Overview

The Respiratory Syncytial Virus (RSV) prevention programs target the highest risk populations and settings. Administering RSV vaccines and prophylactics in the Fall, as well as COVID-19 and flu vaccines, may:

  • provide protection to high-risk infants and older adults
  • protect individual health and the health of families and communities
  • protect and mitigate impacts on our health care system

High-risk older adult RSV vaccine program

Ontario has introduced its first publicly funded high-risk older adult RSV vaccine program.

The vaccine is indicated for adults aged 60 years and older.

Current eligibility

Ontario’s publicly funded RSV prevention program is targeted for high-risk individuals and settings. The program includes individuals 60 years and older who are:

  • living in long-term care homes
  • living in Elder Care Lodges
  • residents of retirement homes licensed to provide dementia care
  • patients in hospital receiving alternate level of care (ALC)
  • patients receiving hemodialysis or peritoneal dialysis
  • recipients of solid organ or hematopoietic stem cell transplants
  • individuals experiencing homelessness
  • individuals who identify as First Nations, Inuit, or Métis

Given the decreased incidence of RSV cases in Ontario since December 2023, the Ministry of Health is not offering the free RSV vaccine during the Spring and Summer seasons. Recommendations, including eligibility, for the 2024-2025 season will be made closer to Fall 2024.

Effective as of April 9, 2024, the Ministry of Health recommends, for those administering vaccines, that:

  • planned and existing clinics may continue as scheduled, but should begin to wind down
  • new clinics should not be organized
  • doses in open vials may be administered, to the extent possible, prior to their use before date
  • new vials should not be opened

Access to publicly funded RSV vaccines

During the upcoming 2024-2025 RSV season, providers wishing to administer the RSV vaccine to individuals eligible for the publicly funded supply may reach out to their local public health unit to place an order.

Private purchase of RSV vaccines

Individuals aged 60 years and older who do not qualify for the free RSV vaccine can still purchase the vaccine with a prescription from their family doctor or other primary care provider. Some private insurers may cover all or part of the cost of the vaccine.

Primary care providers cannot order publicly funded vaccine supply for patients wishing to purchase it privately. With a prescription, individuals can purchase the vaccine at their pharmacy and either have it administered at the pharmacy or by a primary care provider.

Pharmacy administration

Following regulatory amendments made under the Pharmacy Act, pharmacy professionals are now authorized to administer the RSV vaccine.

While pharmacists are authorized to administer the adult RSV vaccine in Ontario, pharmacists do not have access to the publicly funded RSV vaccine supply and cannot be reimbursed for administration by the province.

Co-administration

As a precaution, it is recommended that eligible individuals receive the RSV vaccine at least 14 days before or after receiving the COVID-19 or flu vaccine. Maintaining a two-week interval between administration provides for better identification of any adverse events following immunization (AEFIs) that may occur. 

Additional research is ongoing to further inform guidance on same-day administration of the RSV vaccine and other adult vaccines, including the COVID-19 vaccine.

Resources

Contact Information

For inquiries regarding the high-risk older adult RSV vaccine program, please contact us.

For questions regarding vaccine storage and handling, vaccine ordering or local distribution, please contact your local public health unit.

RSV Prophylaxis for High-Risk Infants Program

Through the RSV Prophylaxis for High-Risk Infants Program, the Ministry of Health covers the full cost of Synagis® (palivizumab) used to prevent a serious lower respiratory tract infection caused by RSV in infants who are younger than 2 years of age at the start of the RSV season and who are at high risk for RSV disease.

The injection is only provided during the active season to infants who meet the ministry’s eligibility criteria for funding. The active season is generally from November to April, with variations in various regions of Ontario. The specific start and end dates for the 2023/2024 season are set out below.

Palivizumab is currently funded for RSV prophylaxis in infants who are residents of Ontario, have a valid Ontario Health card and meet any of the following clinical criteria:

  • Infants born prematurely at or less than 32 completed weeks gestation and aged 6 months or younger at the start of, or during, the local RSV season.
  • Infants 33 to 35 completed weeks gestation and aged 6 months or younger at the start of, or during the local RSV season, who do not live in remote communities and have a Risk Assessment Tool Score of 49 to 100.
  • Infants 33 to 35 completed weeks gestation and aged 6 months or younger at the start of, or during the local RSV season, and who live in remote communities defined by lack of immediate access to medical care (less than 30 minutes from a Level I hospital) or inability to access pediatric services in a timely manner (less than 90 minutes).
  • Children younger than 24 months of age with Down Syndrome / Trisomy 21.
  • Children younger than 24 months of age with bronchopulmonary dysplasia/chronic lung disease (BPD/CLD; see reference manual for definition of BPD/CLD) and who required oxygen and/or medical therapy specifically for chronic lung disease within the 6 months preceding the RSV season.
  • Children who were younger than 12 months of age and approved for coverage in the previous RSV season for BPD/CLD.
  • Children younger than 12 months of age with hemodynamically significant (HS) cyanotic or acyanotic congenital heart disease (CHD) requiring corrective surgery or are on cardiac medication for congestive heart failure or diagnosed with moderate to severe pulmonary hypertension (children 12 to 24 months of age with ongoing HS CHD will be considered on a case-by-case basis).

Infants and children with other specific medical illnesses that place them at high risk of hospitalizations and complications from an RSV infection may also be considered for the injection if they meet necessary requirements. The enrolment forms for these infants and children will be reviewed on a case-by-case basis by the ministry’s medical consultant(s) with expertise in RSV prophylaxis.

Additional supports

Find guidelines, general information, answers to frequently asked questions and applicable forms for the current RSV prophylaxis season for health care professionals below.

The RSV Program for High-Risk Infants in Ontario started on October 30, 2023.

The RSV Program for High-Risk Infants in Ontario ended on February 9, 2024.

Information and Guidelines

Contact Information

For inquiries regarding the Respiratory Syncytial Virus (RSV) Prophylaxis for High-Risk Infants Program, please email: RSVProphylaxisProgram@ontario.ca.