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MRESVIA is a sterile white to off-white injectable suspension for intramuscular use.
Each 0.5 mL dose of MRESVIA contains 50 mcg of nucleoside modified mRNA encoding the RSV F glycoprotein stabilized in the prefusion conformation (pre-F protein).
Each 0.5 mL dose of MRESVIA also contains the following ingredients: a total lipid content of 1.02 mg (SM-102 (heptadecan-9-yl 8-((2-hydroxyethyl) (6-oxo-6-(undecyloxy) hexyl) amino) octanoate), polyethylene glycol 2000 dimyristoyl glycerol [PEG2000-DMG], cholesterol, and 1,2-distearoyl-sn-glycero- 3-phosphocholine [DSPC]), 0.25 mg tromethamine, 1.2 mg tromethamine hydrochloride, 0.021 mg acetic acid, 0.10 mg sodium acetate trihydrate, 44 mg sucrose, and water for injection.
MRESVIA does not contain a preservative. The rubber tip cap and plunger used for the pre-filled syringe are not made with natural rubber latex.
MRESVIA is indicated for active immunization for the prevention of lower respiratory tract disease (LRTD) caused by respiratory syncytial virus (RSV) in individuals 60 years of age and older.
Administer a single dose (0.5 mL) of MRESVIA as an intramuscular injection.
MRESVIA is supplied as a pre-filled syringe that contains a frozen suspension that must be thawed prior to administration.
Thaw each syringe before use, either in the refrigerator or at room temperature, following the instructions in Table 1.
Table 1: Thawing Conditions and Times
| Configuration | Thaw in Refrigerator | Thaw at Room Temperature |
| Carton of one pre-filled syringe in single blister pack | Thaw between 2°C to 8°C (36°F to 46°F) for 60 minutes. Let each pre-filled syringe stand at room temperature for between 10 and 20 minutes before administering the vaccine. |
Thaw between 15°C to 25°C (59°F to 77°F) for 45 minutes. If MRESVIA is thawed at room temperature, the vaccine is ready to be administered. |
| Carton of 10 pre-filled syringes in blister packs | Thaw between 2°C to 8°C (36°F to 46°F) for 155 minutes. Let each pre-filled syringe stand at room temperature for between 10 and 20 minutes before administering the vaccine. |
Thaw between 15°C to 25°C (59°F to 77°F) for 140 minutes. If MRESVIA is thawed at room temperature, the vaccine is ready to be administered |
Administer MRESVIA intramuscularly.
MRESVIA is an injectable suspension. A single dose is 0.5 mL.
MRESVIA is supplied as follows:
| NDC 80777-345-90 | Carton of 1 single-dose pre-filled plastic syringe in a blister pack containing 1 dose of 0.5 mL (NDC 80777-345-01). |
| NDC 80777-345-96 | Carton of 10 single-dose pre-filled plastic syringes, each syringe containing 1 dose of 0.5 mL (NDC 80777-345-01). Each carton contains 5 blisters, and each blister contains two syringes. Use one syringe per person per dose. |
During storage, minimize exposure to room light, and avoid exposure to direct sunlight and ultraviolet light.
Store frozen between -40°C to -15°C (-40°F to 5°F).
Storage at 2°C to 8°C (36°F to 46°F):
Storage at 8°C to 25°C (46°F to 77°F):
Thawed pre-filled syringes can be transported at 2°C to 8°C (36°F to 46°F) using shipping containers which have been qualified to maintain 2°C to 8°C (36°F to 46°F). Once thawed and transported at 2°C to 8°C (36°F to 46°F), pre-filled plastic syringes should not be refrozen and should be stored at 2°C to 8°C (36°F to 46°F) until use.
Manufactured for: Moderna US, Inc. 5 Vaughn Drive, Princeton, NJ 08540. Revised: Oct 2024
In a clinical trial (NCT05127434), the most commonly reported (≥10%) adverse reactions were injection-site pain (55.9%), fatigue (30.8%), headache (26.7%), myalgia (25.6%), arthralgia (21.7%), axillary (underarm) swelling or tenderness (15.2%), and chills (11.6%).
