loss of appetite
  • runny nose
  • cough
  • wheezing
  • sore throat
  • headache
  • general feeling of being sick

Premature babies may not have respiratory symptoms and instead be very tired, irritable, feed poorly and may have short periods of interrupted breathing. Infection with RSV can make medical conditions such as asthma and chronic lung disease worse. Sometimes severe illness can result in pneumonia, bronchiolitis, ear infections and tonsillitis.

Symptoms generally begin 4-6 days after exposure. An ill person can spread the virus for up to 8 days and sometimes longer. It can take 1-2 weeks to feel better.

How is RSV Spread?

RSV spreads by respiratory droplets in infected persons through coughing, sneezing or talking. It is also spread through contact with surfaces contaminated with RSV, such as toys, eating utensils, and unwashed hands. The virus can live on surfaces for many hours and on unwashed hands for a half hour. RSV is not spread though the air..

You can lower the chance of getting sick with RSV by doing the following:

Wash your Hands

Make sure hands are properly washed after wiping a child’s nose, coughing, sneezing, blowing the nose, shaking hands, before eating, before touching the eyes, nose or mouth. If your hands are not visibly dirty, an alcohol-based hand rub can be added to your hand hygiene routine.

Cover your cough or sneeze

Coughing and sneezing can spread germs to others. Cough or sneeze into a tissue and throw it away. If you don’t have a tissue, cough or sneeze into your sleeve. Always clean your hands after coughing or sneezing.

Clean surfaces

Frequently clean and disinfect surfaces and objects that are touched a lot like doorknobs, keyboards, counter tops, sink taps, toys, light switches, hand railings, remote controls, phones etc.

Stay home if you are sick

Staying home when you are ill is important to help reduce the spread of illness.

How is RSV Treated?

Most cases of RSV do not require any treatment, and the ill person recovers on their own. For severe cases, oxygen and/or an antiviral medication may be prescribed. It is important to drink lots of fluids to avoid dehydration and to watch for increased difficulty in breathing.

RSV Vaccines and Monoclonal Antibody Product Information

The Ontario 2025-26 Respiratory Syncytial Virus (RSV) prevention program information has been updated.

Older High-risk Adults

  • New! All individuals aged 75 years and older
  • Individuals 60 to 74 years of age who qualify under specific eligibility criteria.

The chart below outlines Ontario’s 2025-2026 RSV Prevention Program for older adults and includes details of who is eligible for the program, which prevention product is recommended, and where eligible individuals will be able to access services.

  • For additional information and resources for Healthcare Providers, visit the Ministry webpage.
  • Individuals who are 60 years and older who do not qualify for this publicly funded prevention program can purchase the vaccine at a pharmacy with a prescription from their healthcare provider.

Eligibility Criteria

Prevention Product

Where can eligible individuals access services?
  • All individuals aged 75 years and older (new for the 2025—2026 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 hospitals receiving alternate level of care (ALC) including similar settings (e.g. complex continuing care, hospital transitional programs)
    • Patients with glomerulonephritis 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

*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 indicated or recommended at this time. The timing for subsequent doses is currently unknown. Studies are ongoing to determine the duration of protection.		 Arexvy (vaccine)

OR

Abrysvo (vaccine)

• One dose
  • Long-term care homes
  • Retirement homes
  • Hospitals
  • Healthcare Provider offices
  • Some walk-in clinics

 

Pharmacists will NOT be administering RSV vaccine for publicly funded individuals.

 

Infants and High-risk Children

The 2025-26 RSV prevention program for infants, high-risk children and pregnant individuals has been updated.
There are two approved RSV immunization options, both of which are available to residents of Ontario regardless of OHIP coverage:

  • Abrysvo – a maternal RSV Vaccine administered during pregnancy to protect the infant being born during RSV season
  • Nirsevimab (Beyfortus) – A long-acting monoclonal antibody administered directly to infants less than 8 months of age, and high-risk children up to 24 months of age

Due to the seasonality of the RSV virus and to ensure optimal protection, Nirsevimab (Beyfortus) or Abrysvo should be administered shortly before and during the active RSV season (November 1 to March 31, peaking in December), with regional variation across Ontario and between years.

