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**CoV2 preS dTM + AS03** is a recombinant protein subunit vaccine for prevention of COVID-19. It combines a recombinant prefusion-stabilized spike protein (preS dTM) of SARS-CoV-2, produced using a baculovirus expression vector system in insect cells, with AS03, a proprietary oil-in-water adjuvant composed of α-tocopherol, squalene, and polysorbate 80. The preS dTM protein is designed for increased stability and immunogenicity through specific mutations (including proline substitutions and deletion of the transmembrane domain with addition of a T4 foldon trimerization domain). AS03 enhances immune responses, promoting both neutralizing antibody production and cellular immune activation against spike protein, with demonstrated protection in animal models and humans. CoV2 preS dTM + AS03 has been evaluated in clinical trials for efficacy, safety, and immunogenicity as a primary immunization and booster against COVID-19, and is manufactured in both monovalent (ancestral and variant B.1.351 spike) and bivalent formulations[1][2][3][4].
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