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a vaccine cannot be directly compared to rates in the clinical trials of another vaccine and may not reflect the rates observed in practice.
The safety of MRESVIA was evaluated in Study 1 (NCT05127434), a placebo-controlled, observer blinded clinical study conducted in 22 countries that includes participants from North America/ Europe, Central/Latin America, Africa and Asian/Pacific regions. A total of 18,231 participants received MRESVIA and 18,181 received saline placebo (0.5 mL).
In Study 1, the median age of the participants was 67 years (range 60-108 years). Overall, 51.0% of the participants were male, 49.0% were female, 33.6% were Hispanic or Latino, 61.8% were White, 12.0% were Black or African American, 11.0% were Asian, 4.9% were American Indian or Alaska Native, 0.1% were Native Hawaiian or Pacific Islander, 5.5% were other races, and 4.1% were Multiracial. Demographic characteristics were comparable between participants who received MRESVIA and those who received placebo.
Local and systemic adverse reactions (ARs) were solicited in an electronic diary for 7 days following injection (i.e., the day of injection and 6 subsequent days) among participants receiving MRESVIA (n=18,160) and participants receiving placebo (n=18,098). Events that persisted for more than 7 days were followed until resolution, but not to exceed 28 days after the study injection.
The percentage of participants who reported solicited local and systemic adverse reactions are presented in Table 2 and Table 3. Solicited local and systemic adverse reactions had a median duration of 1 to 2 days.
Table 2: Percentage of Participants with Solicited Local Adverse Reactions Any Grade and ≥Grade 3 Starting Within 7 Days* of Vaccination
| Local Adverse Reactions‡ | MRESVIA (N=18,154 – 18,156) % |
Placebo† (N=18,093 – 18,094) % |
| Injection Site Pain, Any Grade§ | 55.9 | 13.8 |
| Injection Site Pain, Grade 3§ | 1.7 | 1.1 |
| Erythema (Redness), ≥ 2.5 cm | 2.0 | 0.6 |
| Erythema (Redness), Grade 3, >10 cm | 0.6 | 0.3 |
| Swelling (Hardness), ≥ 2.5 cm | 3.7 | 0.3 |
| Swelling (Hardness), Grade 3, >10 cm | 0.9 | <0.1 |
| Axillary (underarm) swelling or tenderness, Any Grade¶ | 15.2 | 6.1 |
| Axillary (underarm) swelling or tenderness, Grade 3¶ | 0.8 | 0.6 |
| Abbreviations: Any = Grade 1 or above; Percentages were based on the number of exposed participants who submitted any data for the event. N = number of vaccinated participants with available data for the events listed. * 7 days included day of vaccination and the subsequent 6 days. Adverse reactions and use of pain medication were collected in the electronic diary (e-diary). † Placebo is 0.9% sodium chloride (normal saline) injection. ‡ No Grade 4 solicited local adverse reactions were reported. § Injection site pain grading scale: Does not interfere with activity (Grade 1); repeated use of over-the-counter pain reliever >24 hours or interferes with activity (Grade 2); any use of prescription pain reliever or prevents daily activity (Grade 3). ¶ Axillary (underarm) swelling or tenderness grading scale: No interference with activity (Grade 1); repeated use of over-the-counter pain reliever >24 hours or some interference with activity (Grade 2); any use of prescription pain reliever or prevents daily activity (Grade 3). |
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Table 3: Percentage of Participants with Solicited Systemic Adverse Reactions Any Grade and ≥Grade 3 Starting Within 7 Days* of Vaccination
| Systemic Adverse Reactions‡ | MRESVIA (N=18,146 – 18,153) % |
Placebo† (N=18,092 – 18,093) % |
| Fever, Any Grade (≥38°C / ≥100.4°F) | 2.7 | 1.3 |
| Fever, Grade 3 (39.0°C – 40.0°C / 102.1°F – 104.0°F) | 0.4 | 0.2 |
| Fever, Grade 4 (>40.0°C / >104.0°F) | 0.2 | 0.2 |
| Headache, Any Grade§ | 26.7 | 18.8 |
| Headache, Grade 3§ | 1.5 | 1.1 |
| Fatigue, Any Grade¶ | 30.8 | 20.0 |
| Fatigue, Grade 3¶ | 1.7 | 1.2 |
| Myalgia, Any Grade# | 25.6 | 14.4 |
