Health experts are urging New Zealand to introduce universal immunisation against Respiratory Syncytial Virus (RSV), warning the country is falling behind comparable nations while hundreds of infants continue to be hospitalised each winter with a preventable illness.
A new Public Health Communication Centre Aotearoa briefing argues that introducing nationwide RSV immunisation would significantly reduce infant hospital admissions, ease winter pressure on the health system and improve health equity for Māori and Pacific communities.
A Major Cause of Infant Hospitalisations
RSV is the leading cause of bronchiolitis and viral pneumonia in infants and remains the single biggest cause of respiratory-related hospital admissions during the first year of life.
According to the briefing, around 2,000 New Zealand children under five are hospitalised with RSV each year, with approximately half of those admissions involving babies under six months old. The illness places predictable pressure on emergency departments, paediatric wards and intensive care units every winter.
The report also highlights a significant equity issue, with Māori and Pacific infants disproportionately affected by severe RSV. Household crowding, material hardship and cold, damp housing all contribute to both the spread and severity of the virus.
Beyond the immediate illness, growing international evidence suggests RSV infection in infancy may also increase the likelihood of recurrent wheezing and asthma later in childhood.
New Prevention Options Available
Until recently, prevention options in New Zealand were limited to Palivizumab (Synagis), a monoclonal antibody available only to a small number of infants at the highest risk of severe disease, such as babies born very prematurely or with serious congenital heart conditions.
The authors say this treatment has helped protect some vulnerable infants but requires multiple injections during the RSV season and cannot be delivered on a population-wide basis. As a result, most babies hospitalised with RSV receive no protection before becoming ill.
The briefing outlines two newer prevention strategies now being adopted internationally:
- Long-acting monoclonal antibodies, including nirsevimab and clesrivomab, which provide season-long protection from a single dose.
- Maternal RSV vaccination during pregnancy using RSVpreF (Abrysvo), allowing protective antibodies to pass to the baby before birth.
International studies cited in the report show the monoclonal antibody approach reduces RSV-related hospitalisations by 70 to 90 percent, while maternal vaccination is approximately 70 percent effective at preventing severe RSV disease during the first six months of life.
Māori and Pacific Equity at the Centre
The authors argue universal immunisation has particular importance for Māori and Pacific communities because it would help address longstanding inequities in infant respiratory health.
While maternal vaccination depends on timely access to antenatal care, newborn immunisation protects infants regardless of pregnancy care or gestational age. The report concludes that offering both approaches would provide the strongest protection while helping reduce disparities affecting Māori and Pacific babies.
New Zealand Falling Behind
The report notes the World Health Organization now recommends countries introduce immunisation options to protect infants from severe RSV disease.
Many comparable nations—including Australia, the United Kingdom, the United States, Chile and much of Europe—have already incorporated either maternal RSV vaccination, infant monoclonal antibody programmes or both into their national immunisation schedules.
In contrast, New Zealand has yet to introduce a universal RSV prevention programme.
Although nirsevimab has ranked highly through Pharmac’s prioritisation process, the report says regulatory approval and funding decisions have progressed slowly. The authors argue the current approval pathway does not adequately reflect the wider public health benefits of vaccines.
Reducing Winter Pressure on Hospitals
Researchers estimate RSV-related hospital care costs New Zealand more than $25 million each year, before accounting for emergency department visits, primary care consultations, parental time away from work and longer-term respiratory complications.
The authors say preventing RSV would not only reduce hospital admissions but also ease annual winter pressures on health services, reduce disruption for whānau and deliver long-term savings across the healthcare system.
Call for Urgent Action
The Public Health Communication Centre briefing concludes that RSV immunisation represents a high-impact, cost-effective public health intervention that should be rapidly approved and incorporated into New Zealand’s National Immunisation Programme.
The authors recommend replacing the existing targeted Palivizumab programme with long-acting monoclonal antibodies while also making maternal RSV vaccination available through routine antenatal care. They also call for a review of New Zealand’s vaccine assessment process to avoid delays in introducing effective public health interventions.
With RSV continuing to place predictable strain on hospitals each winter, the report argues universal immunisation offers an opportunity to protect the country’s youngest children while reducing pressure on an already stretched health system.
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