Junwoo Leea, Dongwoo Khanga,b,c,d
aCollege of Medicine, Gachon University, Incheon 21999, South Korea
bLee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, South Korea
cGachon Advanced Institute for Health Science & Technology, Gachon University, Incheon 21999, South Korea
dDepartment of Physiology, College of Medicine, Gachon University, Incheon 21999, South Korea
Corresponding author: Dongwoo Khang
Despite the global administration of approved COVID-19 vaccines (e.g., ChAdOx1 nCoV-19®, mRNA-1273®, BNT162b2®), the number of infections and fatalities continue to rise at an alarming rate because of the new variants such as Omicron and its subvariants. Including COVID-19 vaccines that are licensed for human use, most of the vaccines that are currently in clinical trials are administered via parenteral route. However, it has been proven that the parenteral vaccines do not induce localized immunity in the upper respiratory mucosal surface, and administration of the currently approved vaccines does not necessarily lead to sterilizing immunity. This further supports the necessity of a mucosal vaccine that blocks the main entrance route of COVID-19: nasal and oral mucosal surfaces. Understanding the mechanism of immune regulation of M cells and dendritic cells and targeting them can be another promising approach for the successful stimulation of the mucosal immune system. This paper reviews the basic mechanisms of the mucosal immunity elicited by mucosal vaccines and summarizes the practical aspects and challenges of nanotechnology-based vaccine platform development, as well as ligand hybrid nanoparticles as potentially effective target delivery agents for mucosal vaccines.