Item - 2025.HL28.3

The Board of Health:  

1. Requested the Ministry of Health establish respiratory syncytial virus (RSV) prevention programs (e.g., vaccination, public communication) for older adults and infants as permanent, seasonal initiatives, and provide specific funding to public health units for activities to increase respiratory syncytial virus prevention.

2. Requested the Ministry of Health and Ontario Health conduct evaluations of province-wide respiratory syncytial virus (RSV) prevention programs to measure their public health impact and publish the findings to inform future program improvements and support evidence-based decision-making.

3. Requested the Ministry of Health increase accessibility to respiratory syncytial virus (RSV) vaccine for eligible older adults through expanded availability, including through pharmacies.

4. Requested the Ministry of Health develop and implement population-wide communications campaigns to improve vaccine confidence, with the goal of increasing immunization coverage, including respiratory syncytial virus (RSV) vaccines and prophylaxis among eligible populations.

Respiratory syncytial virus (RSV) poses a significant health burden in Toronto, particularly among infants and older adults. The 2024-25 season included increased severe Respiratory syncytial virus disease and hospitalizations in older adults. During the 2024-25 respiratory illness season, publicly funded respiratory syncytial virus vaccines were available for some populations including specific groups of older adults at higher risk for severe disease as well as infants and high-risk children.

Previously, only those 60 years and older living in long-term care homes, Elder Care Lodges, as well as some retirement home residents, were eligible for the publicly funded respiratory syncytial virus vaccination program. In fall 2024, the Province of Ontario’s publicly funded vaccination program expanded to include all residents of retirement homes aged 60 and older, as part of broader efforts to protect older adults, who are more vulnerable to severe disease. For infants, in 2024, the Province of Ontario launched a universal program for all infants and high-risk children up to 24 months old using a newly licensed and available prophylaxis agent (Beyfortus®).

Toronto Public Health (TPH) distributed over 37,000 RSV infant doses to health care providers, with strong uptake in hospitals and primary care settings. Over 10,000 respiratory syncytial virus vaccine doses were distributed for pregnant individuals and high-risk adults. Toronto Public Health also led public awareness efforts, integrating respiratory syncytial virus into its fall respiratory communications campaign, and collaborating with healthcare partners to promote access to respiratory syncytial virus vaccines. Provincially, the 2024-25 season was one of Ontario's most severe Respiratory syncytial virus seasons in at least 15 years for Respiratory syncytial virus hospitalizations but was a moderate season for hospitalizations among infants and children, after the introduction of Beyfortus® for infants.

For the 2025-26 respiratory season, the Ontario government expanded eligibility for publicly funded respiratory syncytial virus vaccines to all adults 75 years of age and older. In contrast to COVID-19 and influenza vaccines that are available at pharmacies and primary care offices, the publicly funded respiratory syncytial virus vaccine for all adults aged 75 and older is not available through pharmacies.

The respiratory syncytial virus prevention program to protect infants is in its second year; Beyfortus® is available through hospitals, primary care offices and select public health units.

In response to the expanding respiratory syncytial virus prevention program, Toronto Public Health is launching new service models, such as breastfeeding clinic pilots, community vaccine clinics for older adults, and outreach with Toronto Paramedic Services to promote immunization among populations at risk for severe respiratory syncytial virus disease and in high-risk settings. Toronto Public Health is delivering communication to the public about respiratory syncytial virus prevention and where to access Respiratory syncytial virus vaccines and prophylaxis.

Looking ahead, the availability of safe and effective respiratory syncytial virus immunization and prophylaxis products presents an opportunity to reduce respiratory syncytial virus disease burden in Toronto. Toronto Public Health's efforts to increase respiratory syncytial virus vaccination aligns with its 2024-28 Strategic Plan priorities, including strengthening health protection, promoting well-being across the lifespan, and advancing health equity through targeted, evidence-informed interventions.