What to know about RSV and the free vaccine coming in February

Pregnant women across Australia will be offered a free vaccine to protect their babies against respiratory syncytial virus (RSV) from next month.

The government’s $174.5 million investment will ensure the vaccine can be offered free of charge as part of the National Immunisation Program from February 3 this year.

The vaccine will be made available to women who are between 28 to 36-weeks pregnant, to protect them and their child from the virus.

Health Minister Mark Butler says the “cutting-edge” vaccine is the “centrepiece” of the country’s program to protect children.

What is RSV?

RSV is a highly infectious virus that is spread via droplets and is the most common cause of respiratory infections in children.

An average of 12, 000 babies end up in hospital with the virus every year.

Symptoms include a runny nose, cough, fever, wheezing and difficulty breathing. Like other respiratory illnesses, it’s more common in the colder months.

Catherine Bennett, chair of epidemiology at Deakin University, said it can be “particularly nasty” for younger children.

“They can really struggle with their breathing, some might need to be on ventilators, they have low oxygen in their blood, and it can be fatal,” Professor Bennett said.

“It is a really serious respiratory infection we need to worry about.”

How will the vaccine help during pregnancy?

The vaccine in play — called Abrysvo — was registered for use in pregnancy by the regulator that approves medicines, the Therapeutic Goods Administration (TGA), in March.

Professor Bennett says giving the vaccine to a mother in the later stages of pregnancy, between 24 and 36 weeks, helps protect their babies when they are born.

“It stimulates the mother to produce RSV-specific antibodies, and they can actually travel across the placenta to the baby, so the baby then actually gains some protection from the mother’s antibodies,” she said.

“So when the baby comes into the world, it’s less vulnerable in those first six months to severe disease, because it’s not immunologically naive, it actually has some of the mother’s maternal antibodies in its system already.”

Royal Australian College of GPs (RACGP) president Michael Wright said the free RSV vaccine for pregnant women would “save lives”.

“It will help keep babies safe and save expectant families money,” Dr Wright said.

“RSV must be taken very seriously, and I urge all pregnant women to get this vaccine once its available. It’s completely free and may make all the difference as to whether your newborn baby ends up in hospital with a severe case of this virus, or worse.”

Mr Butler said the vaccine — combined with the RSV jabs given to eligible infants after birth — could significantly reduce the number of infants who get very sick from RSV each year.

“We know that RSV is the biggest driver of hospitalisation of babies and infants in Australia, hospitalising, on average, around 12,000 babies every year, primarily during the winter season.

“A quarter of those little ones end up in the intensive care unit. It’s very, very big pressure on the hospital system, but obviously an enormous driver of distress for parents who bought their beautiful newborns home, and often only within a few weeks or a couple of months, have to take their precious babies back to hospital because of this really devastating illness.

“We think that this program, the maternal vaccine, and the vaccine for newborns, will reduce that number by as much as 10,000 hospitalisations.

“An enormous relief to mums and dads who’ve just had their precious newborn baby, but also a huge relief to pressured hospitals … during those difficult winter months.”

How common is RSV?

Very common.

Most children will catch RSV at least once before they turn two, health authorities say.

In the year to date, there have been more than 172,000 reported cases of RSV across Australia, according to the Australian Respiratory Surveillance Report.

The virus also puts a lot of pressure on health systems. The Department of Health says it’s the leading cause of hospitalisation from lower respiratory tract diseases — like pneumonia — in babies younger than six months.

More broadly, the National Centre for Immunisation Research and Surveillance Australia says that between 2016 and 2019, there were more than 115,000 hospitalisations due to RSV in Australia.

Three-quarters of those were children aged under five.

Is there a vaccine for infants?

The TGA has approved Nirsevimab — a long-acting monoclonal antibody — for high-risk infants and children, or babies whose mothers didn’t receive the vaccine while pregnant.

Australian National University infectious diseases specialist Sanjaya Senanayake said Nirsevimab wasn’t technically a vaccine as it doesn’t activate the immune system.

“This antibody in general is the end-product of what happens with vaccinations,” he said.

“With vaccinations, you’re trying to induce immunity, but a monoclonal antibody means you give the ready-made antibodies to that person, so they don’t have to make the antibodies for themselves.

“For kids who haven’t got antibodies to RSV, you can prepare them for the winter months by giving them antibodies and protect them from severe RSV.”

Nirsevimab has been considered by the PBAC before for babies born during or entering their first RSV season and vulnerable children aged up to two years old.

But the PBAC didn’t recommend it for listing on the PBS, saying its cost-effectiveness was still “substantially underestimated and highly uncertain”.

Can my child get an RSV immunisation for free?

Under the National Health Act, the federal government can’t list medicines or vaccines on the PBS unless the PBAC has recommended them.

However, in November it announced it would work with the states and territories to ensure there was national access to Nirsevimab for eligible babies and young children.

South Australia, Queensland, Tasmania, NSW and Victoria all have various programs where infants whose mothers did not receive the Abrysvo vaccine while pregnant and those who are high-risk have access to the free RSV monoclonal antibody — although eligibility and timing depends on when babies were born as the programs are designed around RSV seasons in each state.

In Western Australia, it was offered last year for babies under eight months, or at risk children under 19 months. In the Northern Territory, infants born between August 2024 and January 2025 can get the free RSV shot if they are born premature, are less than six months of age with complex medical conditions, or are Aboriginal or Torres Strait Islander.

In 2024, eligible babies in ACT hospitals were able to receive the medicine as part of the NSW Health RSV vulnerable babies program.

The immunisation’s protection lasts for five months, which is expected to cover babies through an average RSV season.