New era for infant RSV protection in Australia
In 2025, Australia introduced free access to RSV immunisations for all infants, a landmark step in protecting the youngest, most vulnerable Australians from severe respiratory disease. Early indicators are encouraging: sentinel hospital data suggest a substantial drop in RSV-related hospitalisations and intensive care admissions during the peak months of April to July 2025 compared with the previous year. Yet as the nation celebrates a major public health achievement, it must also confront ongoing challenges around misinformation, equitable access, and consistent program delivery.
The two-pronged approach: maternal and infant immunisation
For the first time, families could access two complementary strategies at no cost through the RSV Mother and Infant Protection Program (RSV-MIPP): a maternal vaccine (Abrysvo) given during pregnancy and an infant immunisation (Beyfortus, nirsevimab) given after birth. Abrysvo is funded through the National Immunisation Program (NIP), ensuring expectant mothers have protection for their newborns, while Beyfortus, operating through state and territory programs, offers immediate protection after birth.
Impact to date
Preliminary data indicate that approximately 140,000 babies have been protected so far. In the critical months of April to July 2025, hospital admissions due to severe RSV declined by nearly one-third compared with the same period in 2024, and intensive care admissions also fell. This suggests the dual approach is delivering meaningful protection and easing the burden on Australian hospitals during RSV season.
Gaps in access: a fragmented rollout
Despite the encouraging national trend, the RSV-MIPP rollout has faced real-world hurdles. The funding of Abrysvo via the NIP and Beyfortus through state programs has created a patchwork system with inconsistent eligibility criteria and guidance across jurisdictions. This fragmentation has translated into uneven uptake: uptake of Beyfortus among eligible infants ranged from 13.4% in New South Wales to 40.5% in Western Australia. Such disparities hamper the program’s overall effectiveness and equity goals.
Human stories and frontline challenges
Stories from families, like baby Blake who missed maternal protection by just a few days and subsequently contracted RSV, underscore the human cost of inconsistent rollout. Confusion about eligibility in some regions, combined with variations in briefing and training for frontline staff, has left some families frustrated and unprotected. Health advocates have called for clearer, nationwide guidance to ensure every infant who could benefit can access Beyfortus without delay.
Safety, accuracy, and the need for better training
There have been concerning safety and accuracy incidents, including RSV vaccines being administered to the wrong population. Reports to the Therapeutic Goods Administration show Abrysvo delivered to some babies outside the intended group, Beyfortus given to females aged 15–54, and Arexvy used in pregnant women. These events point to gaps in training, communication, and systems for verifying eligibility at the point of care. Strengthening education for clinicians and better monitoring are essential to restore trust and ensure correct use of vaccines and monoclonal antibodies.
Looking ahead: a unified, gold-standard program
Experts argue that a true gold-standard RSV program would provide both maternal and infant immunisations at no cost through the NIP, with uniform access nationwide. While state programs have filled a void and protected many babies, the lack of national consistency remains a barrier to optimal uptake. The goal is to extend protection to all infants and, in time, to other at-risk groups, including older adults, because RSV remains a significant source of hospitalisations each winter.
Research and the future of RSV protection
Evaluation efforts, including the REVIVE study, are assessing whether the dual maternal–infant strategy outperforms infant-only approaches and what the long-term respiratory benefits might be for children. Some researchers are exploring whether widespread infant immunisation could influence rates of asthma and chronic wheeze, helping to shade the broader discussion about RSV and long-term lung health.
Conclusion: protecting all, listening to families
Early data show that Australia’s RSV program has already protected thousands of babies. The lasting impact will depend on closing gaps in equity, simplifying access, and ensuring accurate administration. By aligning parents, healthcare providers, researchers, and policymakers, Australia can maximise the life-saving potential of RSV protection and safeguard all at-risk populations from severe disease.
Author: Catherine Hughes AM, Founder and Director of the Immunisation Foundation of Australia. The views expressed reflect the author’s perspective and not necessarily official policy of medical associations or institutions.
