Safety and efficacy of mRNA vaccines: a mechanistic and public health perspective.

Global deployment of mRNA vaccines during the COVID-19 pandemic provided an unprecedented real-world evaluation of this platform, with billions of doses administered across diverse populations.

COVID-19 大流行期间，mRNA 疫苗的全球部署提供了一次前所未有的现实世界评估，数十亿剂疫苗在不同人群中进行了接种。

In this Review, we critically examine the safety and efficacy of mRNA vaccines from mechanistic, preclinical, clinical, and public health perspectives.

在这篇综述中，我们从机制、临床前、临床和公共卫生角度，批判性地审视了mRNA疫苗的安全性和有效性。

We outline the biological basis of mRNA vaccines, including their transient cytoplasmic expression, lack of genomic integration, and rapid clearance, distinguishing them clearly from other gene therapies.

我们概述了mRNA疫苗的生物学基础，包括它们在细胞质中的瞬时表达、缺乏基因组整合和快速清除，这些特点清晰地区别于其他基因治疗。

We synthesise evidence on vaccine components, manufacturing quality controls, and regulatory standards that underpin safety, alongside data from randomised trials, post-authorisation surveillance, and active pharmacovigilance systems.

我们综合了疫苗成分、生产质量控制和确保安全性的监管标准的证据，以及来自随机试验、授权后监测和积极药物警戒系统的数据。

We also review real-world effectiveness across age groups, pregnancy, and populations that are immunocompromised, along with the effects on transmission.

我们还回顾了在不同年龄组、妊娠期以及免疫功能受损人群中疫苗的实际效果，以及其对传播的影响。

Last, we address public perception and vaccine confidence, and discuss implications for next-generation mRNA vaccines, including strategies to reduce reactogenicity, improve breadth and durability of immunity, enhance global access, and support sustainable public trust.

最后，我们讨论公众对mRNA疫苗的看法和接种信心，并探讨下一代mRNA疫苗的含义，包括减少反应性、提高免疫的广度和持久性、增强全球可及性以及支持可持续的公众信任的策略。

Together, the accumulated evidence affirms mRNA vaccines as a safe, effective, and adaptable platform with enduring relevance for future infectious disease prevention and public health preparedness, and for the treatment of cancer and autoimmunity.

综合累积的证据，mRNA疫苗被证实是一种安全、有效且适应性强的平台，对于未来传染病预防和公共卫生准备，以及癌症和自身免疫性疾病的治疗具有持久的相关性。