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Influenza and Heart Attack

Flu vaccination protects more than your lungs — it can also save your heart.

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Key Summary

  • What’s the link: Influenza doesn’t just cause pneumonia and hospitalisations — it can also trigger heart attacks by inflaming arteries, disrupting plaques, and straining the heart.
  • Risk reduction: Annual flu vaccination can almost halve the risk of heart attacks in older adults and people with heart disease.
  • Research findings: Extending vaccination to adults aged 50–64 could prevent:
    • 1,482 heart attacks
    • 314 cases of flu/pneumonia
    • 338 respiratory hospitalisations
    • Saving up to $31.4 million annually
  • Sudden cardiac arrest: Vaccination could prevent more than 1,200 sudden cardiac arrest deaths and nearly $4 billion in costs each year.
  • Who should vaccinate: Strongly recommended for anyone with cardiovascular disease, including congenital heart disease, heart failure, or coronary artery disease.
  • Access: Free under the National Immunisation Program for those with medical risk conditions; available through GPs and many pharmacies.

About

Evidence from several studies indicates that annual vaccination against seasonal influenza reduces cardiovascular morbidity and mortality in patients with cardiovascular conditions. Studies indicate that the influenza vaccine almost halves the risk of heart attacks in older adults. [1][2]

“The Immunisation Coalition recommends influenza vaccination for patients with Acute Coronary Syndromes (ACS) prior to discharge from hospital and as part of comprehensive secondary prevention in persons with coronary and other atherosclerotic vascular disease. Healthcare providers, including specialists, who treat individuals with cardiovascular disease can help improve influenza vaccination coverage rates by asking about vaccination status, strongly recommending and providing vaccination before and throughout the influenza season.”

Prof Raina MacIntyre, University of University of New South Wales and member of the Immunisation Coalition

2024 was Australia’s worst flu season on record with 365,580 laboratory confirmed cases. While influenza is recognised as causing pneumonia, hospitalisations and death – what is less known is its role in triggering a heart attack. There is clear evidence to show heart attacks and cardiac deaths increase during the influenza season.[1][2]

“Influenza poses a serious threat to the heart which is not well understood. The virus causes a number of mechanisms that may lead to a blockage in the coronary arteries, including the inflammatory release of cytokines, disruption to atherosclerotic plaques and tachycardia.”

Associate Professor Tim Tan, Cardiologist, Blacktown Hospital

This research is one of the first economic evaluations of the protective effect of influenza vaccination on myocardial infarction in Australia, led by an independent team at University of New South Wales. It uncovered the significant value of extending the National Immunisation program (NIP) and providing the influenza vaccination to adults aged 50-64 as a preventive measure for heart attack and respiratory hospitalisations.[3]

The research shows that extending vaccination each year has the potential to prevent:

  • 1,482 heart attacks
  • 314 cases of influenza/pneumonia
  • 338 respiratory hospitalisations
  • Save up to $31.4 million annually, largely from avoided hospital admissions due to heart attacks

Further research published in 2024 evaluated the cost-benefit of influenza vaccination in preventing sudden cardiac arrest (SCA) in Australian adults aged 50–64 years:

  • 1,269 SCA deaths and 278 hospitalisations could be prevented annually
  • Estimated annual cost savings of nearly $4 billion, primarily due to averted premature deaths
  • The benefit-cost ratio (BCR) was 59.94, indicating significant economic value even under conservative modelling assumptions[4]

“More Australians need to be encouraged to be vaccinated against influenza. The current rates of flu vaccination in high-risk groups under age 65 sits at just 30%. This needs to change. Flu vaccinations should become a critical step in the management of cardiovascular disease and the prevention of heart attacks.”

Dr Rod Pearce, Adelaide GP and Chairman of the Immunisation Coalition

The Australian Immunisation Handbook strongly recommends annual influenza vaccination for anyone with chronic cardiovascular disease, including those with[5]:

  • Congenital heart disease
  • Congestive heart failure
  • Coronary artery disease

Vaccination can be administered by GPs and participating pharmacies, and is funded under the NIP for those with medical risk conditions, including heart disease.

“It is important that people understand that symptoms of a heart attack (nausea, chills, aches, sweats) can be mistaken as signs of influenza and vice versa. It is important for healthcare providers to tell their patients to not take those symptoms lightly – especially when they have a history of cardiovascular disease”.

Bill Stravreski, General Manager Heart Health, Heart Foundation

References 

  1. Ischaemic heart disease, influenza and influenza vaccination: a prospective case control study-MacIntyre CR, et al. Heart 2013; 99: 1843-1848
  2. Acute myocardial infarction and influenza: a meta-analysis of case-control studies-Barnes M, et al. Heart 2015;0 1-10.
  3. Newall AT, MacIntyre CR, Scuffham PA. Influenza-related disease burden and economic impact of extending the National Immunisation Program in Australia to adults aged 50–64 years. Vaccine. 2020;38(7):1881–1887.
  4. Wei J, Tan TC, Moa AM, MacIntyre CR. Cost-benefit of influenza vaccination in preventing sudden cardiac arrest amongst Australian adults. Vaccine. 2024;42(9):1455–1462. doi:10.1016/j.vaccine.2024.02.008
  5. Australian Technical Advisory Group on Immunisation (ATAGI). Australian Immunisation Handbook – Influenza (flu): People with medical conditions that increase their risk [Internet]. Canberra: Department of Health and Aged Care; 2024 [cited 2025 May 8]. Available from: https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/influenza-flu#people-with-medical-conditions-that-increase-their-risk-of-influenza

Additional resource: Influenza vaccine as a coronary intervention for prevention of myocardial infarction-MacIntyre CR, et al. Heart 2016;102: 1953-1956