Background and Aim
Respiratory syncytial virus (RSV) is a leading cause of infant hospitalisation globally, with infants under 6 months at particular risk of severe disease. Australia recently introduced two RSV prevention strategies: nirsevimab (a long-acting monoclonal antibody) from April 2024, and Abrysvo (maternal RSV vaccine) from December 2024, with National Immunisation Program inclusion from February 2025. Vaccine coverage rates on the Sunshine Coast are among Queensland’s lowest, yet contemporaneous regional RSV immunisation coverage data were lacking. This study aimed to quantify RSV immunisation coverage following the sequential introduction of these products and characterise coverage trends over time.

Methods and Analysis
A retrospective cohort study included all infants born at Sunshine Coast University Hospital (SCUH) between 1 May 2024 and 30 September 2025. RSV immunisation coverage was defined as receipt of valid nirsevimab (prior to hospital discharge) or antenatal Abrysvo (28–36 weeks gestation, ≥14 days before delivery). A novel maternal-neonatal data linkage approach integrated birth records from the SCUH birth register and HBCIS with nirsevimab administration data from the ieMR and maternal vaccination records from the Australian Immunisation Register, with manual reconciliation of unmatched records. Ethics approval was obtained from Metro North Ethics Committee (ID: 102241).

Outcomes
Of 4,898 infants born during the study period, 3,473 (70.9%) were immunised against RSV. The majority received nirsevimab (46.8%), while 24.2% were covered by valid antenatal Abrysvo. Monthly coverage ranged from 65.3% to 75.6%. Despite Abrysvo’s introduction, overall coverage did not improve, reflecting a programmatic transition rather than an additive coverage gain. Our estimate is comparable to Western Australian (71%) and United States (72%) data, but lags European estimates of 80–90%, where correspondingly greater reductions in RSV hospitalisations have been observed.

Conclusion and Future Actions
RSV immunisation coverage at SCUH is suboptimal compared to European benchmarks. The introduction of Abrysvo has not improved aggregate coverage, suggesting structural and attitudinal barriers persist across the perinatal care pathway. Future research should examine the knowledge, attitudes and practices of the multidisciplinary provider workforce — including midwives, obstetricians, paediatricians, GPs and pharmacists — and explore patient-level barriers through qualitative research with peripartum populations. Understanding these factors is essential to designing targeted interventions to close the gap with European performance and reduce RSV morbidity in our community.

Background and Aim

Western Australia (WA) spans multiple climatic regions which has implications for RSV immunisation policy. In the subtropical and tropical north (the Kimberley and Pilbara), RSV epidemics show more variability in timing, intensity, and duration than in temperate southern WA. In 2025, WA introduced a hybrid infant RSV immunisation program combining a maternal vaccine with the monoclonal antibody nirsevimab. Although nirsevimab was available year-round, its use in the Kimberley and Pilbara was concentrated in the 6-month period that nirsevimab was available in southern WA. Our aim is to model RSV epidemiology in northern WA to explore the impact of RSV immunisation programs in different epidemiological settings.

Methods and Analysis

We extended a dynamic transmission model and calibrated it using RSV-laboratory confirmed hospitalisations in children under 5 years (2015-2020) in northern WA. Given the substantial Aboriginal population in this region and their heightened risk of severe RSV, the model was stratified by Aboriginal status. Hospitalisation risk was modelled as a function of age, prior RSV exposure, and Aboriginal status.

Outcomes

The model reproduces the higher RSV transmission rates observed in northern WA and captures the greater variability in epidemic amplitude and peak timing. The calibrated age specific risk function shows that hospitalisation risk among Aboriginal infants is nearly three times that of non Aboriginal infants. Overall, infants in northern WA experience elevated hospitalisation risk throughout their first year compared with those in southern WA.

Conclusion and Future actions

This model will now be used to evaluate RSV immunisation programs in northern WA and guide further development of immunisation policy. By capturing regional differences in transmission intensity and age specific risk, the model provides a framework for assessing the effectiveness, timing, and equity impacts of RSV immunisation programs.

RSV is a major cause of infant morbidity and hospitalisation. In Queensland, nirsevimab (Beyfortus) for newborns and infants commenced 15 April 2024; maternal RSVpreF vaccine (Abrysvo) was initially available via private prescription, then state funded from 1 December 2024 and nationally funded via the NIP from 3 February 2025. We aimed to quantify uptake, changes over time, and the proportion of newborns discharged with RSV prevention coverage across Mater Hospital’s three South-East Queensland maternity services (one public, two private), and to demonstrate the utility of routinely collected health data for program monitoring and improvement.

