Introduction: A watershed moment for RSV protection
In 2025, Australia introduced free access to RSV immunisations for all infants, supported by the national RSV Mother and Infant Protection Program (RSV-MIPP). Early indicators are promising: thousands of babies have been shielded from severe RSV, and hospital admissions for RSV-related bronchiolitis and pneumonia have fallen compared with the previous year. Yet as the program scales, it faces ongoing challenges around misinformation, equitable access, and consistent guidance across states and territories.
What changed in 2025
The initiative offers two principal tools against RSV: maternal vaccination with Abrysvo and infant immunisation with Beyfortus (nirsevimab). Abrysvo is funded through the National Immunisation Program (NIP) for pregnant women, while Beyfortus is delivered via state and territory programs. This dual approach is designed to protect infants from birth and during the first months of life, when RSV can be most dangerous.
Initial impact: thousands protected, hospitalisations down
Preliminary data from sentinel hospital surveillance indicate a notable decline in severe RSV cases between April and July 2025, compared with the same period in 2024. Hospital admissions for severe RSV and pediatric intensive care unit (PICU) admissions declined, suggesting the program is on track to reduce the burden of RSV on Australian families. By mid-2025, around 140,000 babies had been protected through the program.
Challenges: fragmentation, misinformation, and miscommunication
Despite the positive momentum, the rollout has been described as fragmented. Differences in eligibility criteria and guidance between state programs for Beyfortus have created confusion and inconsistent uptake. For example, NSW reported relatively low uptake compared with Western Australia, highlighting regional disparities in access and awareness. Concerning misapplication of vaccines has also emerged: reports to the Therapeutic Goods Administration (TGA) show vaccines administered to the wrong patient groups, underscoring the need for clearer frontline guidance and training.
Case in point: real-world consequences
There have been heartbreaking stories where eligibility confusion or late maternal immunisation left babies unprotected. Parents describe the experience as traumatising when a child contracts RSV despite parental attempts to shield them. These anecdotes emphasize that a successful program requires reliable, uniform information and consistently applied protocols across all jurisdictions.
Path to a gold-standard program
Experts say a nationwide best-practice RSV immunisation program should ensure free access to both maternal and infant vaccines through the NIP, with uniform eligibility criteria and robust frontline education. While state and territory programs address immediate gaps, they may not deliver the uniform reach needed for optimal population protection. A fully integrated approach would also consider extending protection to other at-risk groups, such as older adults, who remain at high risk of severe RSV and related hospitalisations.
Looking ahead: research, equity, and broader protection
Evaluation efforts, including the REVIVE study, are comparing the dual maternal–infant strategy with infant-only immunisation to refine best practices. Researchers are also exploring whether protecting infants against RSV has downstream benefits for respiratory health, including asthma and chronic wheeze—a question still debated in the field.
Conclusion: protecting all Australians from severe RSV
The early success of Australia’s RSV‑MIPP demonstrates the life-saving potential of universal, well-coordinated immunisation programs. The path forward requires closing gaps in access, simplifying guidance for frontline staff, and maintaining clear, accurate information for families. By uniting policymakers, healthcare providers, researchers, and parents, Australia can maximise the protection offered by RSV immunisation and reduce the winter burden of this dangerous virus.
Author: Catherine Hughes AM, Founder and Director of the Immunisation Foundation of Australia. The views expressed here are those of the author and not necessarily of the AMA, MJA, or InSight+. Subscribe to the free InSight+ weekly newsletter for updates.
