The Lancet in conversation with
Jul 31, 2026 · 24 min · 11 segments
What are mRNA vaccine, how do they work, and how might they be used for in the future? And why is there a gap between the evidence and some people’s perception of their safety and efficacy? Niall…
Anna BlakneyGuest
Niall BoyceHost
I've, I've been working in the field for 10 years now, so actually, in 2016, it was, yeah, a much smaller field, and there was a lot less known about them in general.
So I kind of stumbled upon it for my postdoctoral training and just thought there was a lot of potential in the platform and a lot to learn about the technology, so that's how I really got interested in it, in it in the first place.
So, so just remind us, how exactly do mRNA vaccines work? How are they different to, to the vaccines that, that we've known about for, for centuries, indeed things like smallpox vaccines?
So I like to think about it from, like, what we're trying to accomplish with a vaccine and h- the different ways we might accomplish that.
So with any vaccine, we're trying to train your immune system to recognize a foreign pathogen without being exposed to that foreign pathogen.
Like, we don't want you to get an infection, but we want your immunity to be able to be trained against it.
So historically, you know, one of the first ways we did it was just by inactivating a virus or a bacteria and using that as a vaccine.
Then, as technology progressed, we moved on to being able to do this with, say, recombinant proteins, so just taking a part from the surface of a virus, for example, and being able to manufacture that and then inject that into people as a vaccine.
And how mRNA does this differently is instead of manufacturing the protein or growing up a virus, which is really time and resource intensive, instead, we use a patient's cells as the bioreactor.
We give them the code to make that protein, and they make the protein themselves and, and train your immune system against it.
So advantage of this and why everybody was pushing to move towards this is really for, like, scalability and cost and manufacturing reasons.
It's just a lot easier to manufacture an mRNA than it is a, a new protein or a virus, especially in the context of an outbreak.
So essentially, when I got the mRNA vaccine, my body was doing the manufacturing instead of it happening in some, some piece of laboratory equipment.
I've, I've been working in the field for 10 years now, so actually, in 2016, it was, yeah, a much smaller field, and there was a lot less known about them in general.
So I kind of stumbled upon it for my postdoctoral training and just thought there was a lot of potential in the platform and a lot to learn about the technology, so that's how I really got interested in it, in it in the first place.
So, so just remind us, how exactly do mRNA vaccines work? How are they different to, to the vaccines that, that we've known about for, for centuries, indeed things like smallpox vaccines?
So I like to think about it from, like, what we're trying to accomplish with a vaccine and h- the different ways we might accomplish that.
So with any vaccine, we're trying to train your immune system to recognize a foreign pathogen without being exposed to that foreign pathogen.
Like, we don't want you to get an infection, but we want your immunity to be able to be trained against it.
So historically, you know, one of the first ways we did it was just by inactivating a virus or a bacteria and using that as a vaccine.
Then, as technology progressed, we moved on to being able to do this with, say, recombinant proteins, so just taking a part from the surface of a virus, for example, and being able to manufacture that and then inject that into people as a vaccine.
And how mRNA does this differently is instead of manufacturing the protein or growing up a virus, which is really time and resource intensive, instead, we use a patient's cells as the bioreactor.
We give them the code to make that protein, and they make the protein themselves and, and train your immune system against it.
So advantage of this and why everybody was pushing to move towards this is really for, like, scalability and cost and manufacturing reasons.
It's just a lot easier to manufacture an mRNA than it is a, a new protein or a virus, especially in the context of an outbreak.
So essentially, when I got the mRNA vaccine, my body was doing the manufacturing instead of it happening in some, some piece of laboratory equipment.
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