In a bid to protect those with heart disease, the American College of Cardiology today has issued Concise Clinical Guidance (CCG) recommending vaccines for this adult patient population against influenza, COVID-19, RSV, and other diseases where vaccination is shown to offer cardiovascular protective benefits. The guidance is in this document, and also provides detailed evidence for each vaccine recommendation and answers to frequently asked questions to guide conversations between clinicians and patients.1
The college is communicating the importance of immunize thispatient population against severe disease, hospitalization and death.
“Vaccination against communicable respiratory diseases and other serious diseases is critical for people with heart disease, but barriers exist to ensuring people are educated on which vaccines to get, how often to get them and why they are important,” Paul Heidenreich, MD, FACC, chair of the CCG writing committee, said in a statement. “With this document, we want to encourage clinicians to have these conversations and help their patients manage vaccination as part of a standard prevention and treatment plan.”
The ACC issued this CCG to consolidate vaccine-specific recommendations made by ACC/American Heart Association guidelines and the Centers for Disease Control and Prevention.
What You Need to Know
Vaccination is strongly recommended for adults with heart disease against influenza, COVID-19, RSV, pneumococcal disease, and shingles, as these vaccines can reduce risks of severe illness, hospitalization, cardiovascular events, and death.
The ACC emphasizes clinician-patient conversations to overcome barriers such as vaccine hesitancy, confusion about schedules, and lack of awareness, integrating vaccination into routine cardiovascular care.
The guidance consolidates evidence-based recommendations from the ACC, AHA, and CDC, highlighting both respiratory and non-respiratory vaccines (like shingles) that may provide cardiovascular protective benefits.
The guidance mainly focuses on respiratory vaccines but also offers guidance based on emerging evidence that other vaccines—such as the herpes zoster (shingles) vaccine—may offer cardiovascular protective benefits.
Vaccine specific guidance includes:
- Influenza. An annual flu vaccine is recommended for all adults to reduce cardiovascular morbidity, cardiovascular mortality and all-cause death. Nasal versions of the vaccine are not recommended in patients over 50.
- Pneumococcal. recommended for adults 19 or older with heart disease to get this one-time vaccine to protect against pneumonia, bacteremia and meningitis and related risk of hospitalization and death. Following CDC/Advisory Committee on Immunization Practices recommendation, the guidance advises a single dose of PCV20 or PCV21, or PCV15 followed by PPSV23 depending on prior vaccination history.
- COVID-19. For the 2024–25 season, all adults with heart disease were recommended to receive the seasonal COVID-19 vaccine. Future vaccination frequency may change, but it is likely vaccination will remain beneficial for those with heart disease. Benefits include reduced risk of infection, severe infection, death, heart attack, COVID-19 induced pericarditis/myocarditis, COVID-19 induced stroke and atrial fibrillation, and long COVID symptoms.
- RSV. recommended for adults 75 or older and for adults aged 50–74 with heart disease to protect against lower respiratory disease that can result in hospitalization and death. Current guidance recommends a single dose, rather than annual vaccination.
- Shingles. recommended for adults 50 or older to receive two doses to protect against increased risk of stroke and heart attack when infected. People with heart disease are at an increased risk of shingles infection.
In addition, the document outlines strategies to improve vaccination rates, address hesitancy and overcome barriers to access, noting that clinician-patient discussions about vaccination during cardiology visits can be an important opportunity to integrate vaccination into a cardiovascular care plan.
Reference
1.American College of Cardiology issues vaccine guidance for adults with heart disease ACC press release. August 26, 2025. Accessed August 26, 2025.
https://www.eurekalert.org/news-releases/1095588?
