Australia’s RSV protection milestone: free infant immunisation for all babies
In 2025, Australia rolled out free access to RSV immunisations for all infants, marking a watershed moment in the fight against a virus that routinely causes hospitalisations among young children. Early indicators suggest the program has saved lives and reduced the burden on hospitals, but the rollout has also exposed gaps in consistency, information, and equity that must be addressed to maximise protection.
What’s included in the national effort
The national effort combines maternal protection with infant protection. Pregnant women can receive the Abrysvo (maternal RSV vaccine) through the National Immunisation Program, while Beyfortus (nirsevimab) is delivered to eligible infants via state and territory programs. Together, these options aim to shield babies from severe RSV during their first months and beyond.
Early signs of impact
Preliminary sentinel hospital data for April–July 2025 show a decline in severe RSV admissions by about one third compared with the same period in 2024. Intensive care admissions also fell, suggesting the dual approach is making a tangible difference to vulnerable infants.
Promises and praise, but also persistent challenges
There is much to celebrate: thousands of babies protected, and a growing willingness among parents to take up vaccines that prevent hospitalisations. Yet the program faces real, ongoing challenges that stem from misinformation, uneven rollout, and changing eligibility criteria across jurisdictions.
Because Beyfortus is administered through state and territory programs, eligibility rules have varied. This has led to inconsistent uptake—from as low as 13.4% in New South Wales to 40.5% in Western Australia—and, in some cases, confusion about who qualifies. The result: gaps where babies slip through the cracks and later contract RSV.
The consequences have been personal as well as public. Some families report late protection or no protection when eligibility criteria shift or are unclear. There have also been misadministrations: reports to the Therapeutic Goods Administration (TGA) describe instances where Abrysvo was given to unqualified recipients, Beyfortus to females aged 15–54, and Arexvy (for older adults) to pregnant women. These cases underscore the need for consistent, clear guidance for frontline providers.
Learning from individual stories
Stories such as that of baby Blake, born just days before materal vaccination could have helped him, highlight the human cost of a fragmented rollout. When confusion about uptake criteria arises in states like NSW, families can bear the consequences in the form of preventable illness and hospital stays. The aim now is to translate national ambition into dependable, equitable access for every infant, regardless of where they are born.
A path to a gold-standard program
A truly gold-standard RSV immunisation program would ensure both maternal and infant options are free through the National Immunisation Program, with consistent guidance across all states and territories. While state-led Beyfortus delivery has filled a critical void, genuine national uniformity remains elusive—and essential for protecting all babies, not just those in receptive regions.
Looking ahead: protecting broader age groups
Expanding RSV vaccination to older adults is a logical next step, given their ongoing risk each winter. Broadening access could reduce hospitalisations across generations and further diminish RSV’s annual toll. Researchers are also probing whether infant immunisation has longer-term benefits for respiratory health, including asthma and chronic wheeze, though consensus on these outcomes remains under study.
Conclusion: from protection to equity
Early data suggest the RSV program has protected thousands of Australian babies in 2025. The true measure of success will be equitable access, trusted information, and consistent delivery across all jurisdictions. By uniting parents, clinicians, researchers, and policymakers, Australia can sustain and strengthen RSV protection, ensuring every at-risk child gains the shield they deserve.
© Catherine Hughes AM, Immunisation Foundation of Australia. The views expressed are those of the author unless stated otherwise.