| Myalgia, Grade 3# | 1.4 | 0.8 |
| Arthralgia, Any Grade# | 21.7 | 14.0 |
| Arthralgia, Grade 3# | 1.1 | 0.7 |
| Nausea/vomiting, Any Grade♠ | 7.0 | 5.2 |
| Nausea/vomiting, Grade 3♠ | 0.4 | 0.4 |
| Chills, Any Grade♥ | 11.6 | 6.8 |
| Chills, Grade 3♥ | 0.6 | 0.4 |
| Abbreviations: Any = Grade 1 or above; Percentages were based on the number of exposed participants who submitted any data for the event. N = number of vaccinated participants with available data for the events listed. * 7 days included day of vaccination and the subsequent 6 days. Adverse reactions and use of pain medication were collected in the electronic diary (e-diary). † Placebo is 0.9% sodium chloride (normal saline) injection. ‡ With the exception of fever, no Grade 4 solicited systemic adverse reactions were reported. § Headache grading scale: No interference with activity (Grade 1); repeated use of over-the-counter pain reliever >24 hours or some interference with activity (Grade 2); significant, any use of prescription pain reliever or prevents daily activity (Grade 3). ¶ Fatigue grading scale: No interference with activity (Grade 1); some interference with activity (Grade 2); significant, prevents daily activity (Grade 3). # Myalgia and arthralgia grading scales: No interference with activity (Grade 1); some interference with activity (Grade 2); significant, prevents daily activity (Grade 3). ♠ Nausea/vomiting grading scale: No interference with activity or 1-2 episodes per 24 hours (Grade 1); some interference with activity or >2 episodes per 24 hours (Grade 2); prevents daily activity, requires outpatient intravenous hydration (Grade 3). ♥ Chills grading scale: No interference with activity (Grade 1); some interference with activity not requiring medical intervention (Grade 2); prevents daily activity and requires medical intervention (Grade 3). |
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Incidence of unsolicited adverse events, serious adverse events, and medically attended adverse events within 28 days of vaccination were similar in the groups that received MRESVIA or placebo. Unsolicited adverse events within 28 days considered related to the study vaccination were numerically higher in the recipients of MRESVIA (5.7%) than in the placebo recipients (4.4%), primarily attributed to events that were consistent with solicited adverse reactions.
There was a numerically higher incidence of urticaria in the MRESVIA group than the placebo group within 7 days post injection (8 and 2 participants, respectively) and within 28 days post injection (15 and 5 participants, respectively).
The median duration of safety follow-up was 311 days (range 1 to 585 days), and 96.6% of participants had at least a 6-month follow-up duration after vaccination. SAEs throughout the study were reported by 7.8% and 7.9% of participants in the MRESVIA group and the placebo group, respectively. One participant in the MRESVIA group had an SAE of facial paralysis with onset four days after vaccination assessed as related to MRESVIA. Within 28 days and 42 days post vaccination, there was no imbalance in reports of facial paralysis (including Bell’s palsy) between treatment groups. There were no other notable patterns or numerical imbalances between treatment groups for specific categories of serious adverse events that would suggest a causal relationship to MRESVIA.
No Information Provided
Included as part of the "PRECAUTIONS" Section
Appropriate medical treatment must be immediately available to manage potential anaphylactic reactions following administration of MRESVIA.
Syncope (fainting) may occur in association with administration of injectable vaccines, including MRESVIA. Procedures should be in place to avoid injury from fainting.
Immunocompromised individuals, including those receiving immunosuppressive therapy, may have a diminished immune response to MRESVIA.
Advise the vaccine recipient or caregiver to read the FDA-approved patient labeling (INFORMATION FOR RECIPIENTS AND CAREGIVERS).
