How Much Do You Really Know About RSV Risks? Key Facts for Older Adults

Winter in Australia typically brings increased attention to respiratory illnesses such as influenza and COVID-19. But this year, RSV has emerged as the most commonly notified of the three, with more than 83,000 RSV cases already recorded across Australia.

Since the beginning of winter, an average of around 890 confirmed RSV notifications have been recorded each day. This marks the first time RSV has led mid-year notifications ahead of both influenza and COVID-19 since it became nationally notifiable in 2021.

While RSV is often associated with babies and young children, it can pose a serious health risk at the other end of the age spectrum too. 

RSV is a common and highly contagious respiratory virus that can lead to significant health complications in older adults, including pneumonia and hospitalisation. In fact, fatalities associated with RSV are reported to be nearly four times higher among older adults than in children under five.

Despite this, RSV may not always receive the same level of attention or concern among older Australians as other respiratory illnesses. And while many people recognise that RSV can be serious, recent Australian research suggests there may be a considerable gap between being aware of the virus and understanding the risk it can pose to you personally.

Older Australians may be underestimating their RSV risk

Research commissioned by GSK Australia suggests there may be a disconnect between knowing RSV can be serious and recognising it as a personal health risk. Among Australians aged 65 and over who were familiar with RSV, 90% recognised it as a serious illness, yet only 38% felt very or extremely concerned about catching it themselves.

That perception may also shape how respiratory symptoms are handled. The research found that almost 9 in 10 older Australians tend to either manage respiratory symptoms themselves or wait before seeking medical advice. More than three-quarters (76%) felt their symptoms were not serious enough to speak with a healthcare professional or expected them to improve without medical attention.

And in many cases, respiratory infections such as RSV can be mild and manageable at home. But our ability to fight infection can change as we get older, and RSV can have more serious consequences for some older adults — something we'll explore further in this article later.

The research also shows that while 82% of those surveyed knew at least one fact about RSV, only 5% were able to correctly identify all seven facts presented to them, suggesting there are still significant gaps in what older Australians know about the virus and its potential impact.

RSV vaccination uptake is still lagging behind flu

The gap can also be seen in vaccination uptake among older Australians.

According to the Immunisation Foundation of Australia’s 2026 Mid-Winter RSV Report Card, 722,530 older Australians eligible for free RSV vaccination had received the vaccine, compared with 1.76 million people in the same age groups who had received an influenza vaccine.

So, how well do you know the risks? Below, we answer some key questions about RSV that are particularly important for older adults.

Why does our immune system become less effective as we get older?

Our immune system doesn't suddenly become weak when we reach a certain age. Instead, it gradually changes throughout our lives — a process known as immunosenescence. These changes can affect how quickly and effectively the body recognises and responds to infections. 

The thymus produces fewer new T cells

T cells are white blood cells that play an important role in recognising infected cells and coordinating the body's immune response.

These cells develop in an organ called the thymus. Research into age-related changes in the thymus shows that it gradually shrinks and becomes less active over time, resulting in fewer new naïve T cells being produced.

This process is known as thymic involution and is considered one of the major changes associated with an ageing immune system.

We have fewer T cells ready to recognise new threats

Among the T cells affected by ageing are naïve T cells. Think of these as immune cells that haven't yet encountered the particular pathogen they're designed to recognise.

When the body encounters a new threat, naïve T cells can become activated and develop into specialised cells that help fight the infection.

A systematic review of research into T-cell ageing found that ageing is associated with a decline in naïve T cells and a reduction in the diversity of T-cell receptors, while the proportion of memory and highly differentiated T cells increases.

In simple terms, our immune system retains plenty of experience from infections it has encountered before, but its pool of cells available to recognise a wide variety of new threats becomes less diverse with age.

Our antibody response changes too

T cells aren't the only part of the immune system affected by ageing. B cells, which are responsible for producing antibodies, also undergo changes.

Research into B-cell immunosenescence has found that antibody responses generally decline with age. This includes a reduced ability to produce highly targeted, protective antibodies against infectious agents.

So, what does this mean when fighting an infection? 

Importantly, none of these changes mean that an older person's immune system stops working. Rather, the way the immune system responds changes, and some of its responses may be less effective than they were earlier in life. 

A 2026 review published in the European Respiratory Review examined how the ageing immune system responds to respiratory viruses. The researchers found that age-related changes to both innate and adaptive immunity can make older adults more vulnerable to respiratory infections and increase the risk of poorer outcomes. 

When combined with underlying health conditions and other age-related changes, this helps explain why illnesses such as RSV can pose a greater risk as we get older, even though the infection may be relatively mild for many younger, healthy adults.

What are the possible complications of RSV in older adults?

For many healthy adults, RSV causes mild, cold-like symptoms that improve on their own. However, the risk of developing complications can increase with age, particularly for older adults and those with existing health conditions.

Some complications associated with RSV in older adults can include:

• Pneumonia – RSV can spread to the lower respiratory tract and cause infection in the lungs.

• Bronchiolitis – Inflammation of the small airways in the lungs can make breathing more difficult.

• Worsening of existing heart or lung conditions – RSV may aggravate conditions such as asthma, chronic obstructive pulmonary disease (COPD) or congestive heart failure.

• Hospitalisation – More severe RSV infections may require hospital care, particularly among older or medically vulnerable adults.

• Serious respiratory illness – In severe cases, RSV can cause significant breathing difficulties and other complications that require medical treatment.

What health conditions can increase the risk of severe RSV?

Age is an important risk factor for severe RSV, but it isn't the only one. Certain existing health conditions can make some older adults more vulnerable to developing serious illness if they become infected.

