Bottom Line: GPs should proactively identify eligible patients aged 75+ (and First Nations patients aged 60+) and consider offering the NIP-funded Arexvy RSV vaccine from 15 May 2026, ideally timed before winter to maximise protection during peak RSV season.
Why RSV Matters for Older Australians
Respiratory syncytial virus is one of the most significant causes of respiratory illness in older adults. While RSV is widely recognised as a childhood disease, the burden in older Australians is substantial. Australian data show that RSV-attributable respiratory hospitalisations in adults aged 65 and over occur at a rate 35 times higher than in adults aged 18–64, with hospitalisation rates greatest in those aged 75 and over (194 per 100,000 population).
RSV-attributable mortality in adults aged 65 and over accounts for 4–6% of all cardiorespiratory deaths in this age group. Between 2006 and 2015, 59% of in-hospital RSV deaths occurred in adults aged 65 or older. These figures are likely underestimates, as RSV is not routinely tested for in many older adults presenting with respiratory illness.
The RACGP has welcomed this NIP expansion, noting that general practice will play a central role in delivering the RSV vaccine alongside existing influenza and COVID-19 immunisation programs. GPs are uniquely positioned to provide tailored vaccination advice, particularly for older patients with complex medical needs.
The Change in Detail
Who Is Eligible?
From 15 May 2026, the following groups are eligible for a free RSV vaccine under the NIP:
- All Australians aged 75 years and over
- Aboriginal and Torres Strait Islander people aged 60 years and over
There are currently no NIP-funded RSV vaccines for adults with medical risk conditions who fall outside these age-based criteria. These patients may still access RSV vaccination via private prescription, but cannot be reimbursed through the NIP.
Which Vaccine Is Funded?
The NIP-funded vaccine for older adults is Arexvy (recombinant RSV vaccine, adjuvanted), manufactured by GSK. Arexvy was approved by the Therapeutic Goods Administration (TGA) in 2024 following international clinical trials involving nearly 25,000 older adults.
Key details:
- Single-dose intramuscular injection
- Protection duration: At least two RSV seasons (approximately two years); the need for further doses has not yet been established
- Storage: Refrigerated (2–8°C)
It is important to note that while both Arexvy and Abrysvo are TGA-approved for adults aged 60 and over, only Arexvy is NIP-funded for older adults. Abrysvo continues to be NIP-listed exclusively for use in pregnant women.
Where Can Patients Access the Vaccine?
From 15 May 2026, eligible patients can receive their free RSV vaccine at:
- General practice clinics
- Community pharmacies (through the NIPVIP program)
- Aboriginal and Torres Strait Islander health services
- Community health clinics
Patients do not require a prescription for NIP-funded vaccines administered at participating pharmacies.
Timing Considerations
The ideal time to vaccinate is before the winter RSV season (typically June–September in most of Australia). The 15 May start date is deliberately timed to allow vaccine administration before peak RSV circulation. Given that a single dose provides protection for at least two seasons, there is no need to revaccinate annually.
RSV Vaccination in Pregnancy and Infants
While the May 2026 NIP expansion focuses on older adults, it is worth noting the existing NIP provisions for maternal and infant RSV protection.
Maternal Vaccination (Abrysvo)
Since 3 February 2025, pregnant women have been able to access Abrysvo free under the NIP through the RSV Mother and Infant Protection Program (RSV-MIPP). A single dose is recommended at 28–36 weeks gestation to provide passive antibody protection to the newborn during their first RSV season.
Abrysvo is available at GP clinics and community pharmacies for pregnant women of all ages, including those under 18.
Infant Immunisation (Nirsevimab / Beyfortus)
For infants whose mothers did not receive the RSV vaccine at least two weeks before birth, or who are at high risk of severe RSV disease, nirsevimab (Beyfortus) — a long-acting monoclonal antibody — is recommended before their first RSV season.
Nirsevimab is not currently NIP-funded nationally. Instead, it is available through state and territory-funded programs, which vary by jurisdiction:
- NSW: Available through the NSW RSV Maternal and Infant Immunisation Program
- Victoria: State-funded program running mid-March to 30 September 2026
- Western Australia: Expanded program covering babies born between 1 October 2025 and 31 March 2026, with additional eligibility for high-risk infants born between 1 April and 30 September 2026
- Queensland: Available through the state-managed program
GPs should check their own state or territory health department for the most current infant RSV immunisation eligibility criteria.
Clinical and Practical Implications
The addition of RSV vaccination to the NIP represents a meaningful shift in preventive care for older Australians. Previously, the $300 out-of-pocket cost was a significant barrier to uptake, particularly among patients on fixed incomes. With NIP funding, GPs can now recommend RSV vaccination in the same conversation as influenza and COVID-19 boosters, streamlining the winter immunisation discussion.
For practice workflows, GPs should consider integrating RSV vaccination into existing recall systems for patients aged 75 and over. Since the vaccine is a single dose with at least two seasons of protection, the administrative burden is low compared to annual influenza vaccination. However, practices will need to ensure they have stock ordered through the usual NIP vaccine distribution channels in their state or territory.
Clinicians should be aware of the TGA safety updates for both Arexvy and Abrysvo. While the vaccines have demonstrated a favourable safety profile in clinical trials, post-marketing surveillance is ongoing. As with all immunisations, GPs should assess individual patient suitability, particularly in those with a history of severe allergic reactions.
What You Need to Do
- Identify eligible patients — Run a search in your clinical software for patients aged 75+ and Aboriginal and Torres Strait Islander patients aged 60+ who have not received an RSV vaccine.
- Order NIP stock — Ensure your practice has ordered Arexvy through your state or territory’s NIP vaccine distribution system ahead of 15 May.
- Update your recall systems — Add RSV vaccination as a prompt for eligible patients, ideally timed with influenza and COVID-19 booster appointments.
- Counsel patients on timing — Advise vaccination before winter (ideally May–June) for optimal protection during peak RSV season.
- Document in the AIR — Record all NIP-funded RSV vaccinations on the Australian Immunisation Register, as with all NIP vaccines.
- Inform patients about the maternal program — Remind pregnant patients about the free Abrysvo vaccine available from 28 weeks gestation.
- Check state-specific infant programs — For infants at risk, check your state or territory’s current nirsevimab (Beyfortus) eligibility and access pathways.
Summary
- Effective date: 15 May 2026
- Eligible groups: Adults aged 75+; Aboriginal and Torres Strait Islander people aged 60+
- Funded vaccine: Arexvy (GSK) — single-dose intramuscular injection
- Protection duration: At least two RSV seasons
- Cost to patient: Free under the NIP (previously ~$300 out of pocket)
- Government investment: $445.3 million
- Access points: GP clinics, community pharmacies, Aboriginal health services, community health clinics
- Maternal program: Abrysvo remains NIP-funded for pregnant women (28–36 weeks gestation)
- Infant program: Nirsevimab (Beyfortus) available through state and territory-funded programs — not nationally NIP-funded
This article is intended for educational purposes and does not constitute medical advice. GPs should consult the Australian Immunisation Handbook and their state or territory health department for the most current clinical guidance. Information current as at April 2026.
