International Journal of Clinical Case Reports 2024, Vol.14, No.3, 117-129 http://medscipublisher.com/index.php/ijccr 125 crucial role in optimizing vaccine design and predicting immune responses, thereby accelerating the development of more effective mRNA vaccines (Iavarone et al., 2017; Kim et al., 2021). 8.3 Addressing current challenges Despite the significant progress made in mRNA vaccine technology, several challenges remain that need to be addressed to fully realize their potential. One of the primary challenges is the stability of mRNA, which can be rapidly degraded in the body, reducing the effectiveness of the vaccine (Pardi et al., 2018; Liang et al., 2021). Advances in delivery systems, such as the use of lipid nanoparticles and other biocompatible carriers, have shown promise in protecting mRNA from degradation and enhancing its delivery to target cells (Feldman et al., 2019; Gote et al., 2023). However, further research is needed to optimize these delivery systems and ensure consistent and efficient mRNA expression in vivo (Schlake et al., 2012; Iavarone et al., 2017). Another challenge is the potential for adverse immune reactions, such as cytokine storms, which can pose significant risks to vaccine recipients (Kim et al., 2021; Liang et al., 2021). Understanding the mechanisms of action of mRNA vaccines and their interactions with the immune system is crucial for mitigating these risks (Iavarone et al., 2017). Additionally, addressing the logistical challenges of mRNA vaccine storage and distribution, particularly in resource-limited settings, will be essential for their global deployment (Feldman et al., 2019; Maruggi et al., 2019). By tackling these challenges through continued research and innovation, the full potential of mRNA vaccines can be harnessed to improve public health outcomes worldwide. 9 Concluding Remarks The systematic study of clinical trials on mRNA vaccines, particularly mRNA-1273 and BNT162b2, has demonstrated significant efficacy and safety in preventing COVID-19 across diverse populations. The mRNA-1273 vaccine showed an efficacy of 94.1% in preventing symptomatic COVID-19 and 98.2% in preventing severe disease, with no major safety concerns identified. Similarly, the BNT162b2 vaccine exhibited a 95% efficacy in preventing COVID-19 and a 96.7% efficacy against severe disease, maintaining a favorable safety profile over six months. In children aged 5 to 11 years, mRNA vaccines were associated with reduced risks of SARS-CoV-2 infection and severe COVID-19-related illnesses, with most adverse events being mild and transient. Additionally, mRNA vaccines have shown robust immunogenicity and acceptable safety profiles in various age groups and among immunocompromised patients, although the latter group exhibited lower seroconversion rates. Acknowledgments Authors thank to the anonymous peer reviewers for their comments on the manuscript. Conflict of Interest Disclosure The authors affirm that this research was conducted without any commercial or financial relationships that could be construed as a potential conflict of interest. References Alberer M., Gnad-Vogt U., Hong H., Mehr K., Backert L., Finak G., Gottardo R., Bica M., Garofano A., Koch S., Fotin‐Mleczek M., Hoerr I., Clemens R., and Sonnenburg F., 2017, Safety and immunogenicity of a mRNA rabies vaccine in healthy adults: an open-label, non-randomised, prospective, first-in-human phase 1 clinical trial, The Lancet, 390: 1511-1520. https://doi.org/10.1016/S0140-6736(17)31665-3 Baden L., Sahly H., Essink B., Kotloff K., Frey S., Novak R., Diemert D., Spector S., Rouphael N., Creech C., Mcgettigan J., Kehtan S., Segall N., Solis J., Brosz A., Fierro C., Schwartz H., Neuzil K., Corey L., Gilbert P., Janes H., Follmann D., Marovich M., Mascola J., Polakowski L., Ledgerwood J., Graham B., Bennett H., Pajon R., Knightly C., Leav B., Deng W., Zhou H., Han S., Ivarsson M., Miller J., and Zaks T., 2020, Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine, The New England Journal of Medicine, 384(5): 403-416. https://doi.org/10.1056/NEJMoa2035389 Bergman P., Blennow O., Hansson L., Mielke S., Nowak P., Chen P., Söderdahl G., Österborg A., Smith C., Wullimann D., Vesterbacka J., Lindgren G., Blixt L., Friman G., Wahren-Borgström E., Nordlander A., Gomez A., Akber M., Valentini D., Norlin A., Thalme A., Bogdanovic G., Muschiol S., Nilsson P., Hober S., Loré K., Chen M., Buggert M., Ljunggren H., Ljungman P., and Aleman S., 2021, Safety and efficacy of the mRNA BNT162b2 vaccine against SARS-CoV-2 in five groups of immunocompromised patients and healthy controls in a prospective open-label clinical trial, EBioMedicine, 74: 103705. https://doi.org/10.1016/j.ebiom.2021.103705.
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