Respiratory infections can increase the risk of heart attack, heart failure or stroke. And those with cardiovascular disease are at higher risk of serious illness if infected by, for example, flu or SARS-CoV-2. It’s a two-way street.
The growing evidence linking respiratory disease and cardiovascular health led the European Commission to prioritise vaccination in the EU Safe Hearts Plan published in late 2025.
One of the Flagship Initiatives included in Safe Hearts will see the European Commission prepare a ‘Council Recommendation’ which would support national governments in increasing vaccination against influenza, COVID-19, RSV, pneumococcal disease and herpes zoster (shingles). The aim will be to better identify at-risk individuals who would benefit most from vaccination, and for better monitoring of vaccine uptake in this group.
A European Commission spokesperson told Vaccines Today that the timeline for implementing this Flagship Initiative is currently being worked out, but it is already clear that the European Centre for Disease Prevention and Control (ECDC) will have a key role in improving data monitoring and reporting by 2029.
‘The monitoring of vaccination coverage is essential, which is why we must support Member States in strengthening their electronic registration systems for vaccination and their linkage with electronic health records,’ the Commission spokesperson said. ‘This is to support vaccine coverage monitoring for specific vulnerable groups, such as individuals suffering from or at risk of cardiovascular disease.’
Prof Colin Russell, Co-Chair of the Steering Group on Prevention of Respiratory Infections, says the Council Recommendation should include annual EU-wide targets for flu, COVID-19, RSV and pneumococcal disease. The existing 75% uptake target for flu in at-risk populations should be used as a ‘benchmark’ to increase immunisation rates across the life-course, according to the Steering Group.
‘Concrete targets matter because they make progress measurable,’ Prof Russell told Vaccines Today. ‘A target is not a mandate, but a common goal that helps Member States understand the level of ambition needed to benefit from the full potential of immunisation, best protect the population and reduce the burden of vaccine preventable diseases, and gives all actors a clear landing zone to work towards.’
For targets to be meaningful, he added, they must be supported by practical measures that make immunisation easier to access. This includes reminder systems, removing unnecessary prescription requirements, and using existing healthcare visits to deliver additional recommended immunisation, among other measures.
Prof Russell, a professor at the University of Amsterdam School of Medicine, also highlighted the need for consistent and timely data on immunisation uptake, along with sustained investment in immunisation.
