RSV Prevention Programs 2026/2027 Implementation Package

This memo provides information on Ontario’s 2026/2027 Respiratory Syncytial Virus (RSV) prevention programs: the Infant and High-risk Children RSV Prevention Program and the Older Adult RSV Vaccine Program. RSV prevention remains important this season to protect infants, young children and older adults from severe illness, as well as mitigate the impacts of respiratory diseases on our health care system.

Key messages

• RSV immunization products for infants, high-risk children, pregnant people and older adults are available to order.
• Primary care providers are encouraged to administer Nirsevimab (Beyfortus®) to eligible infants and high-risk children, and the RSV vaccine to eligible adults.
• Use the new billing code G849 for RSV administration.

Infant and High-Risk Children RSV Immunization Program

Administration of RSV immunizing agents for the Infant and High-risk Children program can begin October 1, 2026, pending product availability. This includes:

• Nirsevimab (Beyfortus®), a monoclonal antibody (mAb), for infants and children who meet any one of the following criteria:
  • Infants born April 1 or after and less than 8 months of age at the time of immunization
  • Children under 24 months old who remain at increased risk of severe RSV disease following a discussion with their pediatric specialist, including children with specific medical conditions.
• RSVpreF vaccine (Abrysvo®) for pregnant individuals between 28 and 36 weeks gestation who are expected to deliver during the RSV season.

Ontario will continue to offer nirsevimab (Beyfortus®) for eligible infants and high-risk children based on demonstrated effectiveness and duration of protection. Alternatively RSVpreF (Abrysvo®) during pregnancy is another effective option.

Typically only one of Nirsevimab (Beyfortus®) after delivery or RSVpreF vaccine (Abrysvo®) during pregnancy is indicated, but both may be recommended in certain situations, such as for premature infants or infants born less than 14 days after the pregnant individual received RSVpreF (Abrysvo®).

RSVpreF (Abrysvo®) may be administered between 28 and 36 weeks gestation, as recommended by the National Advisory Committee on Immunization (NACI). Please note that RSVpreF (Abrysvo®) is currently approved by Health Canada for use between 32 and 36 weeks gestation, and administration as early as 28 weeks is at the clinical discretion of the health care provider.

Older Adult RSV Vaccine Program

RSV vaccine (Abrysvo® or Arexvy) for eligible older adults can be given at any time during the year. This includes but is not limited to:

• Individuals aged 75 and older
• Individuals aged 60 to 74 who
  • live in a long-term care home, Elder Care Lodge, retirement home or similar setting
  • are in hospital receiving alternate level of care (ALC), or in a similar setting
  • are receiving dialysis, have glomerulonephritis with moderate to severe immunocompromise, or are on home oxygen or chronic oxygen therapy
  • are solid organ transplant recipients, or stem cell transplant recipients within the past two years or with ongoing immunosuppression
  • are experiencing homelessness
  • identify as First Nations, Inuit, or Métis (FNIM)

Older adults are currently recommended a single dose of RSV vaccine and boosters are not currently recommended. Older adult program eligibility has been updated to include those receiving home oxygen or chronic oxygen therapy and hematopoietic stem cell transplant timing.

Requested Actions

A new billing code, G849, is available for RSV immunization. Please use this code when applicable and refer to the April 2026 Schedule of Benefits for further details.

Please discuss RSV prevention with your patients, particularly pregnant individuals, parents of young infants and older adults at higher risk and encourage those who are eligible to receive RSV protection along with other recommended respiratory vaccines, including COVID-19 and influenza.

Health care providers caring for pregnant individuals can provide information on both nirsevimab (Beyfortus®) and RSVpreF (Abrysvo®) to support informed decision-making. Publicly funded RSV products can be accessed through health care providers, hospitals, long-term care and retirement homes and Hamilton Public Health clinics.

Resources, including the Ministry fact sheets and product monographs, can be found at hamilton.ca/fallrespiratoryvaccines.

Please visit Ontario's RSV Prevention Programs for additional information and tools to help your patients make an informed decision about RSV prevention.

Key Dates

• October 1, 2026: The infant program begins, pending product availability.
• November 1 to March 31: RSV season, with activity typically peaking in December.
• March 31, 2027: Last day to give nirsevimab (Beyfortus®) or RSVpreF (Abrysvo®) under the Infant and High-risk Children program, unless the RSV season is announced as prolonged.

Co-administration

Please consider co-administering RSV vaccine or RSV monoclonal antibody (mAb) product with COVID-19 and influenza vaccines for eligible individuals, to maximize uptake and protection. Nirsevimab (Beyfortus®) can be administered on the same day or any time before or after routine childhood vaccines, and RSVpreF (Abrysvo®) may be administered in pregnancy on the same day as Tdap, COVID-19 and influenza vaccines.

Adverse Events Following Immunization (AEFI)

Health care professionals are reminded to report adverse events following immunization to the Medical Officer of Health within 7 days of recognizing the reportable event. Please use the Public Health Ontario AEFI form. Completed reports should be faxed to Hamilton Public Health at 1-844-444-0295.

It is not necessary to report expected events such as injection site reactions and mild fever. Unexpected, severe and unusual adverse events should be reported promptly.

Beyfortus® is a monoclonal antibody rather than a vaccine, and adverse reactions are not reportable to Public Health. Suspected side effects can be reported directly to Health Canada through the Side Effect Reporting Form.

For more information about the RSV prevention programs, please call 905-540-5250.

RSV Products Ordering

Administration for both the Older Adult Program and the Infant and High-risk Children RSV Program can start as soon as immunization products are received.

To place and order, please use the standard fall respiratory vaccine order form available at www.hamilton.ca/Vaccine-HealthCareProfessionals. When ordering, please allow 24-48 hours for processing and ensure that you attach 4 weeks of refrigerator temperatures.

Attachments found at hamilton.ca/RSV

• RSV Prevention Program Letter to HCP(PDF, 128.39 KB)
• RSV Fact Sheet: Older Adult Prevention for HCP(PDF, 245.14 KB)
• RSV Fact Sheet: Infant and High-risk Children RSV Prevention Program for HCP(PDF, 819 KB)
• RSV Fact Sheet: Infant and High-risk Children RSV Vaccine Program for the Public(PDF, 109.08 KB)