For adults with heart disease, annual vaccination against the flu, COVID-19, respiratory syncytial virus (RSV), and other respiratory illnesses are especially important. That’s the message stressed in new guidelines published in August in the Journal of the American College of Cardiology.
Ankeet Bhatt, MD, MBA, a research scientist at the Kaiser Permanente Division of Research and a cardiologist with Kaiser Permanente in San Francisco, helped write the new guidelines. We spoke with Dr. Bhatt about why vaccines are especially important for people with heart disease.
Why did the American College of Cardiology publish these clinical guidelines?
For people with heart disease, routine vaccination against the flu and other respiratory illnesses can mean the difference between a mild illness and a severe infection requiring hospitalization. Our goal was to make it easy for clinicians to have the information they need to talk to patients about the benefits of vaccination and address any questions.
What do the studies show?
People with heart disease are more likely to become ill when exposed to a respiratory virus. They also have a higher risk of hospitalization or death. Studies have shown that vaccination reduces these risks. Vaccination against flu, COVID-19, and RSV may also reduce the risk of heart attacks and heart failure.
The American College of Cardiology clinical guidance mainly focuses on respiratory vaccines. But it also notes that there is new evidence, suggesting other vaccines — such as the herpes zoster (shingles) vaccine — may also help keep the heart healthy.
As a cardiologist, what do you want your patients to know about vaccines.
Getting more people vaccinated against the flu is an important public health goal.
These vaccines are especially important for people who have pre-existing heart conditions, because we know vaccination can reduce risks of complications, hospitalization, or death.
Currently, less than half of U.S. adults receive an annual flu vaccine. And among certain groups, flu vaccination rates are declining. One recent study found that older adults, men, and more educated adults were less likely to receive the flu vaccine in 2024 than they were in 2022. Yet, the flu causes more than 40,000 deaths in U.S. adults each year, and those with heart disease and other cardiovascular-related risk factors are most at risk for flu-related complications.
When patients see their cardiologists, they want to talk about their heart health, and we want to be sure vaccines are part of that conversation.
Current vaccination recommendations from the American College of Cardiology and the Centers for Disease Control and Prevention
- Influenza: An annual flu vaccine is recommended for all adults. Nasal versions are not recommended in patients over 50.
- Pneumococcal: The one-time vaccine is recommended for adults 19 or older with heart disease to protect against pneumonia, bacteremia, meningitis, and related risk.
- COVID-19: All adults with heart disease should receive the 2024-2025 COVID-19 vaccine.
- RSV: A single dose of this vaccine is recommended for all adults 75 or older and for adults 50-74 with heart disease.
- Shingles: This vaccine is recommended for adults 50 or older; it is given in 2 doeses.