Eligibility Criteria Prevention Product Where can eligible individuals access services?

October 1, 2025 - March 31, 2026

  • Infants born on or after April 1, 2025, are eligible for RSV immunization for the upcoming season, up to less than 8 months of age
  • For out-of-season births (April 1 to September 30), families can access RSV immunization through their primary care providers, clinic or local public health units.
  • Infants born on or after October 1 should ideally receive Nirsevimab soon after birth to ensure immediate protection.


Second Season Eligibility (Children < 2 years old)
Children under two years of age who meet high-risk criteria are eligible for a dose during their 2nd RSV season, starting October 1, 2025.


High-risk conditions include:

  • Chronic Lung Disease (CLD) – including bronchopulmonary dysplasia, requiring assisted ventilation, oxygen, or chronic medical therapy within the past 6 months.
  • Down Syndrome / Trisomy 21
  • Cystic Fibrosis – with respiratory involvement and/or growth delay.
  • Neuromuscular Disease – impairing the ability to clear respiratory secretions.
  • Severe Congenital Airway Anomalies
  • Severe Immune Deficiency
  • Hemodynamically Significant Congenital Heart Disease (CHD) – requiring corrective surgery, cardiac medications for congestive heart failure, or associated with moderate to severe pulmonary hypertension.

*Beyfortus (monoclonal antibody immunizing product)

 

Dose – dependent on the age and weight of recipient
  • Hospitals
    • LHSC clinic for infants and high-risk children: if your child does not have a healthcare provider, please call 519-685-8500 ext. 50071 and leave a message with your child’s name and date of birth. You will receive a call back with an appointment date and time.
  • Healthcare providers
    • Call your primary healthcare provider or midwife.
  • MLHU
    • RSV appointments are available for those who cannot access vaccine at other healthcare providers (call 519-663-5317).

  • Please note: Pharmacists cannot provide or administer publicly funded RSV immunizations
Maternal Immunization with Abrysvo
  • For pregnant individuals who would prefer the maternal RSV vaccine, Abrysvo should be administered between 32 and 36 weeks' gestation, again starting October 1, 2025.
 Abrysvo (vaccine)  

Notes:

  • Arexvy RSV vaccine is NOT licensed for use during pregnancy.
  • Giving the monoclonal antibody to an infant is the recommended approach over vaccination in pregnancy to protect infants, based on recommendations from the National Advisory Committee on Immunization (NACI). Decision making should be made with the pregnant individual’s healthcare provider.
  • Administration of both Abrysvo (vaccine) during pregnancy and Beyfortus (Nirsevimab monoclonal antibody) is not needed except under the following situations:
    • Infants born less than 14 days after administration of Abrysvo OR
    • Infants who meet the medical criteria for increased risk of severe RSV disease:
      • All premature infants (i.e.,
      • Infants who meet any of the above high-risk criteria in the chart

Co-administration of RSV Prevention Products with Vaccines

  • Arexvy and Abrysvo (vaccines) can be administered on the same day as or any time before or after other vaccines.
  • Beyfortus (Nirsevimab monoclonal antibody) can be administered on the same day as or any time before or after childhood vaccines, including seasonal vaccines (such as influenza), including live vaccines.

More information

 

References

1Centers for Disease Control and Prevention (2005). Respiratory Syncytial Virus. Retrieved January 12, 2016 from Retrieved from
www.cdc.gov/Features/RSV/
2Pickering, L. K. (Ed.). (2012). Respiratory syncytial virus. In 2012 Red Book: Report of the committee on infectious diseases (29th ed; pp. 609-618). Elk Grove Village, IL: American Academy of Pediatrics.
Date of creation: January 18, 2016
Last modified on: October 6, 2025