Implementation of the publicly funded respiratory syncytial virus vaccine program

Advisory Alert

November 07, 2023

*Cette information est seulement disponible en anglais.

To: Long-term care homes and Elder Care Lodges


Implementation of Ontario’s respiratory syncytial virus (RSV) vaccine program

Ontario has launched a targeted RSV prevention program for the 2023/2024 RSV season. Individuals 60 years of age and older who live in long-term care homes (LTCHs) including Elder Care Lodges, and retirement homes (RHs) licensed to provide dementia care, have been prioritized for and are eligible to receive publicly funded Arexvy® RSV vaccine.

Vaccinating these vulnerable populations this fall will be very important to help protect the health of individuals, families, and communities and mitigate impacts on these settings and our health care system.

This Advisory Alert provides you with details on program implementation considerations, vaccine product information, reporting of immunizations, and monitoring and reporting of adverse events following immunization (AEFI).

Program implementation considerations

Clinic planning timelines

As an interim recommendation, Arexvy® vaccine should generally NOT be co-administered* with other vaccines. Arexvy® vaccine should be administered 14 days before or after the receipt of other vaccines, including COVID-19 (C-19) and influenza vaccines.

*There may be scenarios where co-administration may be considered in situations where, in the provider’s best judgment, the benefits outweigh the risks, including:

Resources to support program implementation

The Ministry of Health has provided several resources to support implementation of the RSV program in LTCHs and Elder Care Lodges. You are encouraged to provide information to your residents and substitute decision-makers/caregivers about the program so that they can make an informed decision about vaccination.

Please find enclosed an RSV fact sheet for health care providers and a fact sheet for vaccine recipients or substitute decision makers and caregivers. In the future, the ministry may provide a consent form template that can be modified for your internal use. In the interim you are encouraged to develop or modify a consent form that meets your legislative requirements so as not to delay program implementation.

Ordering vaccine

Arexvy® vaccine may be ordered from Public Health Sudbury & Districts using the Vaccine Ordering Form. Completed forms can be emailed to or faxed to 1.705.677.9616. Pick up instructions are provided on the form.

Vaccine product information

Arexvy® vaccine is indicated for persons 60 years of age and older without contraindications to the product or its container. The vaccine contains both antigen and adjuvant components and must be reconstituted in accordance with the manufacturer’s instructions. It is administered as a single dose of 0.5 mL intramuscularly and is to be administered 14 days before or after other vaccines. The need for future doses is unknown at this time.

Detailed information on vaccine administration is provided in the fact sheet for health care providers, including instructions for reconstituting the product.

Vaccine storage and handling

To ensure optimal protection, Arexvy® (both the lyophilized antigen powder and adjuvant) must be maintained at a temperature between +2°C and +8°C and this temperature must always be monitored to ensure cold chain is maintained. Refer to the product monograph for more information on Arexvy® storage and handling. For additional information on provincial vaccine storage and handling requirements, refer to the Vaccine Storage and Handling Guidelines (Ministry of Health, PDF).

To ensure optimal use of available quantities of Arexvy® vaccine, it is critical that vaccine is handled and administered in accordance with best practice guidelines to avoid wastage. Once distribution to priority settings is complete, any available vaccine will be distributed to other priority groups as determined by the Ministry. Vaccine temperature excursions and wastage must be reported promptly to Public Health Sudbury & Districts by calling 705.522.9200, ext. 490, or via email to

Monitoring and reporting of adverse events following immunization (AEFI)

Surveillance and reporting of AEFI is a key component of vaccine pharmacovigilance. Individuals with concerns following vaccination with Arexvy® should be clinically assessed and reported promptly to Public Health Sudbury & Districts as appropriate using the Adverse Event Reporting Form (PDF) and supplemental AEFI reporting resources available on our website Completed AEFI forms should be sent to Public Health Sudbury & Districts’ secure fax at 705.677.9618.

RSV vaccine administration reporting requirements

Documentation of vaccine administration is required in accordance with your internal policies and procedures. Similar to the approach for influenza vaccine reporting, aggregate reporting of total doses of RSV administered will be required upon program completion and as requested by the Ministry of Health.

Thank you for the tremendous work that you have done to support this fall’s vaccination efforts. Your continued support for the new RSV vaccine program is very important as we move further into fall and the co-circulation of respiratory viruses increases. Additional information about the program will be shared with you as it becomes available.

Please contact the immunization program at 705.522.9200, ext. 458 or toll-free 1.866.522.9200 for clinical questions or support around the implementation of the RSV program in your setting


Original Signed By

Dr. Penny Sutcliffe
Medical Officer of Health and Chief Executive Officer

NOTE: All Advisory Alerts are found on our website.

This item was last modified on November 7, 2023