How Long Does the Arexvy Vaccine Last? Plus Answers to 7 More Arexvy FAQs

When you think of respiratory syncytial virus (RSV), infants and young children likely come to mind. After all, most children get their first RSV infection within their first 2 years of life. But adults can get RSV, too. In fact, it’s estimated that up to 180,000 older adults are hospitalized due to RSV every year.

Prior attempts to develop a safe RSV vaccine that worked well had been unsuccessful. But decades later, recent discoveries have made it a reality. In May 2023, the FDA approved Arexvy, the first RSV vaccine. Then, two more RSV vaccines — Abrysvo and mRESVIA — achieved approval.

With that in mind, you may be wondering if you should get the RSV vaccine. Here, we’ll discuss what you need to know about Arexvy, including who can get it, how well it works, possible side effects, and more.

1. What is Arexvy?

Arexvy is a recombinant subunit vaccine. This means it contains pieces of the virus to teach your immune system how to protect your body. It works by targeting a specific form of the F protein called preF. RSV normally uses this protein to latch onto and infect your cells.

Arexvy contains the preF protein, which is then mixed with an adjuvant. An adjuvant is a substance that helps your immune system respond to a vaccine better.

After an intramuscular shot of Arexvy, your immune system is alerted, since preF is seen as a foreign invader. As part of this response, your body makes antibodies and other memory cells to remember preF. This helps your immune system recognize and fight RSV faster and better if you’re exposed to it in the future.

2. How well does Arexvy work against RSV?

Many adults with an RSV infection only experience cold-like symptoms. And, in some cases, you may not even realize you have RSV. But as you get older, or are diagnosed with other health conditions, your immune system may not fight off infections as well. For some, the infection can lead to serious illness — or even death.

An RSV infection can result in a serious lower respiratory tract disease (LRTD), including pneumonia. In clinical trials, Arexvy helped prevent older adults from developing LRTD due to RSV.

Compared to people who didn’t get the vaccine, those who received Arexvy had a significantly lower risk of LRTD from RSV. The vaccine was nearly 83% effective against LRTD, and 94% effective against severe LRTD.

3. How long does the Arexvy vaccine last?

Arexvy was approved in 2023, so there is limited data on how long its protection lasts. Follow-up studies show that Arexvy works well for at least 23 months (about 2 years). But like some vaccines, its protection lowers over time. It’s important to note that these studies are still ongoing.

4. How often should you get the Arexvy vaccine?

Arexvy is recommended as a one-time vaccine. Currently, a booster dose is not approved or recommended. An additional dose could be recommended in the future, but more studies are needed. 

5. Who should get the Arexvy vaccine?

The FDA and CDC play different roles in determining who a vaccine is approved for and who is recommended to receive it. The FDA approves a vaccine for specific groups after determining its safe and effective based on clinical studies. Experts, such as the CDC’s Advisory Committee on Immunization Practices (ACIP), then make recommendations about who should receive it based on factors such as age, health risks, and how easily the virus can spread.

The FDA has approved Arexvy for adults ages 60 and older, as well as adults ages 18 to 59 who are at higher risk for severe RSV illness.

However, the CDC’s ACIP recommendations are more narrow. The CDC recommends adults ages 75 and older, as well as adults ages 50 to 74 who are at higher risk for severe illness should receive the RSV vaccine.

This means that some younger adults may be eligible to receive Arexvy based on its FDA-approved indication, even though the CDC doesn’t currently recommend routine vaccination for this group. If you are 18 and older, you may be able to get Arexvy if you are diagnosed with certain health conditions that place you at a higher risk for severe illness such as:

• Chronic lung disease such as asthma

• Chronic heart disease such as heart failure

• Chronic kidney disease

• Type 1 or Type 2 diabetes

• Obesity

• Chronic liver disease such as hepatitis infection

These health conditions can affect how well your immune system works, making it harder for your body to fight off an RSV infection. If you aren’t sure if you are at high risk, speak with your healthcare team about whether you should get this vaccine.

6. What are the side effects of Arexvy?

As with most vaccines, you may experience temporary side effects after receiving a dose of Arexvy. During clinical trials, adults receiving Arexvy experienced side effects that included:

• Injection site pain

• Muscle pain

• Fatigue

• Headache

• Joint stiffness or pain

A small number of people receiving the RSV vaccine experienced atrial fibrillation, a type of abnormal heart rhythm, within 30 days of receiving their dose. This also happened among a few people who received the placebo, and not the vaccine. More studies are needed to find out if Arexvy caused this change in heart rhythm.

The FDA has also issued an important safety warning of people experiencing Guillain-Barré syndrome — a rare but serious condition where your immune system attacks your nerves. It’s not clear if this is a side effect that can be linked to Arexvy specifically. But Arexvy’s manufacturer will be monitoring for any other reports.

Keep in mind: Arexvy won’t make you sick with RSV, but you may not feel your best for a few days after you get the vaccine. Contact a healthcare professional if you experience any severe side effects or side effects that don’t go away. You can also report any side effects here. This helps to track vaccine safety in real time.

7. Can you get Arexvy at the same time as other vaccines?

Yes, you can get Arexvy at the same time as other vaccines such as flu and COVID. In fact, getting multiple vaccines at the same time can help you stay up to date with recommended vaccinations. But you may experience more chances of side effects, such as fever, tiredness, and headache, when getting more than one vaccine at a time.

Talk to a healthcare professional to see if they would recommend Arexvy with other vaccines or to space them out. They will be able to give you individual guidance on timing for your vaccines.

8. How much does Arexvy cost?

The average retail price of Arexvy is about $350 for a one-time dose. Luckily, it’s considered a routine vaccine so most insurance plans cover Arexvy and administration fees at no cost to you. As long as you’re eligible, the following insurance plans cover Arexvy: 

• Medicare Part D

• Medicaid

• Tricare

• Commercial insurance plans, including Affordable Care Act marketplace plans

If you don’t have insurance, you may be able to access Arexvy’s manufacturer patient assistance program. You can check your eligibility here.

Some local health departments or vaccine clinics in your area may offer a free or low-cost vaccine.

A GoodRx coupon is also available for Arexvy. You can pay as low as $326.99 for one shot.

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Written by:

Sheila McAdoo, PharmD

Sheila McAdoo, PharmD, is a licensed pharmacist in Virginia and New York. She has worked in the pharmacy industry for 14 years.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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