July 10, 2026Journal of Clinical Medicine0 citationsOpen Access
View Full PaperInfluenza Vaccination as Cardiovascular Prevention in Adults with Heart Disease
Key Result
Influenza vaccination reduces major adverse cardiovascular events and mortality in higher-risk secondary-prevention populations, with high-dose vaccines showing benefits in adults aged ≥65 years.
Key Points
- This research aims to assess the role of influenza vaccination as a preventative measure in adults with cardiovascular disease.
- Evaluation of randomized trials and meta-analyses focusing on influenza vaccination in adults with cardiovascular disease.
- Comparison of high-dose influenza vaccine, standard-dose vaccine, and placebo across various healthcare settings.
- Inclusion of pragmatic trials such as DANFLU-2 and GALFLU for evidence on hospitalization outcomes.
- High-dose influenza vaccination significantly reduces major adverse cardiovascular events in older adults (HR not specified).
- Substantial declines in cardiovascular mortality and all-cause mortality post-myocardial infarction with vaccination support (HR and statistics not provided).
- Increased hospitalization reduction for influenza or pneumonia and heart failure with high-dose vaccination in adults 65 and older.
Structured PICO
Does influenza vaccination reduce major adverse cardiovascular events and mortality in adults with established cardiovascular disease?
P
Population
Adults with established cardiovascular disease, particularly older adults and patients with recent acute coronary syndrome or heart failure
I
Intervention
Influenza vaccination (standard-dose or high-dose inactivated)
C
Comparator
Placebo, no vaccination, or standard-dose vaccination
O
Outcome
Major adverse cardiovascular events, cardiovascular mortality, all-cause mortality, and hospitalizations (influenza/pneumonia, cardiorespiratory, heart failure)hard clinical
Influenza vaccination is an evidence-supported component of cardiovascular prevention that reduces major adverse cardiovascular events and mortality in adults with established heart disease.
Abstract
Seasonal influenza is not only a respiratory infection but also a clinically relevant trigger of acute cardiovascular events. In adults with established cardiovascular disease, particularly older adults and patients with recent acute coronary syndrome or heart failure, influenza vaccination should be considered a low-risk, evidence-supported component of cardiovascular prevention rather than solely protection against respiratory disease. The evidence addresses three related but distinct questions: influenza infection as a cardiovascular trigger; influenza vaccination versus placebo or no vaccination; and enhanced or high-dose vaccination versus standard-dose vaccination. Randomized trials and meta-analyses support reductions in major adverse cardiovascular events, cardiovascular mortality, and all-cause mortality in higher-risk secondary-prevention populations, with particularly persuasive evidence after myocardial infarction. Recent pragmatic active-comparator trials of high-dose inactivated influenza vaccine, including DANFLU-2 and GALFLU, and the individual-level pooled FLUNITY-HD analysis provide incremental evidence in adults aged 65 years or older, strongest for hospitalization for influenza or pneumonia, cardiorespiratory hospitalization, and heart failure hospitalization. The current priority is implementation: screening, offering, documenting, and communicating vaccination across hospitalization, outpatient cardiology, cardiac rehabilitation, heart failure pathways, primary care, pharmacies, and long-term care. Influenza vaccination should complement, not replace, established guideline-directed cardiovascular therapies.