The ACC has released an updated Concise Clinical Guidance document addressing "Adult Immunizations as Part of Cardiovascular Care," providing clinicians with vaccine-specific guidance related to the influenza, pneumococcal, COVID-19, RSV and zoster (shingles) vaccines, respectively. The document integrates guidance from existing ACC/AHA guidelines, the American College of Physicians, and the Centers for Disease Control and Prevention and discusses the latest evidence tied to vaccine benefits, along with strategies for improving vaccination rates and overcoming barriers linked to access and vaccine hesitancy. Read the full document in JACC.

Key Updates

Led by Chair Paul A. Heidenreich, MD, FACC, and Vice Chair Ankeet Bhatt, MD, key updates from the new document include a focus on recent vaccine effectiveness studies confirming the benefits of the RSV vaccines. "Patients with heart disease face a higher risk of adverse outcomes, including hospitalization and death, following [RSV] compared with the general population," the authors write. "Additionally, the likelihood of infection after exposure may be elevated in this population."

High-dose vs. standard-dose influenza vaccinations in adults over the age of 65 are also recommended based on recent findings from large, randomized trial showing lower rates of hospitalization for respiratory disease, cardiovascular disease and heart failure.

Shared Decision-Making

Shared decision-making as a means of ensuring optimal patient care is another focus of the document, with authors noting the importance of care decisions "jointly reflecting patient preferences and clinician judgement, particularly in areas of clinical uncertainty."

In general, the document underscores "that adverse health effects from vaccination are exceedingly rare and are far outweighed by the demonstrated benefits, particularly in patients with heart disease." Clinicians should use the document to support, not replace, clinical decision-making and seek expert input when appropriate.