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Kofidameran (ARCT-154) is a self-amplifying messenger RNA (sa-mRNA) vaccine developed for the prevention of COVID-19. Unlike conventional mRNA vaccines, kofidameran incorporates genetic circuitry derived from an alphavirus (typically Venezuelan equine encephalitis virus) that encodes a viral replicase. Once delivered into host cells via lipid nanoparticles, this replicase enables the mRNA to self-replicate, leading to sustained and high-level expression of the SARS-CoV-2 spike protein antigen. This mechanism allows for a significantly lower dose compared to standard mRNA vaccines while maintaining a robust and durable immune response, including both neutralizing antibodies and T-cell activation. Developed by Arcturus Therapeutics in partnership with CSL Seqirus and Meiji Seika Pharma, it became the first sa-mRNA vaccine to receive full regulatory approval globally when it was authorized in Japan in November 2023.
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