8 FAQs About Vaccination From Patients With Cardiovascular Disease

The American College of Cardiology (ACC) emphasizes that vaccine hesitancy is a distinct and important barrier to preventive care in patients with cardiovascular disease. Unlike vaccine resistance, which reflects firmly held opposition, hesitancy is a state of indecision shaped by a range of influences—socioeconomic challenges, misinformation, social norms, prior vaccine experiences, and, at times, distrust of the health care system, the ACC states.

The COVID-19 pandemic amplified these concerns, as rapidly evolving evidence and the urgency of new vaccine development fueled uncertainty.

The ACC on August 27 issued the 2025 Concise Clinical Guidance (CCG) on vaccination in adults with cardiovascular disease (CVD), underscoring the importance of respiratory vaccines—including influenza, COVID-19, and respiratory syncytial virus (RSV)—as part of standard prevention and treatment strategies. The augmented and lingering halo of uncertainty around immunization is particularly concerning as the US is about to enter the 2025-2026 respiratory virus season.

The ACC’s new CCG emphasizes that addressing vaccine hesitancy starts with understanding its root causes and tailoring interventions accordingly. Education from a trusted clinician, particularly in routine care, is the most effective approach. Clear explanations of vaccine benefits, expected side effects, and common misconceptions—such as the belief that influenza vaccination can cause influenza—help reduce uncertainty. In a dedicated section of the CCG, the ACC presents a number of the questions most frequently asked by adults with heart disease who are vaccine candidates, eg, about infection risk, vaccine safety, myocarditis, cost, and the need for repeated doses. All reflect concerns that fuel hesitancy.

In the short slide show above, we present the ACC's FAQs and several others based on the CCG, and the ACC's suggested departure point for an answer. Overall, the ACC sends a clear message: vaccine hesitancy is not immovable, and clinicians have a central role in guiding patients through uncertainty toward informed decisions.

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