These vaccines may also protect your heart

Keeping up with vaccinations can reduce the risk of heart disease and stroke. That’s the message of recent research, which finds that being vaccinated against diseases caused by viruses, such as COVID-19, flu and shingles, provides cardiovascular protection.

Since the updated COVID-19 vaccine can be given at the same time as the flu shot, here’s some advice from experts on what people with cardiovascular issues should know about viruses and vaccines.

Viruses and heart risks

Heart issues and infection are linked in many ways. One is inflammation, said Dr. Saate Shakil, an assistant professor of cardiology at the University of California, San Francisco.

Diseases caused by viruses, such as the coronavirus, influenza and respiratory syncytial virus, or RSV, can cause inflammation. So can bacterial illnesses such as pneumonia.

If you have coronary heart disease, blood flow is restricted by plaque-filled arteries. In such cases, inflammation could lead to a plaque rupture, blood clot and blocked artery that causes a heart attack or stroke, said Shakil, who has studied links between COVID-19 and stroke.

Research has also shown:

• –Heart problems such as heart attacks and heart failure (the inability of the heart to pump properly) occur in about 20% of adults hospitalized with RSV, according to a 2018 study in the Journal of the American College of Cardiology.
• –COVID-19 is linked to an increased risk of irregular heartbeats, heart failure and coronary disease. In a study published in 2021 in The Lancet, COVID-19 was associated with a threefold to eightfold increased risk of having a heart attack and a threefold to sevenfold increased risk of having a stroke.
• –The risk of a heart attack may be as much as six times higher in the week after a flu diagnosis, found a study published in 2018 in the New England Journal of Medicine.

A virus doesn't have to attack the heart directly to endanger it. Someone with pneumonia might have trouble breathing, which strains the heart. Or a high fever caused by infection can lead to heart rhythm issues.

Research indicates Inflammation is also the issue with shingles, the infection caused by the chicken pox virus, which can increase the risk of stroke. One type of shingles vaccine, Zoster Vaccine Live, may prevent some older adults from having a stroke.

A review of Medicare health records of more than 1 million people aged 66 or older who received the Zoster Vaccine Live found that the shingles vaccine lowered the risk of clot-caused ischemic strokes by about 18% and hemorrhagic, or bleeding, strokes by about 12%. The beneficial effects varied by age.

Vaccine protection

The Centers for Disease Control and Prevention says that people who have heart disease or have had a stroke should talk to their health care team about vaccinations for COVID-19, flu and pneumococcal disease, which includes pneumonia and meningitis. They should also stay current on a Tdap vaccine, which protects against diphtheria, tetanus and pertussis (also known as whooping cough).

The CDC also recommends that adults 60 and older ask about the RSV vaccine.

A health care professional can offer advice on other vaccines, as well as whether to avoid certain formulations. For example, the CDC says people who are pregnant, have weakened immune systems or are 50 and older should not receive the nasal spray flu vaccine. "It's not that they can't get vaccinated," Shakil said. "It's just that the type of vaccine has to be tailored for them."

Risks and benefits

Vaccines can have side effects. The COVID-19 vaccine, for example, has been linked to rare cases of myocarditis and pericarditis, types of heart inflammation.

That must be viewed in context, said Dr. Gregory Piazza, director of vascular medicine at Brigham and Women's Hospital in Boston.

"What we're talking about with the risks of the vaccine are very infrequent events," said Piazza, who also is an associate professor of medicine at Harvard Medical School. "And you pit that against the large degree of benefit that you get" by reducing the severity of COVID-19 and reducing the odds of being hospitalized or having a cardiovascular complication.

"Those are real, tangible benefits," he said.

To find locations that provide COVID-19 and flu vaccines, visit the federal website vaccines.gov or call 800-232-0233.