According to the Australian Immunisation Handbook, adults aged 50 years and over may have an increased risk of severe RSV if they have certain medical conditions, including:

• Heart conditions, such as congestive heart failure and coronary artery disease

• Chronic respiratory conditions, including COPD, chronic emphysema, bronchiectasis and severe asthma

• Conditions or treatments that weaken the immune system, including certain cancers and organ or stem cell transplants

• Chronic metabolic disorders, including type 1 or type 2 diabetes

• Chronic kidney disease, particularly advanced chronic renal impairment

• Chronic neurological conditions, including some degenerative nervous system, seizure and neuromuscular disorders

• Chronic liver disease, including cirrhosis and other advanced liver diseases

• Obesity

Having one of these conditions doesn't mean you will necessarily develop severe RSV, however, it can increase your risk of experiencing more serious illness or complications.

Read related article: Can RSV Have Long-Term Effects in Adults?

If you're unsure whether an existing health condition puts you at greater risk, speak with your GP or another healthcare professional for advice based on your individual health.

Can RSV symptoms become worse after starting out mild?

They can. RSV often begins with symptoms that can feel similar to a common cold, which may make it easy to dismiss or simply wait for them to pass.

While many infections remain mild, symptoms can become more serious in some older adults. This is one reason it's important to pay attention to how you're feeling rather than assuming that a respiratory illness will necessarily resolve on its own.

If symptoms are worsening, you're having difficulty breathing, or you're concerned about your health, seek advice from a healthcare professional.

Does every RSV infection lead to hospitalisation?

No. Not every RSV infection will require hospital treatment, however, the risk of becoming seriously unwell can be higher for some older adults, particularly those with existing heart and lung conditions.These groups of older adults are around 5 to 10 times more likely to be hospitalised with RSV.

This includes people living with respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD).

Can you tell RSV apart from COVID-19 or influenza by your symptoms?

Not always. RSV, influenza and COVID-19 are different viral infections, but they can cause many similar respiratory symptoms.

That overlap can make it difficult to know which infection you have based on symptoms alone.

Testing may help distinguish between respiratory viruses. There are now combination rapid antigen tests that can test for multiple viruses from a single sample, including tests that detect RSV alongside COVID-19 and influenza A and B.

👉 You can shop our range of 4-in-1 Rapid Antigen Tests that can help detect RSV, COVID-19 and influenza A & B.

Can you get the RSV and flu vaccines at the same time?

Yes. According to the Australian Immunisation Handbook, older adults can receive an RSV vaccine and influenza vaccine at the same appointment. The RSV vaccine can also be given at the same time as other vaccines commonly recommended for older adults, including COVID-19, shingles and pneumococcal vaccines.

This may come as a surprise to some older Australians, as research from the Immunisation Foundation of Australia found that 64% of older Australians surveyed were unaware that RSV and influenza vaccines could be administered at the same time.

Receiving both during the same appointment can be a convenient way to stay up to date with recommended vaccinations, particularly ahead of the winter respiratory virus season. However, which vaccines are recommended will depend on factors such as your age, health and vaccination history, so it's worth discussing this with your GP, pharmacist or other vaccination provider.

Are RSV vaccinations free for older adults in Australia?

Yes, RSV vaccination is free for some older Australians under the National Immunisation Program (NIP).

As of May 2026, the RSV vaccine Arexvy is funded under the NIP for:

• All adults aged 75 years and over

• Aboriginal and Torres Strait Islander adults aged 60 years and over

The Australian Immunisation Handbook recommends a single dose of RSV vaccine for these groups, who are at greater risk of severe RSV illness.

RSV vaccination is also recommended for adults aged 60 years and over with medical conditions that increase their risk of severe RSV disease.

For the latest eligibility and vaccination recommendations, you can refer to the Australian Immunisation Handbook's RSV guidance.

When is the best time to get an RSV vaccination?

An RSV vaccine can be given at any time of the year, however, it’s recommended to get vaccinated before the RSV season begins. 

In Australia, RSV activity typically increases between April and September, although the timing and severity of the season can vary between regions and from year to year. Getting vaccinated before RSV activity increases gives the body time to develop its immune response ahead of the period when exposure may be more likely.

How long does an RSV vaccination provide protection?

Unlike the influenza vaccine, which is recommended each year, RSV vaccination is currently given as a single dose. Protection lasts for at least two years, and whether additional doses will be needed in the future has not yet been established.

What can older Australians do to reduce their risk of RSV?

In addition to vaccination, many of the everyday precautions used to reduce the spread of other respiratory viruses can also help reduce exposure to RSV.

These include washing your hands regularly, covering coughs and sneezes, avoiding close contact with people who are unwell, and staying home when you're sick. Testing when appropriate can also help identify the respiratory virus responsible for your symptoms and inform your next steps.

Stay informed about your RSV risk

RSV may be a common respiratory virus, but its impact can change as we get older. Understanding your personal risk, recognising factors that can increase the likelihood of serious illness, and knowing the preventive options available can help you make more informed decisions about your health.

With RSV vaccination programs and health recommendations continuing to evolve, it's also important to keep up with the latest advice. For current information on RSV, vaccination eligibility and recommendations, refer to trusted Australian health sources such as the Australian Government Department of Health, Disability and Ageing and the Australian Immunisation Handbook.

If you're unsure about your individual RSV risk or whether vaccination is appropriate for you, speak with your GP, pharmacist or other healthcare professional.

Disclaimer:

The information in this article is based on current research and guidance from Australian health authorities and is provided for general educational and informational purposes only. It should not be used as a substitute for professional medical advice, diagnosis or treatment. Always speak with your GP, pharmacist or another qualified healthcare professional for advice specific to your individual health circumstances.

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