Vaccination as a Novel Pillar in Cardiovascular Disease Prevention.

The European Society of Cardiology (ESC), in collaboration with its partner associations, has released a landmark clinical consensus statement positioning vaccination as a core component of cardiovascular (CV) prevention. Traditionally aimed at infection control, vaccines such as those against influenza, pneumococcus, SARS-CoV-2, herpes zoster, and respiratory syncytial virus (RSV) are now supported by accumulating evidence for their role in reducing major adverse cardiovascular events (MACE).

Respiratory infections have been consistently linked to increased cardiovascular risk, particularly among vulnerable groups like the elderly, heart failure patients, individuals with coronary artery disease (CAD), congenital heart disease (CHD), and transplant recipients. The consensus highlights mechanisms such as inflammation, plaque destabilization, and increased myocardial oxygen demand as critical links between infections and cardiovascular events.

Among the vaccines, the influenza vaccine stands out with robust evidence from randomized controlled trials and meta-analyses showing a reduction of up to 41% in cardiovascular mortality post-myocardial infarction. Similar trends have been observed with pneumococcal vaccines, which confer a modest but meaningful 10% reduction in CV events in older adults, and herpes zoster vaccination, associated with a >50% reduction in CV events post-reactivation.

COVID-19 vaccination, despite concerns regarding rare myocarditis cases—especially in young males—continues to be recommended due to the significantly higher cardiovascular risk associated with SARS-CoV-2 infection itself, including long COVID. For heart transplant recipients and immunocompromised patients, tailored vaccination schedules are advised, with a preference for inactivated vaccines.

Importantly, the ESC statement calls for broader implementation strategies, recommending vaccination during hospitalizations for acute coronary syndromes and emphasizing the role of all healthcare professionals—not just primary care—in vaccination promotion. The document also urges the development of combined seasonal vaccines and further research into immunization’s pleiotropic anti-inflammatory and atheroprotective effects.

Vaccination now joins statins, antihypertensives, and antidiabetic therapies as a recognized pillar in the cardiovascular prevention paradigm, reinforcing the shift towards more integrated and preventive models of care.

Editorial note: This content was developed with the support of artificial intelligence technologies to optimize the writing and structuring of the information. All material was carefully reviewed, validated, and supplemented by human experts prior to publication, ensuring scientific accuracy and adherence to good editorial practices.

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