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Arexvy is a sterile suspension for intramuscular injection containing a recombinant subunit antigen, the respiratory syncytial virus (RSV) glycoprotein F stabilized in the prefusion conformation (RSVPreF3), combined with the AS01E adjuvant system. The AS01E adjuvant consists of the plant-derived saponin QS-21 and 3-O-desacyl-4'-monophosphoryl lipid A (MPL) in a liposomal formulation. By targeting the prefusion form of the F protein—the primary target of neutralizing antibodies during natural infection—the vaccine elicits a robust immune response, including both neutralizing antibodies and antigen-specific T-cell responses. It was the first RSV vaccine approved globally, specifically indicated for the prevention of lower respiratory tract disease (LRTD) caused by RSV in adults aged 60 years and older, and later expanded to adults aged 50 through 59 at increased risk.
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