From pathogen defence to precision health infrastructure: mRNA vaccines beyond infectious disease in preventive health, chronic disease management, and population wellbeing.

Messenger RNA (mRNA) vaccine technology is often portrayed as a pandemic-era innovation for infectious disease control, but this perspective no longer reflects its expanding clinical and societal significance. Although global attention intensified during the SARS-CoV-2 pandemic, mRNA platforms are founded on more than three decades of pre-pandemic research in cancer immunotherapy and experimental vaccinology. Emerging evidence demonstrates that programmable RNA technologies can extend beyond pathogen prevention into oncology, immune modulation, protein replacement, cardiovascular risk reduction, and population-level preventive medicine. Nevertheless, existing literature remains fragmented across disciplines and lacks a unifying framework explaining how a single platform can simultaneously support prevention, therapy, and health-system resilience. This narrative review addresses this gap by synthesising literature from PubMed, Scopus, and Web of Science, emphasising studies published between 2018 and 2025 while retaining seminal pre-2018 mechanistic contributions. We integrate mechanistic, translational, and policy evidence to propose that mRNA vaccines should be reconceptualised as adaptive health infrastructure rather than single-purpose biologics. We introduce the Adaptive Preventive Therapeutics Continuum (APTC), a framework positioning mRNA intervention along a spectrum from anticipatory prevention to chronic disease management and precision restoration of physiological function. The central innovation of mRNA technology lies not only in rapid manufacturing but also in its programmable temporality the capacity to generate transient, titratable, and updateable biological responses tailored to disease stage and population need, thereby supporting resilient and adaptable healthcare systems.