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ESC Designates Vaccination as Fourth Pillar of Cardiovascular Prevention

New evidence links infections to acute cardiovascular events, reinforcing calls for seasonal vaccination of older and high‑risk adults.

Overview

  • An extensive University of California meta-analysis published in the Journal of the American Heart Association finds the first four weeks after infection carry sharply higher risks, including roughly 5× higher stroke and 4× higher heart-attack risk after influenza and 3.1× and 2.9× increases for heart attack and stroke after SARS‑CoV‑2.
  • The European Society of Cardiology now treats targeted immunization as a formal, standalone prevention measure for heart disease, reflecting mounting data that infections precipitate cardiovascular events.
  • National advisors reiterate age- and risk-based recommendations, with Austria offering free influenza and pneumococcal shots for people 60+ and Germany’s STIKO advising annual flu and COVID‑19 boosters plus indicated RSV, zoster and HPV vaccines.
  • Coverage remains poor: about one third of over‑60s receive the flu shot, roughly 20% are vaccinated against pneumococci, and only 16% obtained a COVID booster in winter 2023/24.
  • Studies associate vaccination with fewer cardiovascular events, including about a 34% reduction after influenza vaccination and around a 10% reduction with pneumococcal vaccination in older adults, while proposed mechanisms involve infection-driven inflammation and coagulation; most events cluster in December–February.