Summary of NACI statement of April 10, 2026: Updated guidance on respiratory syncytial virus (RSV) vaccines for older adults and for adults at high risk of severe RSV disease

Date published: April 10, 2026

On this page

• Overview
• What you need to know

Overview

On April 10, 2026, the Public Health Agency of Canada (PHAC) released the National Advisory Committee on Immunization’s (NACI) Updated guidance on respiratory syncytial virus (RSV) vaccines for older adults and for adults at high risk of severe RSV disease. This guidance is based on current evidence and NACI expert opinion.

There are now three vaccines available to protect older adults and adults at high risk of severe disease from RSV in Canada:

• RSVPreF3 (AREXVY, GSK) is authorized to protect individuals 60 years of age and older, and individuals 50 to 59 years of age at increased risk of RSV disease.
• RSVpreF (ABRYSVO, Pfizer) is authorized to protect individuals 60 years of age and older, and individuals 18 to 59 years at increased risk of RSV disease. This formulation is also authorized for use at 32 to 36 weeks of pregnancy to protect infants from RSV.
• mRNA-1345 (mRESVIA, Moderna) is authorized to protect individuals 60 years of age and older, and individuals 18 to 59 years at increased risk of RSV disease.

Following a thorough review of the evidence, NACI makes the following recommendations for public health program decision-making (i.e., provinces/territories making decisions for publicly funded immunization programs):

• NACI strongly recommends RSV immunization for all adults 75 years of age and older and for adults aged 65 to 74 years who are at increased risk of severe RSV disease.
• NACI strongly recommends RSV immunization programs in adults 18 years of age and older who:
  • are residents of nursing homes and other chronic care facilities
  • have had a lung transplant
  • have had a hematopoietic stem cell transplant (in the previous two years or who remain on immunosuppression)
  • are on home oxygen or require chronic oxygen therapy regardless of living at home or elsewhere
  • are receiving dialysis
• For other adults who may seek vaccination outside of a public health program, NACI recommends that RSV vaccines may be considered by adults at increased risk of severe RSV disease as an individual decision informed by discussion with their health care provider. A careful assessment of benefits versus potential harms is warranted, as most younger adults may benefit more from vaccination at an older age or if they develop a condition that increases their risk for severe RSV disease.

For the full statement, refer to: Updated guidance on respiratory syncytial virus (RSV) vaccines for older adults and for adults at high risk of severe RSV disease (PDF).

What you need to know

• Respiratory syncytial virus (RSV) is a common respiratory virus that can have serious complications, including hospitalization, intensive care unit admission, and death, for older adults and adults with certain medical conditions.
• In this update, NACI has recommended a small expansion of the adult RSV vaccine program to also include some groups of adults with medical conditions that place them at higher risk of RSV disease. This update was initiated by the recent extension of the authorized age groups by Health Canada for two RSV vaccines and on new data from Canada and other countries that identified certain medical conditions as being at higher risk of severe RSV disease.
• A single dose of RSVPreF3, RSVpreF, or mRNA-1345 can be used in the authorized age groups. Although NACI judged that all three vaccines work well from a clinical perspective, there are currently less data available for the safety and efficacy/effectiveness of mRNA-1345 compared to the other vaccines since it was authorized more recently.
• Jurisdictions and communities may consider vaccinating individuals in or from First Nations, Inuit, and Métis communities at a younger age given the available evidence on the increased burden of illness due to intersecting structural and social determinants of health.
• An increased risk of Guillain-Barré Syndrome (GBS) has been identified in individuals aged 65 years and older following receipt of the RSVpreF and RSVPreF3 vaccines. However, the benefits of preventing severe RSV disease in this group are deemed to outweigh the very rare risk of GBS following vaccination, particularly given that RSV infection itself may also increase the risk of GBS.
• At this time, an increased risk of GBS has not been observed among adults aged less than 65 years. NACI will continue to monitor safety data on all RSV vaccines (RSVpreF, RSVPreF3, and mRNA-1345) as they become available.
• Available evidence demonstrates that a single dose of RSV vaccine provides protection from RSV disease for at least three years. It is not yet known if the immune responses to these vaccines can be boosted with further doses. As a result, healthy adults may wish to defer vaccination until a time when they are at greater risk.
• Provinces and territories determine their vaccination programs and policies, including those for RSV, based on their unique circumstances, including local epidemiology. Individuals are encouraged to consult a trusted health care provider to see which options are available.

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