mRNA vaccines against viral pathogens: molecular design, delivery systems, and clinical applications

As a next-generation vaccine technology, mRNA vaccines mark a transformative advancement in vaccinology research. Their key strengths lie in rapid development cycles, high-efficiency manufacturing processes, robust immunogenic properties, and adaptable design frameworks. For infectious disease prevention, mRNA-based immunizations targeting SARS-CoV-2, such as the mRNA-1273 vaccine, have shown promising results in clinical evaluations. Validated efficacy metrics and safety profiles have supported their regulatory approval for public use. Additionally, mRNA platforms have shown substantial therapeutic potential against respiratory syncytial virus. However, this technology still faces multiple challenges, including poor stability, limited delivery efficiency, high production costs, unclear mechanisms of adverse reactions. Distinct from existing literature that primarily focuses on COVID-19 or specific delivery technologies, this review provides a comprehensive, integrated framework covering molecular design, delivery systems, and clinical translation across multiple viral pathogens, while also critically analyzing current controversies and future directions. This review aims to provide a comprehensive reference for researchers and clinicians in related fields.