Successes, lessons learned and recommendations for the future: Experiences from the first year of Ontario’s nirsevimab program for respiratory syncytial virus (RSV) prophylaxis in infants

At the conclusion of the 2024/2025 respiratory syncytial virus (RSV) season in Ontario, a panel of healthcare providers who were actively involved in the conduct of the province's first RSV prophylaxis program with nirsevimab in infants, assembled to discuss their experiences. The discussion was a follow-up to a larger pre-RSV season meeting held in June 2024 to develop recommendations supporting a universal prophylaxis program for infants in Ontario. The principal objective of the 2025 meeting was to identify components of the province's program that were successful, as well as those that posed barriers to nirsevimab uptake. A modified version of the World Health Organization's analytical framework for health systems was used to structure the discussion around five key programmatic building blocks: (1) governance and leadership, (2) funding and reimbursement, (3) logistics, demand and distribution, (4) awareness and education, and (5) surveillance and monitoring. A consensus was reached on updated recommendations to enhance the success of Ontario's nirsevimab program for future RSV seasons. These recommendations aim to ensure equitable access for all infants, achieve optimal uptake, and provide the best protection against RSV infection for Ontario's infants.