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Adapted mRNA COVID-19 vaccines are second-generation messenger RNA vaccines designed to provide enhanced protection against SARS-CoV-2 variants, particularly the Omicron lineage. These vaccines, such as the bivalent formulations of Comirnaty (BioNTech/Pfizer) and Spikevax (Moderna), utilize lipid nanoparticle technology to deliver mRNA sequences encoding the spike protein of specific variants (e.g., BA.1 or BA.4/5) alongside or instead of the original ancestral strain. Upon administration, host cells translate the mRNA into viral proteins, triggering both humoral (antibody) and cellular (T-cell) immune responses. In the context of a prospective observational study conducted by the University Hospital Bonn (Universitätsklinikum Bonn), these vaccines were evaluated in high-risk healthcare employees to assess the durability of adaptive immunity and the influence of physical fitness on infection outcomes.
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