When the weather turns cold in Canada, most older adults know the drill: it’s time for your flu and COVID-19 shots. But there is another respiratory virus quietly causing thousands of hospitalizations and deaths among Canadian seniors every year: Respiratory Syncytial Virus or RSV.

While many people still think of RSV as a harmless childhood illness, for Canadians aged 65 and older, this highly contagious respiratory virus infecting the nose, throat, lungs and breathing passages poses a significant health threat that can change a senior’s life overnight. And because of limited testing for it, it is highly under-diagnosed and often underestimated for its severeness, even by doctors.

What makes it so contagious is that RSV can survive on surfaces for extended periods of time, including furniture, skin and even gloves. And once you have the virus, infected individuals are contagious for up to eight days.

The virus is as old as a baby boomer: Scientists first discovered it back in 1956, and for the next several decades, it was strictly viewed as a pediatric problem. Almost every child catches RSV by their second birthday, and for most kids, it passes like a standard cold.

But when COVID-19 struck in 2020, and nose-swab tests were given to adults hospitalized with severe lung infections, doctors discovered that many actually had RSV. And when RSV strikes older adults, it does so with incredible force. 

 

Why RSV Hits Older Adults So Hard

As we age, our bodies go through a natural process called immunosenescence, which is the medical term for the natural and gradual weakening of our immune system. Our immune cells become less effective at recognizing and fighting off invaders.

In a healthy young adult, the immune system traps the virus in the nose and throat. In an older adult, the virus can slip past those weakened defences, leading to severe inflammation, mucus buildup and deep tissue swelling in the lungs.

What makes RSV particularly dangerous for seniors is how it interacts with existing chronic health conditions, and that has changed the expert thinking around it. The National Advisory Committee on Immunization (NACI) recently expanded its recommendation for getting the shot from those 75+ to include people aged 65-74 with chronic, underlying medical conditions. For example, if you suffer from:

• COPD or Asthma: RSV can cause a sudden, severe flare-up, making it incredibly difficult to breathe.
• Congestive Heart Failure: The strain of fighting a lung infection forces the heart to work harder, which can trigger acute heart failure. 
• Diabetes or Kidney Disease: A severe viral infection disrupts the body’s baseline balance, complicating the management of these chronic conditions.

More Than Just a Cold

In Canada, more than 23,000 adults over the age of 60 are estimated to be hospitalized with RSV annually. Scarier still, approximately one in nine patients over the age of 65 who are hospitalized with RSV die within 30 days of admission. While overall case numbers for the seasonal flu remain higher, the proportion of deaths among those hospitalized with RSV can be similarly severe — a finding that is changing how doctors view geriatric respiratory health.

When a senior is hospitalized for RSV, they are often confined to a hospital bed for days or weeks. For an older body, prolonged bed rest leads to rapid muscle loss and weakness. Many seniors who enter the hospital living completely independently find that after surviving RSV, they no longer have the physical strength to manage everyday activities like climbing stairs.

What’s more, respiratory illnesses can have what doctors call the “cascade effect” on those with cardiovascular disease or diabetes. For example, respiratory infections can increase cardiovascular risk for both new-onset and exacerbation of pre-existing cardiovascular disease. For this reason, the European Society of Cardiology considers the prevention of infection as crucial for lowering cardiovascular disease and recently called vaccination the fourth pillar of cardiovascular prevention, along with antihypertensives, lipid-lowering drugs and medications that treat diabetes.

The bottom line is that an RSV infection that can permanently lower a senior’s quality of life, sometimes forcing a transition into assisted living or long-term care facilities. This loss of independence is one of the most devastating impacts of the virus.

Treatment and Prevention 

Unlike bacterial infections, which can be treated with antibiotics, there are no widely available antiviral medications to kill the RSV virus in adults. The best one can hope for is supportive care. This means giving the patient extra oxygen to help them breathe, intravenous fluids to keep them hydrated and medications to manage fever and open up congested airways. Essentially, the treatment relies entirely on keeping the patient stable while their own body fights off the virus.

Because treatment options are so limited, prevention is key. 

In August of 2023, Health Canada approved the first-ever vaccines specifically designed to protect older adults from RSV. These vaccines work by training the immune system to recognize a specific part of the virus called the “prefusion F protein” — the tool the virus uses to lock onto and infect lung cells. By blocking this protein, the vaccines are incredibly effective at preventing the virus from moving deep into the lungs, virtually eliminating the risk of severe illness and hospitalization.

Even with all we know now about RSV, uptake on the vaccine is low. In a national survey on vaccine access and equity conducted by the Canadian Association of Retired Persons in 2025, RSV was ranked second only to COVID-19 as an illness of concern to members. Yet only 23% of the more than 7000 respondents to that survey had ever been vaccinated for RSV and only 20% in the previous two years. 

The Canadian Access Challenge 

While the science behind the success of RSV vaccines is undeniable, depending on where you live in Canada, your access to the vaccine could look entirely different:

• In some provinces, like Ontario, PEI and New Brunswick , the government fully funds the vaccine for seniors aged 75+ and for those living in long-term care homes. 
• In other provinces, like Saskatchewan and BC, seniors are forced to pay out-of-pocket at a local pharmacy, with costs sometimes exceeding $200 to $300 per dose.
• In Quebec, the vaccine is provided free of charge to people aged 60 and over living in government-funded or publicly-run long-term care centres and people aged 75 and over living in private seniors’ residences. 

For the full list of where the RSV vaccine is offered for free and to what age groups, you can refer to this list compiled by Health Canada. Though it may not capture every provincial nuance, it remains the best consolidated reference currently available.

Public coverage helps ensure all seniors can access recommended vaccines. The out-of-pocket cost of the RSV vaccine of around $300 is a major barrier to some, especially for seniors living on a fixed income. This inequality also means that a senior in one province is protected, while an identical senior just across a provincial border remains entirely vulnerable to a life-threatening infection.

Advocacy and Taking Action

To fix this unfair divide, the Canadian Association of Retired Persons –  CARP is actively engaging with federal and provincial governments, presenting data during budget planning sessions, and demanding that RSV vaccines be treated just like the flu shot: fully covered under public health insurance for every Canadian aged 65 and older.

As CARP and other adult vaccine advocates point out, funding the vaccine actually saves the government money. A single dose of a vaccine is infinitely cheaper than the thousands of dollars it costs the taxpayer to care for a senior in an intensive care unit for a week, for example.

So why aren’t these governments doing more to protect these seniors?  As one member pointed out in that CARP survey on vaccine access and equity, “It really is poor public health policy to not cover these vaccines for all seniors in this country.”

Protecting Your Health

RSV is no longer a hidden threat. We now know exactly what it is, how it harms our aging population and — most importantly — how to stop it.

What needs to change? Canadian seniors need to better understand the life-changing ramifications of contracting RSV, why they need the vaccine and demand access. This is especially important right now because, generally, vaccination rates are dropping across Canada. 

For its part, CARP is mobilizing its vast volunteer network to engage with elected officials to educate these policy makers about the health values and cost-savings of a universal public adult vaccination strategy. The goal for CARP is to ensure every adult in every corner of Canada has free and unfettered access to all recommended adult vaccines like the one for RSV.

If you are 65 or older, the most important step you can take today is to be your own health advocate. Talk to your family doctor, nurse practitioner or local pharmacist about the RSV vaccine. Ask if you are a good candidate for it, and find out what the coverage options are in your specific province. By staying informed and demanding equal access to preventative medicine, Canadian seniors can protect their lungs and preserve their independence.