MRNA VACCINE TECHNOLOGIES BEYOND COVID-19: PROPHYLACTIC AND THERAPEUTIC APPLICATIONS

The rapid development and global deployment of mRNA vaccines against SARS-CoV-2 transformed vaccinology and validated a platform with exceptional speed, adaptability, and potency. Beyond COVID-19, the same nucleoside-modified mRNA–lipid nanoparticle technology is now being applied to a broad range of infectious diseases and therapeutic indications. This review critically examines the current state and future potential of mRNA vaccine technologies beyond SARS-CoV-2, with a focus on prophylactic vaccines for influenza, respiratory syncytial virus, cytomegalovirus, Zika virus, HIV, and rabies, as well as therapeutic cancer vaccines and personalized neoantigen approaches. Key aspects of mRNA design—such as nucleoside modification, sequence optimization, and lipid nanoparticle formulation—are discussed in relation to immunogenicity, reactogenicity, and delivery. Clinical progress through 2022 is summarized, including multivalent influenza candidates and personalized cancer vaccines in combination with checkpoint inhibitors. Major challenges remain in optimizing delivery to non-hepatic tissues, reducing systemic reactogenicity, improving durability, and addressing manufacturing and storage limitations. Emerging strategies such as self-amplifying mRNA, circular RNA, and targeted lipid nanoparticles may further broaden the platform. Overall, mRNA vaccines are positioned to become a central pillar of preventive and therapeutic medicine, but translational hurdles must be addressed through continued multidisciplinary research.