Planning and Implementing the Expanded RSV Prevention Program

Insights from Ontario Birthing Hospitals administering Nirsevimab 

Between June and July 2025, 91 healthcare providers across 54 hospitals (62% of Ontario birthing hospitals) responded to an online cross-sectional survey to share their experiences planning and implementing the 2024/2025 expanded RSV prevention program. 

Program Resources and Communications

~2 in 3 reported receiving sufficient notice from the MOH 

Most commonly used sources for RSV Guidance: 

• Ministry of Health
• Provincial Council for Maternal and Child Health (PCMCH) 
• Better Outcomes Registry &Network (BORN) Ontario 

Resources were generally clear, intuitive, and useful. Areas for improvement include earlier communication, better access to translated materials, and centralized education. 

Challenges to Delivery

30% found it challenging to integrate the program into existing activities 

What concerns did hospitals hear from healthcare providers about nirsevimab?

• Unfamiliar with the new product Challenges with medical directives
• Lack of clarity about when patients should receive prenatal vaccination versus infant immunization
• Challenges with documentation of prenatal vaccine and/or infant immunization 
  
  

Implementation Strategies

Hospitals invested significant time and resources to implement the program, using an average of 13 strategies. The most common included: 

• Sharing information with staff
• Resources for staff & families
•  Updating/Revising hospital policies, procedures
•  Establishing a working group 
  
  

Half of hospitals reported plans to adjust their approach to the 2025–26 season

• Increase staff collaboration, education with parents & families, and community partnerships to embed education prenatally 

Top reported barriers in 24/25 season

• Insufficient or delayed product supply
• Storage and refrigeration limitations
• Additional workload related to storage
• Insufficient information to counsel parents (lack of information for staff and easily available translated resources)
• Unclear eligibility criteria
• Missing prenatal vaccine records
• Not within midwifery scope of practice
• Concerns with infant pain management 

3 in 4 respondents felt the RSV program was well received by parents/ guardians.

 
What concerns did hospitals hear from parents/guardians about nirsevimab? 

• Concerns about product safety
• Concerns about potential side effects
• Insufficient time to make decision
• Concerns about the product being new Unfamiliar with the risks of RSV in infants

Planning Checklist for Next Season

Consider the following as you head into the 2025-2026 RSV season 

Communications & Resources

• Have you reviewed the updated materials (e.g., MOH, PCMCH, Centre for Effective Practice) for 2025–2026? 
• Is there a plan to share RSV information with parents/guardians at your hospital?
• How will this information address the top concerns from parents/guardians about nirsevimab?
• Do you have translated materials available to support local language needs?
• Do you know who to contact for questions about the RSV program? 
  
  

Staff Training 

• Do you have a plan to share RSV program information with staff?
• Do you have a strategy for onboarding new staff to the program?
• Do you have a refresher training planned? 
• How can you work with staff to address their top concerns about nirsevimab? 

 
Connecting with other Partners

• Have you considered how to engage parents/guardians in RSV program planning and improvements?
• Have you connected with your public health unit to explore integrating RSV program information into broader initiatives? 
• Have you worked with prenatal care providers to support RSV education and information sharing with parents/guardians and improve documentation of prenatal vaccination to help with identifying eligible patients? 
• Have you connected with your regional network to share training materials? 
  
  

Monitoring & Sharing

• Do you have a plan for monitoring uptake?
• How will you share this information? 
• Did you know? BORN has the RSV Program Prevention Report you can use to facilitate monitoring 
• Will you collect feedback from parents and guardians to inform improvements? 
  
  

Are you interesting in learning about Ontario birthing hospital staffs' perceptions of BORN's RSV-prevention data and information products and data tips for this season? Please see BORN’s RSV Data summary.