MRESVIA has not been evaluated for carcinogenic or mutagenic potential, or impairment of male fertility in animals.
All pregnancies have a risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively.
MRESVIA is not approved for use in persons younger than 60 years of age.
There are no human data to establish whether there is a vaccine-associated risk with use of MRESVIA in pregnancy.
A developmental toxicity study was performed in female rats administered a vaccine formulation that included approximately twice the amount of nucleoside-modified messenger ribonucleic acid (mRNA), encoding the same RSV fusion (F) glycoprotein stabilized in the prefusion conformation, as in MRESVIA. The vaccine formulation was administered twice prior to mating and twice during gestation. The study revealed no evidence of harm to the fetus due to the vaccine (see Data).
Animal Data
In a developmental toxicity study, 0.2 mL of a vaccine formulation containing 96 mcg of nucleoside-modified mRNA per dose (a full human dose of MRESVIA contains 50 mcg of nucleoside-modified mRNA) was administered to female rats by the intramuscular route on four occasions: 28 and 14 days prior to mating, and on gestation days 1 and 13. No vaccine-related fetal malformations or variations and no adverse effects on postnatal development were observed in the study. The developmental toxicity study revealed no evidence of impaired female fertility.
It is not known whether MRESVIA is excreted in human milk. MRESVIA is not approved for use in persons younger than 60 years of age. No human or animal data are available to assess the effects of MRESVIA on the breastfed infant or on milk production/excretion.
The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for MRESVIA and any potential adverse effects on the breastfed child from MRESVIA or from the underlying maternal condition. For preventive vaccines, the underlying condition is susceptibility to disease prevented by the vaccine.
Safety and effectiveness of MRESVIA in individuals younger than 18 years of age have not been established.
MRESVIA is approved for use in individuals 60 years of age and older. Of the total number of participants (N = 36,412) who received MRESVIA or placebo in Study 1 (NCT05127434), 22,554 (61.9%) were 60 to 69 years of age, 10,972 (30.1%) were 70 to 79 years of age, and 2,886 (7.9%) were 80 years of age and older [see ADVERSE REACTIONS and Clinical Studies].
No Information Provided
Do not administer MRESVIA to individuals with a history of a severe allergic reaction (e.g., anaphylaxis) to any component of MRESVIA [see DESCRIPTION].
MRESVIA induces an immune response against RSV pre-F protein that protects against LRTD caused by RSV.
Study 1 (NCT05127434) is a randomized, placebo–controlled, observer–blind, case–driven clinical study to evaluate the safety and efficacy of MRESVIA to prevent RSV–LRTD in individuals 60 years of age and older with or without underlying medical conditions after receipt of a single dose of MRESVIA. Study 1 is being conducted in 22 countries and includes participants from North America/ Europe, Central/Latin America, Africa, and Asian/Pacific regions and is designed to follow participants for up to 24 months after vaccination.
Participants were randomized to a single dose of MRESVIA or placebo (in a 1:1 ratio). Randomization was stratified by age (60 to 74 years; ≥75 years) and risk factors for LRTD, which were defined as congestive heart failure (CHF) and/or chronic obstructive pulmonary disease (COPD) at screening.
The primary efficacy analysis population (Per-Protocol Efficacy Set) included 35,064 participants who received either MRESVIA (n=17,561) or placebo (n=17,503), with a data cutoff of 30 Nov 2022. This study population included 49.1% female, 50.9% male, 63.4% White, 12.2% Black or African American, 8.7% Asian, 5.1% American Indian or Alaska Native, and 10.6% other. Among participants, 34.7% identified as Hispanic or Latino. The median age of participants was 67 years (range 60-96 years), with 30.9% of participants between 70 and 79 years and 5.6% of participants ≥80 years. There were no notable differences in demographics or pre-existing medical conditions between participants who received MRESVIA and those who received placebo. A total of 7.0% had protocol-defined LRTD risk factors (CHF and/or COPD) and 29.5% had one or more comorbidity of interest (COPD, asthma, chronic respiratory disease, diabetes, CHF, advanced liver disease, or advanced renal disease).
