Knife's edge: Balancing immunogenicity and reactogenicity in mRNA vaccines

• Type of Material: Article
• Authors: Jisun Lee, Catholic University of Korea; Matthew C Woodruff, Emory University; Eui Ho Kim, Institut Pasteur Korea, Seongnam; Jae-Hwan Nam, Catholic University of Korea
• Language: English
• Date: 2023-07-10
• Publisher: SPRINGERNATURE
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2023
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1038/s12276-023-00999-x
• Title of Journal or Parent Work: EXPERIMENTAL AND MOLECULAR MEDICINE
• Volume: 55
• Issue: 7
• Start Page: 1305
• End Page: 1313
• Keywords: Science & Technology; IMMUNITY; Biochemistry & Molecular Biology; RECEPTOR 4; ACTIVATION; DELIVERY; Research & Experimental Medicine; Medicine, Research & Experimental; Life Sciences & Biomedicine; GERMINAL CENTER; RESPONSES; T-CELLS; COMPLEMENT; ANTIBODIES; CATIONIC LIPID NANOCARRIERS
• Research Categories: Health Sciences, Immunology; Chemistry, Biochemistry; Biology, Molecular

Abstract

Since the discovery of messenger RNA (mRNA), there have been tremendous efforts to wield them in the development of therapeutics and vaccines. During the COVID-19 pandemic, two mRNA vaccines were developed and approved in record-breaking time, revolutionizing the vaccine development landscape. Although first-generation COVID-19 mRNA vaccines have demonstrated over 90% efficacy, alongside strong immunogenicity in humoral and cell-mediated immune responses, their durability has lagged compared to long-lived vaccines, such as the yellow fever vaccine. Although worldwide vaccination campaigns have saved lives estimated in the tens of millions, side effects, ranging from mild reactogenicity to rare severe diseases, have been reported. This review provides an overview and mechanistic insights into immune responses and adverse effects documented primarily for COVID-19 mRNA vaccines. Furthermore, we discuss the perspectives of this promising vaccine platform and the challenges in balancing immunogenicity and adverse effects.