Protecting Infants Against RSV
Published by the RSV Awareness Consortium in collaboration with the Society for Intelligence Management (SIM) Canada
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Overview
Respiratory syncytial virus (RSV) causes severe disease in infants, potentially leading to hospitalization and placing a $66 million annual strain on the Canadian healthcare system. The approval of nirsevimab by Health Canada in April 2023, a long-acting monoclonal antibody offering protection across an entire RSV season, opened the door to universal prevention and more comprehensive RSV immunization policy.
In 2024–25, Québec and Ontario were among the first jurisdictions in Canada, along with Nunavut, Yukon, and the Northwest Territories, to launch publicly funded RSV immunization programs for all eligible infants.
This report, prepared by the RSV Awareness Consortium in collaboration with SIM Canada, synthesizes evidence from advisory board meetings held with frontline health professionals in Montréal and Toronto, alongside peer-reviewed literature, to deliver the first comprehensive analysis of how these programs were implemented and what they achieved.
What This Report Covers
The report examines five areas of program implementation across both provinces:
- Policy and Governance: How Québec and Ontario designed and mandated their universal nirsevimab programs, including eligibility criteria, dosing protocols, and the role of provincial advisory bodies such as INESSS and CIQ.
- Funding and Logistics: How doses were procured, allocated, and distributed across hospital birthing units, CLSCs, and community care settings, and the challenges of supply forecasting and inventory management.
- Awareness and Education: The outreach strategies used to inform healthcare providers and families, and where gaps in communication and terminology created barriers to uptake.
- Program Impact: Real-world outcomes from the inaugural season, including a 66% reduction in RSV-associated hospitalizations in Québec, 86–88% effectiveness against RSV-associated emergency and ICU admissions, and 70% and 69% nirsevimab coverage in Québec and Ontario respectively.
- Data and Surveillance: The role of provincial registries and digital tools, including BORN in Ontario and the Québec vaccine registry, in monitoring coverage and identifying gaps in real time.
Key Findings
66%
Reduction in RSV-associated hospitalizations (Québec)
86–88%
Effectiveness against RSV-related emergency and ICU admissions
70% / 69%
Nirsevimab first year coverage in Québec / Ontario
41
Infant immunizations needed to avert one hospitalization
Sources: Bemmo et al., 2025; BORN, 2026; Carazo et al., 2025
Who Should Read This Report
This report is intended for Canadian public health policymakers, health system managers, immunization program leads, and public health advocates. It is particularly relevant to jurisdictions currently considering or planning a universal nirsevimab program.
Strategic Recommendations
The report calls for provinces to move toward integrated, supportive RSV immunization frameworks built around five pillars:
- Establishing a consistent, early immunization season start date
- Equipping healthcare providers with standardized, plain-language communication tools
- Strengthening distribution to community care environments, including for newcomers and vulnerable populations
- Investing in granular, real-time data dashboards to identify and close coverage gaps
- Facilitating peer-to-peer learning and knowledge-sharing across regional health authorities
Support for this report was made possible through an educational grant from Sanofi Canada.
