Abstract
Their extraordinary efficacy notwithstanding, the parenterally administered mRNA vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have proven incapable of preventing breakthrough infections in otherwise fully vaccinated subjects.1 Interpersonal transmission of SARS-CoV-2 through respiratory droplets and aerosols by fully vaccinated subjects has also proven resistant to vaccine-induced immunity.1 These relative shortcomings of the parenterally administered mRNA vaccines are hardly unanticipated because upper airway protection against SARS-CoV-2 replication and shedding requires local mucosal rather than systemic humoral immunity.
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