Health Professionals Update – Vol. 19, No. 27
From:
Dr. Nicholas Brandon, MD, MA, MSc, CCFP, FRCPC
Associate Medical Officer of Health
In this issue
2026/27 Respiratory Syncytial Virus (RSV) prevention program for older adults, pregnant individuals, infants and high-risk children.
Key messages
- RSV immunization products (Arexvy, Abrysvo and Beyfortus) are now available to order.
- Primary care providers are encouraged to administer Beyfortus to eligible infants and high-risk children, and the RSV vaccine to eligible adults.
- Use the new billing code G849 for RSV administration.
2026/27 RSV prevention program for infants and high-risk children, pregnant individuals and older adults
The RSV season is generally from November to April, with regional variations. Details regarding the infant program wind-down will be communicated to providers at the end of the RSV season. The older adult program is year-round.
Health care providers can now order RSV vaccines (Arexvy and Abrysvo) and the monoclonal antibody (Beyfortus). Due to order volumes, processing may take approximately 3 to 4 weeks. Your patience is appreciated.
To support timely distribution, respiratory vaccine orders will be fulfilled through free delivery only. Pickup options are not available until further notice.
To ensure all health care providers have access to respiratory vaccines and to maintain product availability throughout the season, order limits are in place. Order only the quantity that can be safely accommodated within your vaccine storage capacity.
Administration can begin as soon as product is available. Co-administration of COVID-19, influenza, and RSV for eligible individuals is strongly encouraged.
Infants and high-risk children
National Advisory Committee on Immunization (NACI) updated RSV guidance for infants and children
In April 2026, NACI removed its preferential recommendation for monoclonal antibodies (Beyfortus) for infant RSV prevention. Beyfortus and Abrysvo are both effective options for preventing severe RSV in infants, with emerging evidence suggesting similar protection. Beyfortus remains available to eligible infants and high-risk children, supported by high uptake and reduced hospitalizations. Abrysvo during pregnancy is an effective alternative for infant protection. Abrysvo and Beyfortus are not routinely recommended together, except in specific cases (e.g., high-risk infants born to vaccinated mothers). Product choice should be discussed with a health care provider.
For more information, please see: Updated guidance to protect infants and children from respiratory syncytial virus (RSV) disease: use of monoclonal antibodies (nirsevimab and clesrovimab) and the RSVpreF vaccine
Beyfortus eligibility as per Ministry eligibility criteria:
- Infants born April 1, 2026 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 2026/27 RSV season will be offered Beyfortus at time of birth prior to discharge.
Vaccination in pregnancy
Pregnant individuals 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: 28 to 36 weeks gestational age who will deliver during the RSV season.
Health Canada authorization is for use at 32-36 weeks of pregnancy. NACI recommends administration between 28-36 weeks; administration before 32 weeks is off-label and at the discretion of the health care provider based on clinical judgment.
Older adult program
Eligibility for RSV vaccine (Arexvy or Abrysvo) as per Ministry eligibility criteria:
- Aged 75 years and older
- 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)
- recipients of a hematopoietic stem cell transplant within the past two years or with ongoing immunosuppression (updated)
- patient on home oxygen or requiring chronic oxygen therapy, regardless of residence (new)
- 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 transplant
- individual who is homeless
- individual who identifies as First Nations, Inuit, or Métis (FNIM)
Adults who previously received a dose of RSV vaccine do not need another dose this season.
For additional guidance: Ministry: Respiratory Syncytial Virus (RSV) prevention programs - HCP guidance and fact sheets
New RSV Billing code
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.
Contact us
The Health Professionals Update (HPU) is distributed to physician offices in Peel region via email. Share this update with other health professionals in your clinic.
More information:
For questions about this update, email healthprofessionals@peelregion.ca.