Living With Heart Disease? Don’t Skip These Vaccines, Cardiology Group Says
A leading cardiology association just recommended 5 vaccines to protect against potentially severe infections that can raise the risk of heart attack and stroke.
The new guidelines are designed to help educate people with heart disease on which vaccines to get, how often to get them, and why they’re important, says Paul Heidenreich, MD, a cardiologist and professor of medicine at Stanford Medicine in California. Dr. Heidenreich served as the writing committee chair for the new recommendations.
People with heart disease are also much more susceptible to severe complications from respiratory infections than people without heart disease, says Christopher Kelly, MD, a cardiologist at UNC Health in Chapel Hill, North Carolina.
Heidenreich says this is partly because the heart and lungs are connected and depend on each other. “If the lungs are damaged from infection, the person’s breathing is worse if they also have heart disease,” he explains.
Inflammation from an infection can also worsen heart disease, Dr. Kelly says.
“During the COVID pandemic, people with preexisting heart conditions were more likely to become critically ill or die as a result of infection,” says Kelly, who wasn’t involved in drafting the guidelines.
The ACC committee was made up of five professors of medicine from around the United States. Two committee members are consultants for drug companies, and three had no ties to the pharmaceutical industry.
The committee recommends the following vaccines for people with heart disease:
Recommendation Annual flu shot for all adults. High-dose or enhanced versions for adults age 65 and older. Nasal spray vaccines are not recommended for anyone older than 50.
Recommendation One dose of PCV20 or PCV21 for adults ages 19 and up with heart disease. All adults 50 years and older are also advised to receive the vaccine. PCV15 is an option but must be followed by PPSV23.
Recommendation Last year (2024–2025 season), the CDC recommended a seasonal COVID vaccine for everyone with heart disease. Advice on vaccine frequency may change in the future, but it’s likely that the vaccine will continue to be recommended for people with heart disease.
Recommendation One-time RSV vaccination for all adults 75 and older, and for adults ages 50–74 with chronic conditions like heart disease. Right now, the RSV vaccine is not recommended as an annual vaccine — guidance on that is pending.
Recommendation Two shingles vaccine doses for all adults 50 and older, spaced two to six months apart.
The guidelines also included answers to the most common questions about vaccines.
Are vaccine side effects serious? No. Most reactions are mild, such as a sore arm and fatigue. Severe side effects are extremely rare, and the benefits for people with heart disease far outweigh the risks.
What about myocarditis from COVID-19 vaccines? Although rare, mRNA COVID-19 vaccines have been linked to a small risk of myocarditis (heart inflammation), most often in younger men. This side effect occurs in about 1 to 19 cases per million doses and is usually mild, with nearly all people making a full recovery. It’s important to note that vaccine-related myocarditis poses less of a health risk and is more benign than COVID-19 infection-related myocarditis.
Can I get multiple vaccines at once? Yes, and it may be more efficient. The only exception is that PCV15 and PPSV23 (two types of pneumonia shots) should not be given together. You may also choose to space out various vaccines to avoid experiencing several side effects at once, says Heidenreich.
Will insurance cover vaccines? Under the Affordable Care Act, CDC-recommended vaccines must be covered at no cost.
Still not convinced? Talk with your doctor. “As a cardiologist, I strongly recommend that my patients receive all age-appropriate vaccinations. People who are reluctant to undergo vaccination should discuss their concerns with their physician and seek information from primary sources, such as clinical research trials,” says Kelly.
Despite what you may hear, all vaccines are subjected to randomized, double-blind clinical trials that identify their risks and benefits — and you can usually find and review the studies if you want to read them yourself, he says.
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