Winter respiratory illnesses are often thought of as a nuisance that can keep you in bed and away from work or school for a few days. But if you’re susceptible to severe infection, they can land you in hospital.
Most people are familiar with influenza and COVID vaccines, which are recommended for people at higher risk of severe infection. But these don’t protect against another virus, respiratory syncytial virus, or RSV, which tends to cause severe illness in young infants and older people.
To reduce this risk the government yesterday announced a vaccine to protect against RSV will be available for free for older people in Australia from May 15.
So who is eligible? And what should you consider if you’re thinking of getting vaccinated?
Remind me, what is RSV?
RSV is a virus similar to influenza, causing acute respiratory illness in winter. In temperate areas, reported RSV case numbers increase in autumn and winter and usually peak in June and July, a little before or around the same time as the flu season.
RSV spreads from person to person, either directly through contaminated secretions or indirectly by contaminated surfaces. People can be infectious before they report symptoms, and for around three to eight days after symptoms begin.
Like influenza, most infections are mild, with cough, fever, sore throat and runny nose.
In some people, the infection can then progress to the lungs, causing a viral pneumonia, with wheezing and shortness of breath.
RSV can also worsen pre-existing illnesses, particularly chronic lung diseases, and cause complications such as heart attacks and strokes.
The highest risk group for RSV is young infants. Encouragingly, a prevention program that combines a maternal RSV vaccine with a monoclonal antibody (called nirsevimab) in infants has been successful in reducing disease in infants.
Read more: Babies in WA will soon be immunised against RSV – but not with a vaccine
RSV also causes severe infection and death in older people. In 2025, RSV was the third most common cause of older adults being hospitalised with a respiratory viral infection, after influenza and COVID. In 2025, 587 deaths in Australia involved RSV.
What is the new RSV vaccine?
The vaccine, known as Arexvy, will be available for adults aged 75 or older, and First Nations people aged 60 or older. It’s a single dose given as an injection.
Unlike influenza, where updated vaccines are required each year, RSV has fewer genetic changes. Protection appears to last at least two to three years.
Although protection does appear to wane over several years, there are no current recommendations for subsequent (booster) doses.
A different vaccine, Abrysvo, is available in pregnancy to protect infants. It’s also available for older adults but isn’t funded. While clinical trials haven’t compared these vaccines head to head, they broadly seem to provide similar degrees of protection.
RSV vaccines are also recommended, but not funded, for people with medical risk factors over 60 years of age. This includes people with heart, respiratory, neurological and liver conditions, immunocompromising conditions, diabetes, chronic kidney disease and obesity.
A third vaccine, mResvia, an mRNA vaccine similar to COVID vaccines, has been approved but is not yet available in Australia. In clinical trials, this vaccine seems broadly similar to the other vaccines, in terms of protection and side effects.
How effective are RSV vaccines?
The original clinical trials primarily evaluated protection against any confirmed illness. In these studies, RSV vaccines were shown to reduce illness from RSV by more than 80% in the first season after vaccination.
Subsequent studies have looked at protection against hospitalisation, as a marker of severe infection. These studies from the United States and United Kingdom suggest it also reduces the risk of hospitalisation with RSV. People who are vaccinated but get RSV appear to have a milder illness and are less likely to be hospitalised.
In Australia, the vaccine was first approved in 2024 for use in people over 60 years of age.
Read more: An RSV vaccine has been approved for people over 60. But what about young children?
Similar national programs for RSV vaccines in older adults have been gradually introduced in several European countries, including Sweden, as well as the UK and the US.
Is the RSV vaccine safe?
In older adults, side effects following Arexvy appear to be similar to other vaccines. The most common reported side effects were:
- pain at the site of injection
- fatigue
- headache
- generalised muscle and joint pains.
These are usually of mild to moderate severity and resolve within a day or so. These side effects are slightly more common if the RSV vaccine is given at the same time as the influenza vaccine.
A small number of cases of a rare neurological disease, Guillain-Barré syndrome, have been reported after RSV vaccines. This risk was estimated at around two cases per 100,000 people vaccinated.
However it’s important to note RSV infection is also associated with a greater risk of developing Guillain-Barré syndrome in the absence of vaccination, with the risk similar to that after vaccination.
How can I get the vaccine?
Free vaccines are available from May 15 at GP clinics, pharmacies, community health centres and Aboriginal health services. The easiest way to find a provider is to use HealthDirect’s service finder. Search your location under “immunisation”, but call ahead to check if they have supplies available.
In addition to all adults over 75 years and First Nations people over 60 years, a free RSV vaccine is also available for pregnant women after 28 weeks of gestation.
Babies may also be protected after birth using an immunisation product, called nirsevimab.
For people over 60 years, particularly those with chronic medical conditions, the vaccine is available but on the private market at a cost of around A$300.
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