Quality assurance audit for all eligible births from 15 April 2024–2 February 2026. Maternal and neonatal RSV prevention status and covariates were extracted and linked from routinely collected sources via Matrix and Verdi EMR integration platform (including My Health Record and the Australian Immunisation Register). De-identified analyses calculated product-specific uptake and total “protected at discharge” proportions over time; characteristics associated with uptake and refusal will be reported.

Among 7,891 eligible newborns before NIP-funded maternal vaccination (15 April 2024–2 February 2025), 6,725 (85.2%) received nirsevimab during the birth admission; 115 (1.5%) were adequately covered via maternal RSVpreF vaccination; and 1,051 (13.3%) were unprotected at discharge. In the 12 months after NIP listing (3 February 2025–2 February 2026; 9,761 eligible newborns), nirsevimab uptake fell to 1,682 (17.2%) while maternal RSVpreF vaccine coverage rose to 7,087 (72.6%); 992 (10.2%) remained unprotected. Total protection remained high (~87–94% by month).

Funding pathway changes coincided with a marked shift from neonatal nirsevimab to maternal vaccination coverage, with nirsevimab remaining integral to achieving high overall uptake. Priorities are to embed RSVpreF vaccine prompts/standing orders into antenatal workflows, standardise a postpartum nirsevimab “safety-net” for unvaccinated or late-presenting mothers, and use linked data for equity-focused monitoring and better targeting the "unprotected at discharge".

Background and Aim
RSV is highly contagious respiratory infection that can cause severe illness (including bronchiolitis or pneumonia) in infants and young children.
In March 2024 the Government of Western Australia (WA) rolled out infant RSV immunisation, Beyfortus (a monoclonal antibody that provides passive immunity), for eligible infants in the 2024 winter season. In February 2025 maternal RSV vaccination, Abrysvo, was added to Australia’s National Immunisation Program and became freely available to pregnant women (who are Medicare eligible) in Australia.
WA continued to fund and provide Beyfortus for eligible infants in 2025, meaning parents in WA had a choice between infant or maternal RSV immunisation to protect their child in the 2025 winter season.
This study aims to understand the drivers of parental acceptance of RSV immunisation, factors that shaped parents’ decision-making process, rationales for their choices, and their overall experience of RSV immunisation in WA.

Methods and Analysis
We conducted in-depth qualitative interviews with parents whose infant received Beyfortus or who accepted Abrysvo during pregnancy in 2025. Interview responses were thematically coded, and deductively and inductively analysed using Nvivo20.

Outcomes
Key findings highlight that immunisation acceptance was significantly driven by parents’ perceptions around the seriousness of RSV infection; their trust in healthcare provider recommendations, and attitudes towards vaccination more broadly; and a desire to protect their baby. Meanwhile, parents’ decision making and choices were shaped by their knowledge/absence of knowledge of the availability of both immunisation options; assessments of convenience; the information provided to them; and discussions with healthcare providers.

Conclusions
This study contributes valuable knowledge around parental attitudes and decision-making pertaining to newly introduced immunisations, and RSV immunisation more specifically. The findings should be considered by healthcare workers, policymakers, and immunisation program managers in their efforts to roll out and support uptake of RSV immunisation to protect infants.

Background and Aim:

NSW influenza vaccination coverage rates are suboptimal in young children. In NSW, the coverage for children aged 6 months to under 5 years declined from 41.3% in 2020 to 24.4% in 2025. Higher coverage is needed to protect children from severe influenza and reduce the impact of influenza infections on the NSW health system. Live attenuated influenza vaccine (LAIV) has been used internationally for over a decade and demonstrates strong acceptability and comparable effectiveness to injectable influenza vaccine. To improve influenza vaccination coverage in young children aged 2 years to less than 5 years, NSW is funding and implementing a program in 2026 offering a newly registered needle-free alternative.

Methods and Analysis:

The implementation of the 2026 NSW nasal spray influenza vaccination program involved extensive program planning, vaccine procurement and distribution strategies as well as comprehensive resource development. Program planning included the management of the intersection with the annual injectable influenza vaccination program, extensive stakeholder engagement including collaboration with other states and territories and clinician and public communication and education strategies.

