ACC Releases Respiratory Disease Vaccination Guidelines for Adults with Heart Disease

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Paul Heidenreich, MD | Image Credit: Stanford University

On August 26, 2025, the American College of Cardiology released Concise Clinical Guidance (CCG) recommending vaccines to protect adults with cardiovascular disease (CVD) against a variety of respiratory diseases, including COVID-19, respiratory syncytial virus (RSV), and influenza, among others.1

These guidelines also aim to improve access to vaccines, effectively circumventing financial barriers to access, providing accurate and practical education, and assuaging concerns that give rise to vaccine hesitancy and resistance.2

“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.”1

Specific vaccine guidelines include the following:

  • Influenza: the CCG recommends an annual vaccine for individuals aged ≥6 months. Nasal vaccines are not recommended for those over 50 years, and specific vaccines are recommended for those aged ≥65 years.
  • COVID-19: the initial and the 2024-2025 vaccine are suggested for individuals aged ≥6 months. The guidelines note that recommendations for annual vaccination may change due to changes to virus biology.
  • Pneumococcal: a 1-time vaccination of either PCV20 or PCV21 is recommended for adults aged ≥19 years. The guidelines also note that other vaccines will require 2 doses instead.
  • RSV: a 1-time vaccination for adults aged ≥60 years is recommended with no additional comments.2

The CCG also provides ample evidence for each vaccine, as well as answering frequently asked questions to help clinicians address common concerns. Clinician-patient discussions are cited throughout the guidelines as a critical chance to integrate vaccination into cardiovascular care plans. These questions include the possibility of side effects, potential cost barriers, issues with pregnancy, and possible dangers of receiving multiple vaccinations at once.2

Additionally, the guidelines detail strategies to improve rates of vaccination and overcome barriers to access. The most recent CDC Surveillance of Vaccination Coverage Among Adult Populations reported that roughly 30% of primary care physicians assess the vaccination status of adult patients at clinical visits. To that end, the authors suggest more direct approaches to bring patients in for vaccinations, such as mailed letters or automated text messages phrased as reminders to get shots already reserved for patients. These specific examples have been shown to increase vaccination rates during previous trials.2

The guidelines also cite insurance systems, noting an association between having insurance and a higher vaccination uptake. They indicate health systems capable of giving money and support, pointing out that they give significantly better vaccine access to individuals. Those with the ability to provide broader and faster vaccine rollout also had higher uptakes and immunity rates.2

Ultimately, the guidelines remind clinicians that access starts with physician knowledge, which leads to decision-making discussions for vaccine administration.2

“The cardiovascular clinician’s effectiveness will be supported by system strategies described in the preceding text including clinical nudges and clinical ‘vaccine champions’ to optimize vaccine uptake, reduce morbidity, and ultimately improve patient length and quality of life,” wrote Heidenreich and colleagues.2

References
  1. American College of Cardiology. American College of Cardiology issues vaccine guidance for adults with heart disease. Eurekalert! August 26, 2025. Accessed August 28, 2025. https://www.eurekalert.org/news-releases/1095588
  2. A. Heidenreich, P, Bhatt, A, Nazir, N. et al. 2025 Concise Clinical Guidance: An ACC Expert Consensus Statement on Adult Immunizations as Part of Cardiovascular Care: A Report of the American College of Cardiology Solution Set Oversight Committee. JACC. null2025, 0 (0). https://doi.org/10.1016/j.jacc.2025.07.003

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