A Review of Comparative Strategies Against Pneumonia: Vaccine and Antibiotic Resistance Mitigation

Pneumonia remains a significant global health problem, worsened by the emergence of multidrug-resistant bacterial strains.

This review aims to analyze the role of DNA vaccines in combating pneumonia, comparing them with mRNA vaccines and other innovations in vaccine technology to mitigate this issue.

The research on DNA and mRNA vaccines for pneumonia and their potential to lower antibiotic resistance was studied in this review. A thorough search was carried out in PubMed and Google Scholar using keywords like “pneumonia,” “vaccines,” “DNA vaccines,” “mRNA vaccines,” and “antibiotic resistance.” Additionally, we have also used Web of Science, Scopus, and DOAJ. Title/abstract and full text studies were evaluated in two phases. Preclinical and clinical research, reviews, and meta-analyses assessing the safety, immunogenicity, effectiveness, or influence on antibiotic resistance were among the articles that were used. Letters, conference abstracts, editorials, and irrelevant research were not included. An overview of current advances, obstacles, and public health potential was provided by examining data on vaccination type, pathogen target, delivery mechanism, research design, and major findings.

Findings indicate that DNA vaccines encoding pneumococcal proteins effectively induce both humoral and cellular immunity, thereby reducing the dependence on antibiotics and slowing the development of resistance. Challenges, such as low immunogenicity and weak antibody responses, were identified, requiring improvements in adjuvant formulations and delivery mechanisms. An analysis of delivery systems, particularly highlighting lipid nanoparticles, which have demonstrated significant success in mRNA vaccines, revealed their potential for enhancing DNA vaccine applications due to high efficiency and biocompatibility. LNP-based systems offer superior antigen stability and immune response for DNA vaccines, while intramuscular injection remains the most accessible method for large-scale immunization. Quantitative data highlights efficacy rates for pneumococcal vaccines and alarming trends in S. pneumoniae antibiotic resistance.

DNA vaccines are a promising approach to control pneumonia and reduce antibiotic resistance by stimulating both humoral and cellular immune responses against pathogens, such as Streptococcus pneumoniae. Studies show that DNA vaccines encoding pneumococcal proteins can lower infection severity and antibiotic use; however, limited immunogenicity in humans remains a key challenge. Enhancements through delivery mechanisms, especially lipid nanoparticles (LNPs), have been shown to strengthen antigen expression and immune activation. Compared with mRNA vaccines, DNA vaccines are more stable, cost-effective, and easier to store, while mRNA vaccines offer higher immunogenicity but require cold-chain storage. Continued advancements in delivery systems, adjuvant technologies, and clinical evaluation are essential to maximize their public health impact.

Despite their current limitations, DNA vaccines demonstrate significant potential in mitigating antibiotic resistance and reducing pneumonia-related mortality. Additionally, when compared with mRNA vaccines, they also appear well-suited for combating pneumonia pathogens. Continued research and development in delivery systems and adjuvant technologies are crucial to overcome existing challenges and fully realize the therapeutic promise of DNA and mRNA vaccines in public health.