Respiratory Syncytial Virus (RSV) is a respiratory virus that infects the nose, throat, and lungs. It usually starts spreading in the fall and peaks in the winter months. RSV infection can happen at any age; however, it can be more serious in young children and older adults with underlying health conditions such as asthma, chronic heart or lung disease, and those with weakened immune systems. Individuals who received a dose of RSV vaccine during the 2023-2024 season, do not need to receive another dose this season.

Symptoms

RSV symptoms usually happen within two to eight days after getting infected, and usually include:

  • Runny nose
  • Decrease in appetite and energy
  • Coughing
  • Sneezing
  • Fever
  • Wheezing

Very young infants may only experience irritability, decreased activity, decreased appetite or feeding and breathing problems.

Testing

Symptoms of RSV are not specific and can overlap with other respiratory infections. People admitted to the hospital may have a nose swab done to confirm the diagnosis.

Treatment

Most people who get RSV recover on their own. However, RSV can cause severe illness in some people, and medical attention and treatment are needed. Antiviral medication is not routinely recommended to fight infection.

You may manage your symptoms by taking the following steps:

  • Reduce fever and pain with over-the-counter fever reducers and pain relievers, such as acetaminophen or ibuprofen. (Do not give ibuprofen to infants under six months old without first speaking to a health care provider. Do not give aspirin to children.)
  • Drink enough fluids. It is important for people with RSV infection to drink enough fluids to prevent dehydration (loss of body fluids). If your baby is having trouble drinking, try clearing nasal congestion with a bulb syringe or saline (salt water) nose drops.
  • Talk to your healthcare provider before giving your child cold medicines. Some medicines contain ingredients that are not good for children.

Additional information for parents on how to manage your child’s symptoms and when to seek medical attention, visit the Ministry of Health’s Respiratory Syncytial Virus webpage.

If you have questions about your illness and you don’t start to feel better after a few days or your symptoms get worse, call you health care provider, or 811 (TTY: 1-866-797-0007) to talk to a registered nurse 24 hours a day, 7 days a week. Calls to 811 do not need you to provide your OHIP number and all information is free, secure, and confidential.

Like the flu and COVID-19, RSV is typically spread through respiratory droplets when people sick with the virus cough, sneeze, or talk near people who are within 2 meters. Less commonly, a person may also get RSV when they touch a surface or object that has the virus on it and then touch their own mouth, nose, or eyes.

People infected with RSV are usually contagious for three to eight days and may become contagious a day or two before they start showing signs of being sick. However, some infants, and people with weakened immune systems, can continue to spread the virus even after they stop showing symptoms, for as long as four weeks.

You can help stop the spread of RSV by:

  • Covering your cough and sneeze with a tissue or your shirt sleeve, not your hands
  • Cleaning your hands often with soap and water or alcohol-based hand rub
  • Cleaning frequently touched surfaces such as doorknobs and mobile devices
  • Wearing a well-fitting, high-quality mask in crowded indoor settings
  • Staying home if you feel sick, even when symptoms are mild
  • Getting an RSV vaccine if you are eligible
  • If possible, breastfeed your baby. Breast milk contains antibodies and other immune factors that help prevent and fight off illness
  • Avoid smoke from tobacco and cannabis products

Abrysvo® is a new vaccine approved by Health Canada for the prevention of lower respiratory tract disease (LRTD) caused by RSV in people 60 years of age and older. It is the only publicly funded RSV product that will be available for older adults in Toronto for the 2024-25 season.

Abrysvo® is given as a single dose and can be co-administered with other seasonal vaccines, such as COVID-19 and the flu.

Eligibility

Individuals 60 years of age and older who are:

  • Living in long-term care homes
  • Living in Elder Care Lodges
  • Living in retirement homes
  • Hospitalized ALC patients
  • Receiving dialysis
  • Transplant recipients
  • Experiencing homelessness
  • Indigenous, including those in urban dwellings

If you are eligible for a publicly funded Abrysvo®, please get vaccinated as soon as possible. Individuals who received a dose of RSV vaccine during the 2023-2024 season, do not need to receive another dose this season. The timing for subsequent doses is unknown at this time. Studies are ongoing to determine the duration of protection.

Anyone who is 60 years of age or older and not eligible for the publicly funded vaccine can speak to their healthcare provider about receiving the RSV vaccine through private purchase.

Speak with your health care provider if you have questions regarding eligibility.

Two new, safe and effective products to help prevent RSV infections in infants and young children are available in Ontario:

  • Nirsevimab (Beyfortus™): a single dose monoclonal antibody (mAb) immunizing agent given to infants just prior to or during RSV season. It is the recommended product for infants as per National Advisory Committee Immunization (NACI) due to its effectiveness, long-lasting protection (up to 6 months), and positive safety profile.
  • Abrysvo ® : a vaccine administered to pregnant individuals between 32 to 36 weeks gestational age. It provides antibody transfer in utero to protect newborns. It is available on a case-by-case basis in consultation with your health care provider.

For the 2024/25 RSV season, Beyfortus™ will be the publicly funded monoclonal antibody product for eligible infants. Administration of both the Abrysvo ® vaccine to the pregnant individual and the Beyfortus™ monoclonal antibody to the infant is not needed except under specific circumstances. Speak with your health care provider for more information.

