RSV Products Updates and Vaccine Ordering Reminders

To: Health Care Professionals in Niagara
From: Clinical Services Division, Niagara Region Public Health
Reference: RSV Products Updates and Vaccine Ordering Reminders
Date: November 10, 2025

This memo is for health care providers and office staff who order and store vaccines and immunizing products.

Changes in Scope of Practice for Midwives

Midwives are now able to prescribe and administer RSV monoclonal antibody products within their scope of practice:

O. Reg. 188/24 DESIGNATED DRUGS AND SUBSTANCES | ontario.ca has been amended to reflect this change
All RSV products can be ordered using the Seasonal Respiratory Products Order Form

Beyfortus® Products are Not to be Split or Combined

As a reminder, the 100 mg product of Beyfortus® cannot be split into two 50 mg doses. As well, two 50 mg are not to be combined to make a 100 mg dose.

Shelf-life Extension and Label Update for Abrysvo®

The inner labels of the vials and prefilled syringes may have different expiry dates from the carton labels because the manufacturer has implemented shelf-life extensions for DIN: 02544040.

Abrysvo® should be used by the expiry date printed on the carton, as the carton labels have been updated to reflect the new expiry dates.

Fee-for-Service Vaccines

Please consider all publicly funded eligibility prior to providing a prescription. Prescriptions written for vaccines are dispensed through a pharmacy and your patient will be charged for the cost of the vaccine. Your patient cannot be reimbursed for the cost, even if they are eligible for the publicly funded program.

Vaccine Ordering

Before placing a vaccine order, please check that your fridge has adequate space for safe vaccine storage. Consider packaging size (e.g. Arexvy® and Abrysvo® mostly come in single dose packaging, which takes up significantly more space.)

Safe vaccine storage:

Do not store vaccines on the fridge floor, in the door of the fridge, or in drawers/enclosed bins (these areas tend to be warmer than the internal shelves)
Keep vaccines away from the back and sides of the fridge to avoid contact with condensation due to the potential exposure to freezing temperatures
- Any boxes of vaccine that have been frozen may not be viable for ongoing use – contact Public Health prior to administration
Consider using perforated baskets to organize stock and prevent contact with fridge walls

Do not over order vaccine. Only order what your fridge can safely hold to avoid compromising vaccine integrity or unnecessary wastage. Prior to ordering vaccine for large immunization clinics, please determine a plan including a tentative date (consider your delivery dates when planning) and approximate number of doses required. Do not book appointments for large immunization clinics until you have received your vaccine order. Consider multiple clinic dates if your vaccine fridge space is limited.

Niagara Region Public Health delivers twice a month. Monitor your vaccine doses, upcoming clinic dates, and delivery timing to plan accordingly.

Please include a copy of your current 4-week fridge temperature log (up to present day) AND submit with the vaccine order at least 3 full business days prior to your scheduled delivery date
Orders that do not meet these requirements will not be processed

Receiving Your Order

When receiving vaccine, please reference the packing slip stapled to the outside of the bag for the contents of your order. Delivery personnel are not informed about the contents of the vaccine bags and do not have access to your order information. If vaccine product(s) were missed and/or you are concerned your full order was not received, call Public Health immediately.

Some vaccine orders may be modified due to availability and supply. As a general practice, Public Health does not hold previous orders to fulfill at a later time. Therefore, please continue to place new orders based on what you've received and what you still need, as earlier orders will not be retained.

More Information

Vaccine Ordering Reminders
Call 905-688-8248 or 1-888-505-6074 ext. 7396