The review published in The Lancet represents one of the most comprehensive scientific evaluations of mRNA vaccines to date. The study combines data from laboratory research, clinical trials, and real-world practice, covering the entire lifecycle of mRNA vaccine development—from design and manufacturing to post-marketing monitoring of their effectiveness and safety. The review is based on evidence accumulated between 2020 and 2025 and the analysis of billions of doses administered worldwide.
According to the study, mRNA vaccines demonstrated high effectiveness in preventing severe cases, hospitalizations, and mortality from COVID-19 and other infectious diseases. Based on a pooled analysis of various studies, their effectiveness was approximately 87% in preventing confirmed SARS-CoV-2 infection, 93% for hospitalization, and 94% for mortality within the period of 14–42 days post-vaccination. Although effectiveness partially waned over time and against the spread of new variants, particularly Omicron, booster doses significantly restored protection, especially against severe illness.
The review confirms that mRNA vaccines effectively protect individuals across various age and risk groups, including children, pregnant women, and immunocompromised individuals. The authors note that regular updates to the vaccine formulations made it possible to maintain their effectiveness even amid the spread of new viral variants.
When evaluating safety, the authors emphasize that, like all medical interventions, mRNA vaccines can be accompanied by side effects, though severe complications are extremely rare. Real-world practice data showed that after the second dose, the incidence of myocarditis and pericarditis was approximately 12.6 cases per million doses for the Pfizer-BioNTech vaccine and 35.6 cases per million doses for the Moderna vaccine. Furthermore, the risk of developing these complications was significantly higher in the case of COVID-19 infection than following vaccination. Other serious adverse events were recorded extremely rarely, while the most common reactions—pain at the injection site, fatigue, and fever—were mild and transient in most cases.
The review also addresses common misconceptions about mRNA technology. The authors explain that mRNA vaccines do not alter human genetic material (DNA). mRNA only temporarily provides cells with instructions to produce a harmless viral protein, which teaches the immune system to recognize and respond to the infection. Both the mRNA and its lipid nanoparticle delivery system degrade rapidly and are eliminated from the body. Beyond COVID-19, the authors view mRNA technology as a platform with broad potential.
Development is underway for vaccines against influenza and Respiratory Syncytial Virus (RSV), personalized oncological vaccines, and other RNA-based therapeutic approaches. The authors assess that the experience gained during the COVID-19 period has significantly accelerated the further development of this technology. The authors of the review pay special attention to the importance of public trust, transparent information delivery, and equitable access to vaccines. They estimate that unequal vaccine coverage was largely driven by misinformation and issues of public trust. Therefore, they recommend evidence-based communication, continuous safety monitoring, expansion of manufacturing capacities—especially in low- and middle-income countries—technology transfer, and the development of local production.
For the attention of the large army of Georgian anti-vaxxers, this review once again confirms that the COVID-19 experience is not just a success story of a single vaccine. It shows that scientific innovation, rigorous safety monitoring, and the continuous evaluation of real-world practice data are integral parts of modern public health.
The authors attach particular importance not only to the development of new technologies but also to the constant evaluation of their safety, technology transfer, the strengthening of local manufacturing capacities, and the expansion of global cooperation, so that mRNA technology can continue to play a significant role in the prevention and treatment of both pandemics and other diseases in the future.
Author: Zaza Tsereteli – International Public Health Specialist