Eligibility

Any infant less than 8 months of age entering or born during their first RSV session living in Ontario and are:

  • Born in 2024 prior to the RSV season
  • Born during the 2024/25 RSV season
  • High-risk children up to 24 months of age who remain vulnerable from severe RSV disease through their second RSV season, with:
    • Chronic lung disease
    • Congenital heart disease
    • Severe immunodeficiency
    • Down syndrome/Trisomy 21
    • Cystic fibrosis with respiratory involvement and/or growth delay
    • Neuromuscular disease
    • Severe congenital airway anomalies impairing clearing of respiratory secretions

Health Canada has authorized the use of Abrysvo® vaccine to be given to pregnant individuals between 32 and 36 weeks of pregnancy who will deliver near the start of or during RSV season. RSV season is generally from November to April, peaking in December. Abrysvo®  is available on a case-by-case basis in consultation with the pregnant individual and their health care provider.

The Abrysvo®  vaccine helps provides immediate protection right from birth, up until approximately six months old, against severe RSV infections. Antibodies are created by the vaccinated pregnant person that are then passed to the infant in utero.

If the Abrysvo®  vaccine is given in pregnancy, the Beyfortus™ monoclonal antibody does not need to be given to the infant (except under specific circumstances such as a high-risk infant born to a pregnant person who received the vaccine). Speak with your health care provider for more information.

Eligibility

Pregnant individuals must live in Ontario and are:

  • 32 to 36 weeks gestational age and will deliver just prior to or during RSV season, in consultation with their health care provider.

People with severe allergies to any of the vaccine ingredients including non-medicinal ingredients, should speak with their physician/allergists about getting the vaccine. Some people with allergies to an ingredient can still be safely vaccinated.

Abrysvo®

Abrysvo® is latex and preservative-free.

Active ingredient: Each dose (0.5 ml) contains:

  • RSV subgroup A stabilized prefusion F protein: 60 micrograms
  • RSV subgroup B stabilized prefusion F protein: 60 micrograms

Non-medical ingredients: Mannitol, polysorbate 80, sodium chloride, sucrose, tromethamine, trometamol hydrochloride, sterile water for injection.

Polysorbate-80 is in the Abrysvo®  vaccine. It is used to hold (or bind) the vaccine ingredients together. Polysorbate-80 can be found in most processed food, sauces, condiments, soups, ice cream, chewing gum, soaps, creams, bath gels, shampoo, body butter, cosmetics, vitamins, heart medication and contraceptives (birth control).

Side Effects & Safety of Abrysvo®

If you are pregnant speak to your health care provider if you have any health concerns or problems, including if you:

  • are allergic to any of the ingredients
  • had severe allergic reaction or breathing problems after other vaccines
  • have a bleeding problem or bruise easily
  • have an infection with a high fever
  • have a weakened immune system
  • are less than 32 weeks pregnant.

Like any other vaccines or medication, RSV vaccines may have some side effects which are usually mild, and last only a few days. Common side effects after receiving the vaccine can include pain, swelling and redness where the shot is given, headache, and muscle pain.

The Abrysvo®  vaccine is authorized by Health Canada and recommended by the National Advisory Committee on Immunization (NACI). It has been shown to be safe and demonstrated high effectiveness in preventing severe RSV disease in their babies from birth up to 6 months old. The vaccine reduced the chances of hospitalization for RSV by 68 per cent within the first three months after birth and by 57 per cent within six months.

Report to your healthcare professional or call Toronto Public Health at 416-338-7600 if you experience a side effect following immunization.

A minor illness, such as a cold should not delay vaccination. Speak to a health care provider if you are unwell before receiving the injection.

Beyfortus™

Beyfortus™ is latex and preservative-free.

Active ingredient: nirsevimab-alip

Inactive ingredients: arginine hydrochloride monohydrate, histidine, L-histidine hydrochloride monohydrate, polysorbate 80, sucrose and water for injection

Polysorbate-80 is in Beyfortus™  and can be found in most processed food, sauces, condiments, soups, ice cream, chewing gum, soaps, creams, bath gels, shampoo, body butter, cosmetics, vitamins, heart medication and contraceptives (birth control).

Side Effects & Safety of Beyfortus™

Common side effects after Beyfortus™ include local reactions at the injection site, such as redness, swelling, and pain. Other mild side effects observed are rash and fever. These are usually mild and last only a few days.

Clinical trials have shown that Beyfortus™ is safe for most full-term and preterm infants (born at least 29 weeks 3 gestation). Beyfortus™ was used in many locations worldwide during the 2023/24 RSV season, including the US, France and showed:

  • a prevention of 82-90 per cent of RSV-associated lower respiratory tract infection; and
  • a prevention of 76-90 per cent of RSV-associated Intensive Care Unit admissions; and
  • 69-90 per cent overall reduction in RSV- associated hospitalization compared to previous season.

Report to your healthcare professional or call Toronto Public Health at 416-338-7600 if you experience a side effect following immunization.

Abrysvo®

Residents of Ontario long-term care homes, Elder Care Lodges, and retirement homes will be offered publicly funded Abrysvo®.

 Anyone who is 60 years of age or older and not eligible for the publicly funded vaccine can speak to their healthcare provider about receiving the RSV vaccine for private purchase at a pharmacy.

For all other eligible populations for the publicly funded Abrysvo® vaccine, please consult your healthcare provider.

Beyfortus™

More information to be shared when the vaccine is available.