Doctors in Melbourne’s Brimbank and North West regions are welcoming expanded access to a newly available respiratory syncytial virus (RSV) vaccine for adults aged 60 and over, following its inclusion in the National Immunisation Program from April 2025. This rollout aims to reduce hospitalisations among older Australians, who face heightened risk of severe lower respiratory tract infection during winter months. General practitioners report increased patient enquiries and vaccine uptake, citing the vaccine’s proven efficacy in preventing RSV-associated pneumonia and bronchiolitis in clinical trials.
Understanding RSV and the Burden on Older Adults
Respiratory syncytial virus (RSV) is a common pathogen that infects the respiratory tract, causing symptoms ranging from mild cold-like illness to severe pneumonia, particularly in infants, immunocompromised individuals, and adults over 60. In older adults, RSV can exacerbate underlying conditions such as chronic obstructive pulmonary disease (COPD) or congestive heart failure, leading to hospitalisation. The virus spreads via respiratory droplets when an infected person coughs or sneezes, and can survive on surfaces for several hours. Unlike influenza, RSV lacks widespread seasonal vaccination programs in many countries, though recent advances have changed this landscape in Australia.
In Plain English: The Clinical Takeaway
- The RSV vaccine for older adults significantly reduces the risk of severe lung infection requiring hospitalisation.
- It is safe for most people over 60, including those with stable chronic conditions like diabetes or hypertension.
- Getting vaccinated before winter offers the best protection, as RSV activity typically peaks between May and September in southern Australia.
Clinical Evidence and Mechanism of Action
The vaccine currently in utilize, Arexvy (GSK), is a recombinant subunit vaccine containing the RSV prefusion F glycoprotein antigen, combined with an adjuvant system (AS01E) to enhance immune response. This mechanism of action prompts the body to produce neutralising antibodies that block the virus from fusing with and entering respiratory epithelial cells. In a pivotal Phase III clinical trial published in The New England Journal of Medicine, Arexvy demonstrated 82.6% efficacy against RSV-associated lower respiratory tract disease (LRTD) in adults aged 60 and over over a single RSV season. Efficacy against severe LRTD was even higher at 94.1%. The trial included approximately 25,000 participants across 17 countries, with a median follow-up of 6.7 months.
Real-world effectiveness data from the UK’s NHS, where the vaccine was introduced in 2023, shows a 76% reduction in RSV-related hospitalisations among vaccinated adults aged 75–79 during the 2023–2024 season. These findings support Australia’s decision to fund the vaccine nationally for older adults, aligning with recommendations from the World Health Organization’s Strategic Advisory Group of Experts on Immunization (SAGE).
Geo-Epidemiological Bridging: Impact on Victorian Healthcare
In Victoria, RSV hospitalisations among adults aged 65 and over averaged 1,200 cases annually between 2019 and 2023, with Brimbank and North West Melbourne recording some of the highest rates due to socioeconomic factors, higher prevalence of comorbid conditions, and population density. The introduction of the free RSV vaccine through general practitioners and community health clinics in these regions is expected to alleviate pressure on emergency departments during peak season. Local public health units are coordinating with general practice networks to prioritise outreach to culturally and linguistically diverse communities, including Somali, Vietnamese, and Indian-Australian populations, who may face barriers to access.
This initiative mirrors strategies used in the UK’s NHS influenza and pneumococcal vaccination programs, where targeted outreach in deprived areas improved uptake by up to 30%. The Victorian Department of Health has allocated additional funding to support nurse-led immunisation clinics in Brimbank’s community health centres, ensuring equitable access regardless of Medicare eligibility or private insurance status.
Funding, Transparency, and Expert Perspective
The underlying Phase III trial of Arexvy was funded by GlaxoSmithKline (GSK), the vaccine’s manufacturer. However, independent data monitoring and analysis were conducted by the NIH-funded Vaccine and Infectious Disease Division at Fred Hutchinson Cancer Center, ensuring methodological rigour. Regulatory approval by the Therapeutic Goods Administration (TGA) in January 2024 was based on a full evaluation of safety, efficacy, and manufacturing quality.
“Older adults bear a disproportionate burden of RSV disease, and this vaccine represents a meaningful advance in preventive care. We’re seeing real-world impact in countries with early adoption — fewer hospitalisations, less strain on health systems.”
– Dr. Helen Chu, Associate Professor of Medicine and Epidemiology, University of Washington School of Medicine. lead investigator in RSV vaccine trials
“Australia’s decision to fund the RSV vaccine nationally reflects a growing recognition of RSV as a serious threat to ageing populations, not just infants. Here’s preventive medicine at its best.”
– Professor Peter McIntyre, Senior Advisor, National Centre for Immunisation Research and Surveillance (NCIRS), University of Sydney
Contraindications & When to Consult a Doctor
The RSV vaccine is contraindicated in individuals with a history of severe allergic reaction (e.g., anaphylaxis) to any component of the vaccine, including the AS01E adjuvant. Those with moderate to severe acute illness should delay vaccination until recovery, though mild illnesses like a cold or low-grade fever do not preclude administration. Common side effects include injection site pain (61%), fatigue (34%), and muscle pain (29%), typically resolving within 2–3 days. Serious adverse events are rare; in clinical trials, the incidence of potential immune-mediated conditions was comparable between vaccine and placebo groups.
Patients should consult their doctor before vaccination if they have a history of Guillain-Barré Syndrome (GBS), are immunocompromised due to conditions like leukemia or immunosuppressive therapy, or are pregnant or breastfeeding — though data on use in pregnancy are limited, animal studies show no evidence of harm. Anyone experiencing difficulty breathing, swelling of the face or throat, or a widespread rash after vaccination should seek immediate medical attention, as these may indicate anaphylaxis.
Looking Ahead: Duration of Protection and Future Research
Current data suggest protection from a single dose of Arexvy lasts at least two RSV seasons, with ongoing studies evaluating the need for revaccination. Researchers are also investigating mRNA-based RSV vaccines (such as Moderna’s mRNA-1345) in Phase III trials, which may offer alternative platforms with similar efficacy. Public health officials emphasize that vaccination should complement, not replace, other preventive measures like hand hygiene, avoiding close contact with sick individuals, and staying home when symptomatic.
As Australia enters its second year of the national RSV vaccination program, surveillance through the Australian Sentinel Practices Research Network (ASPREN) and the National Notifiable Diseases Surveillance System (NNDSS) will be critical in monitoring real-world effectiveness, duration of immunity, and any emerging safety signals. For now, doctors in Brimbank and North West are urging eligible patients to take advantage of this free, evidence-based intervention before the winter peak.
References
- Falsey AR, et al. Respiratory Syncytial Virus Vaccine in Older Adults. N Engl J Med. 2023;388:1421-1431. Doi:10.1056/NEJMoa2206705.
- UK Health Security Agency. RSV vaccine effectiveness in older adults: 2023 to 2024 season. 2024. Https://www.gov.uk/government/publications/rsv-vaccine-effectiveness-in-older-adults-2023-to-2024-season.
- Therapeutic Goods Administration (TGA). Public Assessment Report: Arexvy. 2024. Https://www.tga.gov.au/publication/auspar-arexvy.
- World Health Organization (WHO). SAGE recommendations on respiratory syncytial virus vaccines. 2024. Https://www.who.int/groups/sage/meetings/2024/april.
- National Centre for Immunisation Research and Surveillance (NCIRS). RSV vaccination in older Australians: implementation and early impact. 2025. Https://www.ncirs.org.au/resources/rsv-vaccination-older-australians.