Outcomes:

Monitoring will be conducted using data from the Australian Immunisation Register (AIR) to assess uptake of the needle-free alternative in collaboration with the National Centre for Immunisation Research and Surveillance Australia (NCIRS). Influenza vaccination coverage will be examined including comparing injectable influenza vaccine and LAIV in 2026 and coverage comparison with prior years in children aged 2,3 and 4 years in NSW. Evaluation of the NSW resources and communications will be conducted through targeted stakeholder feedback.

Conclusion and Future actions:

Understanding the impact of a needle free alternative on influenza vaccine uptake in children 2 to less than 5 years in NSW will support consideration of continuing the program in future years and possible expansion to a broader age group.

Background and Aim
Children aged <5 years are at higher risk of severe influenza than older children. Despite annual influenza vaccination for children aged 6 months to <5 years being funded in Australia under the NIP since 2020, coverage is sub-optimal. In 2026, state-funded live-attenuated influenza vaccine (LAIV, nasal spray FluMist) programs are being implemented for children in New South Wales and South Australia (2–<5 years), Queensland (2–<6 years) and Western Australia (2–<12) years. We aim to monitor influenza vaccination coverage among children aged 2–<12 years in 2026, with particular focus on the 2-<5-year age group.

Methods and Analysis
Australian Immunisation Register data will be used to calculate weekly cumulative influenza vaccination coverage between 1 March and early June 2026 for Medicare-registered children by age group (2–<3, 3–<4, 4–<5 and 5-<12 years), jurisdiction, vaccine type (FluMist or injectable) and provider setting. Coverage will be compared between age groups and jurisdictions with/without FluMist programs, and with previous years (2020–2025).

Outcomes
Baseline data show influenza vaccination coverage for children aged 2–<5 years peaked at 41.0% nationally in 2020 but declined year-on-year from 2022. During the 2025 influenza season, only 21.5% of children aged 2–<5 years received an influenza vaccine, with coverage varying substantially by jurisdiction (ranging overall from 16.6% in Queensland to 40.0% in the Australian Capital Territory) and by age group (20.4% in 2–<3, 19.6% in 3–<4 and 24.3% in 4–<5 year olds). Early impact of state-funded FluMist programs will be presented with comparison of 2026 and baseline data by age group and jurisdiction i.e. where FluMist programs have/have not been implemented.

Conclusion and Future Actions
Monitoring uptake of FluMist and assessing impact on influenza vaccination coverage will inform decisions regarding potential inclusion of LAIV on the National Immunisation Program.

Background and Aim:
Influenza can cause serious illness and death with young children, elderly and immunocompromised at highest risk. Annual influenza vaccination is the most effective way to prevent severe infection and despite recommendations and funded programs, vaccination coverage in children remains poor. In 2026, several Australian state governments committed to funding the live attenuated influenza vaccine (LAIV), administered as a nasal spray for children. LAIV has proven safe and effective in clinical trials and increased coverage in Europe and UK. Clear messaging and accessible resources will be essential to successful program implementation. This project explored parent/guardian perspectives on influenza and nasal vaccination, including preferences for messaging and information.
Methods and Analysis:
Parents/guardians of children attending outpatient and community child health clinics within a statewide, paediatric health service were surveyed. Responses were collected anonymously via Microsoft Forms between November 2025 and January 2026. Questions were adapted for LAIV rollout and informed by previous national and international research. Descriptive statistics summarised demographics, behaviours, barriers and messaging preferences.
Outcomes:
There were 318 responses, with 7.5% First Nations and 18% culturally and linguistically diverse respondents. 258 (81%) respondents preferred LAIV over injection. Vaccine safety confidence varied with 35-38% reporting concerns. Annual influenza vaccination was inconsistent with less than half reporting annual influenza vaccination. Most common reason for not vaccinating was belief the vaccine is ineffective (34%). Just over half indicated LAIV would change this decision. 29% reported some difficulty accessing vaccination. Healthcare providers were the preferred information source, with safety and side-effect information prioritised. Respondents favoured a multi-formatted communication approach.
Conclusion and Future Actions:
Findings informed implementation priorities including provider training, patient-facing materials, culturally appropriate engagement and reminder systems. Strong support for LAIV highlights potential to improve influenza vaccine uptake. Targeted, evidence-based safety and efficacy messaging may further strengthen confidence.