Study exclusion criteria included history of myocarditis, pericarditis, or myopericarditis within 2 months prior to screening; autoimmune conditions requiring systemic immunosuppressants (stable HIV-positive participants were permitted); history of serious reaction to any prior vaccination. Individuals were not eligible for inclusion in the Per-Protocol Efficacy Set if they received any other vaccine within 28 days before or after administration of the study injection.
The primary efficacy endpoints were the prevention of a first episode of RSV-LRTD with either ≥2 signs/symptoms or ≥3 signs/symptoms starting 14 days after vaccination. RSV-LRTD was defined based on the following criteria: The participant must have had RT-PCR-confirmed RSV infection and experienced new or worsening of ≥2 (or ≥3) of the following signs/symptoms for at least 24 hours: shortness of breath, cough and/or fever (≥37.8°C [100.0°F]), wheezing and/or rales and/or rhonchi, sputum production, tachypnea (≥20 breaths per minute or increase of ≥2 breaths per minute from baseline measurement in those who have baseline tachypnea), hypoxemia (new oxygen saturation ≤93% or new or increasing use of supplemental oxygen), or pleuritic chest pain. If signs/symptoms could not be captured, radiologic evidence of pneumonia with RT-PCR-confirmed RSV infection was also counted as RSV-LRTD.
The primary efficacy analyses were performed when at least 50% of targeted RSV-LRTD cases had accrued [which occurred after a median of 3.7 months of follow-up (range 15 to 379 days) when 20.2% of participants had reached 6 months of follow-up]. Both primary efficacy analyses met the predefined success criterion (lower bound of the alpha-adjusted CI of the VE was >20%). Additional analyses of efficacy were performed after a median of 8.6 months of follow-up (range 15 to 530 days) when 94.2% of participants had reached 6 months of follow-up after vaccination and met the same success criterion (lower bound of the 95% CI of the VE was >20%). Analyses of efficacy for both timepoints are presented in Table 4.
Table 4: Efficacy of MRESVIA to Prevent First Episode of Protocol-Defined RSV-LRTD (Per-Protocol Efficacy Set)
| Primary Analyses 3.7 months median follow-up |
MRESVIA (N=17,561) n (%) |
Placebo (N=17,503) n (%) |
Vaccine Efficacy* Based on Hazard Ratio (%) (% CI†) |
| RSV-LRTD With 2 or More Signs/Symptoms | 15 (0.09) | 70 (0.40) | (62.78.7 8, 87.9) |
| RSV-LRTD With 3 or More Signs/Symptoms | 5 (0.03) | 26 (0.15) | (50.80.9 1, 92.7) |
| Additional Analyses 8.6 months median follow-up | MRESVIA (N=18,074) n (%) |
Placebo (N=18,010) n (%) |
Vaccine Efficacy* Based on Hazard Ratio (%) (% CI‡) |
| RSV-LRTD With 2 or More Signs/Symptoms | 48 (0.27) | 127 (0.71) | 62.5 (47.7, 73.1) |
| RSV-LRTD With 3 or More Signs/Symptoms | 20 (0.11) | 51 (0.28) | 61.1 (34.7, 76.8) |
| Abbreviations: RSV-LRTD = Respiratory Syncytial Virus-Lower Respiratory Tract Disease; N = number of participants in Per-Protocol Efficacy set; n = number of participants with protocol defined RSV-LRTD; CI = Confidence Interval. * Vaccine efficacy (VE) is defined as 100% x (1 - hazard ratio (MRESVIA vs. placebo)). The CI for VE is based on a stratified Cox proportional hazard model with Efron's method of tie handling and with the treatment group as a fixed effect, adjusting for stratification factors at randomization. Stratification factors at randomization are Age Group (60 to 74 years or 75 years and older) and LRTD Risk (Present or Absent). † For primary analysis for RSV-LRTD with 2 or more symptoms, 95.04% CI where the alpha value of 4.96% was derived from the Lan-DeMets approximation to the Pocock stopping boundary with an information fraction of 0.99 (85 out of total of 86 cases). For primary analysis for RSV-LRTD with 3 or more symptoms, 95.10% CI where the alpha value of 4.90% was derived from the Lan-DeMets approximation to the Pocock stopping boundary with an information fraction of 0.97 (31 out of total of 32 cases). ‡ For additional analyses for RSV-LRTD with 2 or more and 3 or more symptoms, 95% CI |
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Descriptive vaccine efficacy analyses by age subgroup and for participants with at least one comorbidity are presented in Table 5.
