What is RSV and who is most at risk?

RSV — respiratory syncytial virus — causes infections ranging from a mild cold-like illness to serious lower respiratory disease. In healthy adults it usually resolves within one to two weeks, but in adults aged 75 and over it can trigger pneumonia and hospitalisation with much higher frequency. Children under five are also significantly affected — they account for 46% of Australian RSV cases in 2026 — but the clinical burden in older adults is where the new vaccine program is targeted. The virus spreads through respiratory droplets and close contact, the same route as influenza.

I'm in my early 70s and healthy. Is the RSV vaccine worth paying for privately?

That depends on your individual health situation and is worth discussing with your GP. The free vaccination threshold is currently age 75 for most Australians, or age 60 for Aboriginal and Torres Strait Islander people or those with defined medical risk factors. For someone in their early 70s in good health with no qualifying risk factors, the benefit-to-cost calculation is less straightforward than for someone over 75. The private cost sits at around $300. A GP can help you weigh whether your risk profile makes that worthwhile, particularly if you have chronic lung or heart disease, are immunocompromised, or live with someone who is vulnerable.

RSV overtakes flu and COVID-19 as most-notified respiratory virus

What just happened

RSV — respiratory syncytial virus — has overtaken influenza and COVID-19 to become Australia’s most-notified respiratory virus for the first time since national tri-disease tracking began in 2021.

The case numbers are striking. From January to June 2026: 83,678 RSV notifications, 51,655 COVID notifications, 49,785 influenza notifications. RSV now accounts for 45% of notifications across the three viruses — a year-on-year rise of 25%. Since winter began, the daily growth rate has been running at approximately 900 new RSV cases per day. If the current trajectory holds, total RSV cases this winter could exceed 127,000 by season’s end.

This is not a statistical blip. RSV has genuinely displaced flu as the dominant winter respiratory threat in the notification data — and the vaccination response to date has not kept pace with that shift.

The both-and

The vaccination gap is the most urgent part of this story

Australia now offers a free RSV vaccine for adults aged 75 and over. Uptake is running well below the equivalent influenza figures. Only 722,530 people over 75 have received the RSV vaccine, compared to 1.76 million who received a flu shot. That leaves approximately one million Australians in the highest-risk age group unprotected at the peak of the season.

Immunisation Coalition Chair Dr Rodney Pearce has identified two factors that help explain this. The first is cost: for Australians aged 60–74 who fall just below the free vaccine threshold but carry meaningful RSV risk — particularly those with chronic lung disease, heart disease, or diabetes — the private cost sits at around $300. That price point is deterring uptake in this age bracket.

The second is a co-administration awareness gap. Only 36% of older adults know that RSV and influenza vaccines can be given at the same visit — meaning 64% do not. For GPs, this is a direct opportunity. Every flu vaccine encounter with a patient aged 75 and over is also an RSV vaccination opportunity, and the two can be administered at the same appointment.

RSV’s unfamiliarity creates a real uptake barrier

Unlike influenza and COVID-19, RSV has no recent cultural identity as a serious adult illness. For decades it was understood primarily as a childhood disease — the virus behind bronchiolitis in infants and the cough that keeps parents awake in the small hours. The idea that RSV carries meaningful hospitalisation risk for adults over 75 is genuinely new information for many patients.

Dr Pearce notes that patients regularly ask whether RSV is “new like COVID” — which reflects an accurate sense that it has recently become visible, even though the virus has been circulating in Australia for many decades. For older patients weighing whether to organise yet another vaccine, this unfamiliarity can translate into a sense of low urgency that the case numbers do not support.

This is worth naming clearly in clinical conversations. RSV is not new. What is new is the ability to prevent it in the age groups most at risk.

The infant protection picture is more encouraging

Children under five account for 46% of confirmed RSV cases nationally — consistent with RSV’s established role as the leading cause of bronchiolitis hospitalisation in the under-two age group.

The infant and maternal protection programs are showing early positive signals. Approximately 119,000 infants have received RSV protection so far in 2026 through either nirsevimab (a monoclonal antibody for eligible infants up to 8 months during RSV season) or through the antibodies transferred by the maternal RSV vaccine given at 28–36 weeks of pregnancy. Early hospitalisation data from these programs has shown meaningful reductions in serious RSV illness in the under-one group. The programs are not yet reaching every eligible family, but the trajectory is positive.

My two cents

If you have a parent over 75 who has had their flu shot but has not yet asked about RSV vaccination, this week’s data is the prompt for that conversation. A call to their GP clinic to check eligibility and availability is worth making now, before the season peaks further.

For women who are pregnant or planning to become pregnant during RSV season — roughly May to September in Australia — the maternal RSV vaccine at 28–36 weeks is the mechanism by which protective antibodies can be transferred to your baby before birth. If it has not come up at your obstetric appointments yet, it is worth raising.

The co-administration point is simple and underused. If you or someone in your care is eligible for both the flu and RSV vaccines, there is no clinical reason to schedule them separately. They can be given in the same appointment.

RSV has moved into first place among Australia’s winter respiratory threats in the surveillance data. The vaccination response has not yet matched that shift. Closing that gap — one eligible patient conversation at a time — is the most direct clinical action available this winter.

Verdict: yes — worth knowing about.

Sources cited

RACGP newsGP — RSV tops most notified respiratory virus (July 2026). https://www1.racgp.org.au/newsgp/clinical/rsv-tops-most-notified-respiratory-virus