Health Professionals Update - Vol. 18, No. 24

September 26, 2025

From:
Hetal Patel, MD, MPH, CCFP, FRCPC
Associate Medical Officer of Health

In this issue

2025/26 Respiratory Syncytial Virus (RSV) prevention program for older adults, pregnant people, infants and high-risk children.
Register now: Upcoming respiratory immunization webinar hosted by Peel Public Health

Key messages

Specific high-risk settings can now order RSV immunization products (Arexvy, Abrysvo and Beyfortus). Other healthcare providers will be able to begin ordering on October 9.
All individuals 75 years and older are now eligible for the RSV vaccine, in addition to individuals 60 to 74 years with certain high-risk criteria or living in specific high-risk settings.
Primary care providers are encouraged to administer Beyfortus to eligible infants and high-risk children, and the RSV vaccine to eligible adults.
Register now for an upcoming respiratory immunization webinar hosted by Peel Public Health.
Information regarding Influenza and COVID-19 vaccines will be available soon.

2025/26 RSV prevention program for older adults, pregnant people, infants and high-risk children

The RSV season is generally from November to April, with regional variations. Details regarding program wind-down will be communicated to providers at the end of the RSV season.

High-risk settings, including hospitals, long-term care, retirement homes, family health teams and pediatrician offices can now order RSV vaccines (Arexvy and Abrysvo) and the monoclonal antibody (Beyfortus). Ordering for other healthcare providers will open October 9. Due to order volumes, processing may take 3 to 4 weeks. Your patience is appreciated. Publicly funded RSV vaccine will NOT be available in pharmacies this season.

Detailed guidance is available at: Ministry: Respiratory Syncytial Virus (RSV) prevention programs

Older adult program

Administration to eligible adults can begin as soon as product is available.

Eligibility for RSV vaccine (Arexvy or Abrysvo):

Aged 75 years and older (new for the 2025/26 respiratory season)
Aged 60 to 74 years of age and meets one of the following criteria:
- resident of a long-term care home, Elder Care Lodges, or retirement home including similar settings (e.g., co-located facilities)
- patient in hospital receiving alternate level of care (ALC) or in a similar setting (e.g., complex continuing care, transitional programs)
- patient with glomerulonephritis (GN) and is moderately to severely immunocompromised.
- patient receiving hemodialysis or peritoneal dialysis
- recipient of solid organ or hematopoietic stem cell transplant
- individual who is homeless
- individual who identifies as First Nations, Inuit, or Métis

Note: Studies on RSV vaccine efficacy continue to show multi-year protection. Adults who previously received a dose of RSV vaccine, do not need to receive another dose this season.

Arexvy is considered the primary product for older adults this season due to supply availability as Abrysvo distribution will be prioritized for pregnant individuals. Arexvy and Abrysvo are considered interchangeable in seniors and may be substituted based on supply.

Infants and high-risk children

Pending product availability, administration of Beyfortus and Abrysvo for the infant program can begin in early October and should continue to be administered throughout the RSV season.

Beyfortus eligibility:

Infants born April 1, 2025 or after and less than 8 months of age at the time of immunization.
Children up to 24 months of age who remain vulnerable from severe RSV disease through their second RSV season, following discussion with a health care provider, which includes children with:
- Chronic lung disease (CLD), including bronchopulmonary dysplasia (BPD), defined by need for ongoing respiratory support and supplemental oxygen therapy at 36 weeks postmenstrual age (gestational age at birth plus chronological age) or discharged home, if earlier
- Hemodynamically significant cyanotic or acyanotic congenital heart disease (CHD) defined as infants requiring corrective surgery or are on cardiac medication for congestive heart failure or diagnosed with moderate to severe pulmonary hypertension
- Severe immunodeficiency
- Down Syndrome / Trisomy 21
- Cystic fibrosis with recurrent pulmonary exacerbations requiring hospitalization, deteriorating pulmonary function and/or severe growth delay
- Neuromuscular disease impairing clearing of respiratory secretions
- Severe congenital airway anomalies impairing the clearing of respiratory secretions

Infants born in hospital during the 2025/26 RSV season will be offered Beyfortus at time of birth prior to discharge.

All primary care providers and pediatricians are STRONGLY ENCOURAGED to administer Beyfortus to the following groups:

Infants born before the RSV season (born on or after April 1, 2025 and younger than 8 months of age at time of administration).
Infants born during the season who did not receive Beyfortus in hospital.
Infants born outside of hospital settings.
Children up to 24 months of age who remain vulnerable to severe RSV disease through their second RSV season.

From 2024-2025, some parents declined newborn immunization in hospital, preferring to consult with their primary care provider first. Peel Public Health recommends counseling pregnant patients on the importance of RSV immunization for newborns before discharge from hospital.

Multi-language materials for patients and providers from the Provincial Council for Maternal and Child Health are available to support these discussions.

Vaccination in pregnancy

Pregnant people are eligible to receive a single dose of Abrysvo. Abrysvo is the only RSV vaccine currently indicated in pregnancy. Doses in subsequent pregnancies are not currently recommended.

Eligibility: 32 to 36 weeks gestational age who will deliver during the RSV season.

Only one RSV product is recommended for infant protection. NACI recommends Beyfortus as the preferred option over maternal vaccination in pregnancy, except in specific cases (e.g., high-risk infants born to vaccinated mothers).

Register now: Upcoming respiratory immunization webinar hosted by Peel Public Health

Peel Public Health invites physicians and community health care providers to a webinar on RSV, COVID-19, and Influenza Immunization. Learn about the latest respiratory illness trends and immunization recommendations to support your practice and protect patients this season.

Respiratory Immunization Update 2025/26
October 8, 2025
6 to 7 p.m.
Virtual event (Microsoft Teams)
Register for webinar

Peel Public Health clinics

Peel Public Health will be providing respiratory vaccine clinics with RSV appointments for adults 75 years and older without a primary care provider for a limited time in October and November.

Beyfortus for infants and RSV vaccine in pregnancy will not be offered this year. More details will be available soon on the Peel Region website.

Influenza and COVID-19 vaccines

Information on Influenza and COVID-19 vaccines will be available soon.

Contact us

The Health Professionals Update (HPU) is distributed to physician offices in Peel region via fax or email. Share this update with other health professionals in your clinic.

More information:

Review past HPUs
Subscribe to HPU emails
For questions about this update, email healthprofessionals@peelregion.ca