mRNA Reenters the Mainstream

Different Respiratory Disease, Same Technology

In early August this year, mFlusiva (mRNA-1010; Moderna) was approved as the first messenger RNA (mRNA) influenza vaccine, labeled for adults 50 years and older. Based on favorable immunogenicity findings against high-dose conventional vaccines, prescribers may also consider mFlusiva for patients 65 years and older instead of the high-dose vaccination. With a 26.6% relative vaccine efficacy compared with standard-dose therapy, mFlusiva may be a worthwhile option not only for patients with egg allergy concerns but also for the broader at-risk older population.¹

Of course, mRNA vaccines entered the consciousness of health care providers and the public approximately 6 years ago, when COVID-19 was sequenced in early 2020; a vaccine entered trials within a few months, and production and distribution followed within an impressive 12 months of the virus’s discovery.²

Turnaround Time and Reliance on Helping the Body Defend Itself

One advantage of mRNA technology is the short turnaround time from identifying a sequence to producing a matching mRNA product. This is especially valuable for infectious diseases caused by pathogens such as viruses, which mutate rapidly into new strains. Reducing the time from pathogen identification to distribution lowers the odds that new, uncovered mutations will emerge before the vaccine reaches patients. Of course, the vaccine itself does not attack the pathogen; it helps the body ramp up its own immune response to provide protection.

Not Just Infectious Diseases

It’s not just viruses, bacteria, and parasites that we can stimulate the body to respond to. Some of the most exciting work is in oncology, using mRNA to trigger the immune system to attack tumors. In theory, anything that can be sequenced can be encoded into an mRNA product; delivery methods are then designed to protect that mRNA from degradation long enough to stimulate the body’s own immune response, biomedically speaking.

mRNA’s Targeting Capabilities Are Profound

From rotavirus to varicella-zoster virus, respiratory syncytial virus, cytomegalovirus, human papillomavirus, Epstein-Barr virus, rabies, HIV, and mpox, mRNA applications extend well beyond influenza and COVID-19. Oncology, immunodeficiencies, and even durable protein production to treat or cure additional diseases are also within reach. The mRNA therapy market is expected to grow from $63.7 billion in 2025 to nearly $247 billion by 2034, according to Market Data Forecast.³

Individualized Therapies Right Around the Corner

Part of that market growth could come from individualized therapies designed by machines that use artificial intelligence (AI). Triggered by a recent blood draw, biopsy, or other laboratory workup, these machines determine a patient’s specific pathologic and chronic disease needs, then order the requisite mRNA and delivery vehicle for production and administration to the patient. Expect the longevity medicine crowd to keep a watchful eye on the concierge-level capabilities of mRNA technology and applications that could be offered.

What Will Be Society’s Response to the Social Reemergence of mRNA?

This fall will mark the first big reminder to the masses of mRNA technology and the origins of the COVID-19 vaccine and response. What’s unknown is whether the animosity toward the COVID-19 vaccine, its rollout, and the subsequent social media fallout was related more to mRNA technology or to the COVID-19 response itself. KFF has been asking about vaccine hesitancy and foundational beliefs for a few years now, providing instructive insights.

In KFF’s most recent tracking survey from June 2026, 27% of adults in the United States believe the following statement is “definitely true” or “probably true”: “More [individuals] have died from the COVID-19 vaccines than have died from the COVID-19 virus.” This is up 7 percentage points from 20% of respondents in 2023. That’s despite a reduction of 5 percentage points in those believing that “mRNA vaccines can change your DNA” is “definitely true” or “probably true,” from 29% to 24%. One of the biggest factors reducing belief in vaccine myths is having a trusted health care provider: Forty-six percent of respondents without a trusted health care provider believe more individuals died from the COVID-19 vaccine than the virus vs 24% of those who have one. Social media use, AI chatbot use, and lack of a college education were also strongly correlated with belief in vaccine myths.

Investment in mRNA Technology at a Crossroads

A total of 244 mRNA products are in the development pipeline, with approximately half designed to target communicable diseases and the other half noncommunicable diseases.⁴ Of those, 102 are slated for oncology. Whether COVID-19 caused mRNA hesitancy, mRNA caused COVID-19 vaccine hesitancy, or both, the conversation changes substantially when a trusted health care provider says, “You have cancer, and the best available therapy uses the latest mRNA technology.” It’s a good bet that more than the roughly two-thirds of Americans who do have trust in mRNA would respond with, “Yes, please give me access to that therapy.”

A reported 557 clinical trials are currently underway, indicating research and development with mRNA technologies is robust.⁵ Yet, it might be even larger if we didn’t let mRNA and vaccine myths impede greater investment in mRNA technologies. We need to maintain or grow our global commitment to to mRNA technologies and early-stage research through both government- and privately funded research and development, led by the US. Some of the most exciting, innovative, and important therapeutics are near the cusp of becoming a reality at a time when we are taking a relative foot off the pedal.

At 48 years of age, I hope to benefit from continued medical research—evidence-based and regulated to be safe and efficacious—whether to treat disease, prevent disease, or live a healthier, active lifestyle into my 90s and beyond. As a pharmacy workforce, licensed or otherwise, grounded in the scientific process and delivering life-improving and lifesaving medications to patients every day, we should be thankful to all the scientists, taxpayers, and investors who make that possible.⁵

About the Author

Troy Trygstad, PharmD, PhD, MBA, is executive director of CPESN USA, a clinically integrated network of more than 3500 participating pharmacies. He received his Doctor of Pharmacy and Master of Business Administration degrees from Drake University and a doctorate in pharmaceutical outcomes and policy from the University of North Carolina. He has recently served on the board of directors for the Pharmacy Quality Alliance and the American Pharmacists Association Foundation. He also proudly practiced in community pharmacies across North Carolina for 17 years.

REFERENCES

1. mFlusiva. FDA. Updated September 2, 2026. Accessed September 7, 2026. https://www.fda.gov/vaccines-blood-biologics/vaccines/mflusiva

2. Shi Y, Shi M, Wang Y, You J. Progress and prospects of mRNA-based drugs in pre-clinical and clinical applications. Signal Transduct Target Ther. 2024;9(1):322. doi:10.1038/s41392-024-02002-z

3. mRNA market report. Market Data Forecast. Updated July 2026. Accessed September 7, 2026. https://www.marketdataforecast.com/market-reports/mrna-market

4. Moschioni M, Siraji RA, Dissard R, et al. mRNA vaccines and therapeutics beyond COVID-19: a review of the global clinical development landscape, low- and middle-income countries involvement and relevance to their contexts. Hum Vaccin Immunother. 2026;22(1):2628424. doi:10.1080/21645515.2026.2628424

5. Li Q, Zeng M, Lv W, Ye J, Wu S. Current landscape of clinical trials for mRNA-based therapeutics. Hum Vaccin Immunother. 2026;22(1):2635868. doi:10.1080/