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Peer reviewedOpen accessSARSCOVID-19

Mucosal COVID-19 vaccines in clinical development

Vaccine·

Alina Tscherne, Weina Sun, Sean T.H. Liu, Florian Krammer

DOI
10.1016/j.vaccine.2025.127602
PMID
40848675
PMCID
OpenAlex
W4413414701
Study type
Journal article
Publisher
Elsevier BV
Article type
journal-article
Integrity
current

Why this research matters now

Mucosal COVID-19 vaccines may efficiently prevent infection and transmission by inducing immune responses at the site of viral entry, potentially reducing virus circulation in the population. The needle-free administration by non-medical personnel could improve vaccine accessibility and uptake.

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Structured evidence summary

Research question

The review examines the current development status of mucosal COVID-19 vaccines, their ability to elicit systemic and mucosal immunity in the upper respiratory tract, and their potential to prevent infection and transmission of SARS-CoV-2.

Study design

This is a narrative review synthesizing findings from preclinical studies in small animal models and non-human primates, early phase clinical trials, and the development status of at least 28 mucosal COVID-19 vaccines currently in clinical testing across different vaccine platforms.

Population and setting

The review covers preclinical animal models (small animals and non-human primates) and human participants in early phase clinical trials of mucosal COVID-19 vaccines. Five vaccines are already approved or licensed, with at least 28 others in clinical development.

Main findings

Preclinical studies and early phase clinical trials confirmed that mucosal COVID-19 candidate vaccines can induce long-lasting immunity and provide protection against SARS-CoV-2 infection. These vaccines are designed to elicit both systemic and mucosal immune responses in the upper respiratory tract, potentially preventing infection and reducing transmission. They offer the advantage of administration by non-medical personnel without needles.

Public-health relevance

Mucosal COVID-19 vaccines may efficiently prevent infection and transmission by inducing immune responses at the site of viral entry, potentially reducing virus circulation in the population. The needle-free administration by non-medical personnel could improve vaccine accessibility and uptake.

Important limitations

Clinical data for most conducted and completed trials are not publicly available. Several initiated trials have been terminated or withdrawn. This summary relies on the supplied single-article abstract and metadata; the original paper and supplementary materials are required for decision-grade interpretation.

GIDS interpretation

This review is discoverable through disease classifiers for SARS and COVID-19, and topic classifiers for outbreak investigation, transmission dynamics, and vaccination. It provides context on the development pipeline for next-generation vaccines designed to address transmission, though it does not report primary surveillance data or link to a specific outbreak signal.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 11 auditable classifier relationships to diseases, places, topics, and study design.

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