RSV immunisation
options now available in Australia (May 2025)
| Product (TGA-registered) | Formulation / schedule | ATAGI recommendation | Funded on the National Immunisation Program (NIP)? | Other funded programs | Typical private cost* |
|---|---|---|---|---|---|
| Abrysvo ® (Pfizer) | Single 0.5 mL IM dose (bivalent pre-F protein) | • Pregnancy: one dose at 28–36 weeks every pregnancy to protect the infant. • Older adults: – All adults ≥ 75 y 1 dose – ATSI adults ≥ 60 y 1 dose Abrysvo – Adults ≥ 60 y with medical risk factors (COPD, CHF, severe asthma, CKD, diabetes, immunocomp.) – Adults 60–74 y without risk factors may “consider” vaccination | Yes – FREE for all pregnant women from 3 Feb 2025 and is on the National Immunisation Program (NIP) for pregnant women (28-36 weeks). Health and Aged Care Australia NSW Health | None for older adults yet | ≈ $300–$350 per dose for ALL older-adult use |
| Arexvy ® (GSK) | Single 0.5 mL IM dose (adjuvanted pre-F protein) | Same adult schedule as Abrysvo (≥ 60 y with risk factors; all ≥ 75 y; ATSI ≥ 60 y). Not for pregnancy. The Australian Immunisation Handbook | No – private-market only | Nil | ≈ $300 per dose |
| Nirsevimab (Beyfortus™) Long-acting monoclonal antibody (passive, not a vaccine but part of RSV-MIPP) | Single IM dose at birth or just before first RSV season | • Infants whose mothers were not vaccinated ≥ 14 days before delivery. • Infants/children ≤ 24 mo with risk factors for severe RSV. The Australian Immunisation Handbook | Not on NIP | 2025 state-funded infant programs (e.g. NSW, ACT, TAS, SA, QLD, WA) provide free doses for eligible babies; local criteria vary. NCIRS NSW health Tasmanian Health | Private supply scarce; overseas price ≈ A$500 per dose. |
| Palivizumab (Synagis™) Short-acting mAb (monthly x 5) | Only for very high-risk pre-term or cardiac infants when nirsevimab unavailable | PBS-Section 100 (hospital funded) for eligible infants | – | – |
* Costs are the manufacturer list or reported retail price for the vaccine alone; a clinic or pharmacist may charge an additional consultation/administration fee (~A$20–40).
Practical take-aways for clinicians
- Pregnant women – Abrysvo – it is NIP-funded and supplies are widely available through GP clinics, antenatal units and community pharmacies (no script needed; record in AIR).
- Infants in 2025: those not covered by maternal Abrysvo or with risk factors should receive nirsevimab free under their state’s infant RSV program immediately after birth or before winter.
- Older adults (≥ 60 y, especially ≥ 75 y or with chronic lung/cardiac disease): can choose either Arexvy or Abrysvo; both require private purchase at present. Discuss benefit vs cost, noting single-dose protection for at least two seasons.
- Monitoring for NIP changes: PBAC is reviewing RSV-vaccine cost-effectiveness for older adults; funding status may evolve over the next 12 months.