ACC Guidance: Vaccination in Cardiovascular Disease
ACC Guidance: Vaccination in Cardiovascular Disease
Source: Journal of the American College of Cardiology (JACC) – August 28, 2025
1. Core Recommendation
• Adults with cardiovascular disease (CVD) should receive vaccines against:
* Influenza
* COVID-19
* Respiratory syncytial virus (RSV)
• Other vaccines (pneumococcal, shingles) may also provide cardiovascular protection.
2. Rationale
• Respiratory illness increases cardiac workload, leading to dyspnea, chest pain, hospitalization, or death.
• Vaccination may not prevent infection but reduces severity and complications.
3. Evidence & Endorsements
• ESC (2025 consensus): Vaccination should be considered the “fourth pillar” of CVD prevention (after antihypertensives, lipid-lowering drugs, and diabetes meds).
• Data:
* 5% rise in flu activity → 24% rise in HF hospitalizations.
* COVID-19 strongly linked to new/worsened CVD.
* RSV, parainfluenza, adenovirus, pneumococcal infections increase CVD morbidity and mortality.
4. Vaccine Uptake (US Data)
• < 50% adults vaccinated for influenza (2024).
• < 25% for COVID-19 and RSV vaccines.
• FDA (Aug 2025): New updated COVID-19 vaccines approved, with priority for high-risk groups such as CVD patients.
5. Barriers to Vaccination
• Patient unawareness of link between heart disease and infection risks.
• Specialty clinics not structured to provide vaccines.
• Copays and access issues may deter patients.
6. Supporting Data (AHA Research)
• ~20% of adults hospitalized with RSV had MI or HF.
• COVID-19 → higher risk of HF, arrhythmia, CAD.
• Risk of MI ↑ sixfold in the week after influenza.
7. Practical Guidance
• Cardiologists should use clinic visits to educate and recommend vaccination.
• Health plans still required to cover many vaccines at no charge.
