Until recently, long-term conditions (such as diabetes, obesity, cardiovascular disease and cancer) were seen as distinct from infectious diseases.
Now experts are rethinking this division.
Some cancers are caused by infections while shingles vaccine has been linked to reduced dementia risk. There is also growing evidence of links between (long-term) non-communicable diseases and flu, Covid and respiratory syncytial virus (RSV).
Will this scientific evidence translate into clinical guidelines and policies that encourage vaccination? In some fields – like cardiovascular disease – it’s already happening.
Spotlight on respiratory infections
Connecting the dots between this wide range of conditions can be challenging. A new community of experts aims to bring together researchers and clinicians from several specialties to bridge the gap. Known as the Interdisciplinary Disease Collaboration on Respiratory Infections and NCDs (IDC), the group aims to turn emerging science into health policy. (The IDC is hosted by ESWI.)
Dr Marco Goeijenbier, of Spaarne Hospital in The Netherlands, says the group was originally conceived of a decade ago as a way to connect influenza researchers with the diabetes community. This reflects the fact that flu infections can cause complications for people with diabetes – and for some people, influenza can trigger diabetes by damaging insulin-producing cells.
The mission of this group broadened after it became clear that Covid-19 was particularly tough for some people living with NCDs. Covid, which was initially seen as a short-term respiratory infection, is known to have a long-term impact on some people – and can affect multiple organs.
This year, Dr Goeijenbier told a webinar, the group is stepping up its efforts and has broadened its work to include other NCDs such as cardiovascular disease. ‘We are focused on better understanding the bidirectional relationship between acute respiratory infections and non-communicable diseases,’ he said. ‘This will support optimal care for – and prevention of – respiratory virus infections in people living with NCDs.’
Bridging the Gap: A Multidisciplinary Approach to Respiratory Infections and NCDs (created by ESWI)
Dr Cornel Sieber, a Swiss Geriatrician and President of the European Interdisciplinary Council on Ageing (EICA) said many older people present with multiple long-term conditions at once. These NCDs make patients vulnerable to infections that can reduce their quality of life.
‘It’s not just a question of reducing the risk of dying from infection,’ he said. ‘Survival is important but people also want to keep their independence and quality of life. We need to think about functionality. Every infection for an older person can lead down a slippery road towards frailty.’
Life Course Immunization: Why Lifelong Vaccination is Essential for Public Health
Policymakers and patient advocates must be part of the conversation, experts say, because strong evidence on the value of vaccinating people in risk groups is not widely known. The Covid pandemic shone a light on the link between NCDs and infections, but this has not translated into a sustained effort to increase vaccination in adults.
‘Respiratory viruses can trigger NCDs. We see rising diabetes after SARS-CoV-2 infection,’ said Dr Kirsty Short, University of Queensland, Australia. ‘The pandemic highlights why this interdisciplinary approach is so important. We need dialogue between clinicians, researchers, patients and policymakers.’
Some policymakers are already tuning in. Tomislav Sokol MEP pointed to the new EU Safe Hearts Plan as an example of how Europe is taking this issue more seriously. The Plan, published in December 2025, should be followed by targets to increase vaccination in people living with heart disease.
Read: Vaccination is vital to cardiovascular prevention, say heart specialists
MEP Sokol said the European Parliament is currently working on a report that will put more focus on prevention and immunisation. ‘I have specifically highlighted that vaccines are a cost-effective health tool for reducing CVD,’ he said.
Meanwhile, the World Federation of Public Health Associations (WFPHA) is coordinating a broad coalition of organisations advocating for life-course immunisation. A Call to Action signed by more than two dozen medical and patient groups includes a 10-point plan to integrate vaccination and NCD prevention.
There may be a long way to go before this approach is mainstream across Europe, but there is clear momentum behind efforts to enhance prevention.
Putting vaccination at the heart of prevention
Flu vaccination protects against heart attack and stroke. In fact, it reduces the risk of CVD-related deaths by 33% and decreases the risk of heart attack by 30%. Vaccination against flu also cuts the risk of stroke by 26%.
The EU Safe Hearts Plan notes that vaccine coverage among people with cardiovascular disease is ‘suboptimal’ in many European countries. The Plan will be followed by a European Council Recommendation to promise immunisation. It will require national authorities to report vaccination coverage in people with chronic diseases.
Cardiology experts have also issued guidance on the clinical value of vaccinating CVD patients against flu, SARS-CoV-2, RSV, and herpes zoster. Now some experts are asking whether professional bodies in other areas will do the same.
Read more: Flu vaccination protects heart health