Table 5: Efficacy of MRESVIA to Prevent First Episode of RSV-LRTD With 2 or More Signs/Symptoms by Subgroup (8.6 Months Median Follow-up, Per-Protocol Efficacy Set)
| Subgroup | MRESVIA Cases, n/N† |
Placebo Cases, n/N† |
VE*, % (95% CI) |
| Overall (≥60 years) | 48/18,074 | 127/18,010 | 62.5 (47.7, 73.1) |
| 60 to 69 years | 32/11,193 | 77/11,146 | 58.8 (37.8, 72.7) |
| 70 to 79 years | 10/5,455 | 45/5,431 | 78.0 (56.3, 88.9) |
| ≥80 years | 6/1,426 | 5/1,433 | -20.0 (-293.3, 63.4)‡ |
| ≥60 years with ≥1 comorbidity§ | 17/5,365 | 51/5,244 | 67.4 (43.6, 81.2) |
| Abbreviations: RSV-LRTD = Respiratory Syncytial Virus-associated Lower Respiratory Tract Disease * Vaccine efficacy (VE) is defined as 100% x (1 - hazard ratio (MRESVIA vs. placebo)). The CI for VE is based on a stratified Cox proportional hazard model with Efron's method of tie handling and with the treatment group as a fixed effect, adjusting for stratification factors at randomization. All the VE analyses presented are descriptive. † Based on the number of participants in each subgroup. ‡ VE cannot be reliably estimated due to the low number of cases accrued in this age group. § Comorbidities included in this analysis were chronic cardiopulmonary conditions, including CHF, COPD, asthma and chronic respiratory conditions as well as diabetes, advanced liver, and advanced kidney disease |
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MRESVIA
(pronounced em res’ vee ah)
(Respiratory Syncytial Virus Vaccine)
Please read this information sheet before getting MRESVIA. This summary is not intended to take the place of talking with your healthcare provider. If you have questions or would like more information, please talk with your healthcare provider.
What is MRESVIA?
MRESVIA is a vaccine to protect you against lower respiratory tract disease caused by Respiratory Syncytial Virus (RSV).
MRESVIA is for people 60 years of age and older. Vaccination with MRESVIA may not protect all people who receive the vaccine.
MRESVIA does not contain RSV. MRESVIA cannot give you lower respiratory tract disease caused by RSV.
Who should not get MRESVIA?
You should not get MRESVIA if you had
What should I tell my healthcare provider?
Tell your healthcare provider about all of your medical conditions, including if you:
How is MRESVIA given?
MRESVIA is given as an injection into the muscle.
What are the risks of MRESVIA?
There is a very small chance that MRESVIA could cause a severe allergic reaction. A severe allergic reaction would usually occur within a few minutes to one hour after getting a dose of MRESVIA. For this reason, your healthcare provider may ask you to stay for a short time at the place where you received your vaccine. Signs of a severe allergic reaction may include:
Side effects that have been reported in clinical trials with MRESVIA include:
These may not be all of the possible side effects of MRESVIA. Ask your healthcare provider about any side effects that concern you. You may report side effects to the Vaccine Adverse Event Reporting System (VAERS) at 1-800-822-7967 or https://vaers.hhs.gov.
What are the ingredients in MRESVIA?
MRESVIA contains the following ingredients:
MRESVIA does not contain preservative.
What if I have additional questions?
If you would like more information, talk to your healthcare provider, or visit MRESVIA.com or call 1-866-MODERNA (1-866-663-3762).
