Respiratory infections such as influenza, Covid-19 and respiratory syncytial virus (RSV) are well-established drivers of CVD and seasonal hospital strain. Influenza vaccination alone can reduce major adverse cardiovascular events by over one-third. Yet, across the EU a mismatch persists: high burden and low vaccination coverage rates. Covid-19 vaccination rates in many members states have fallen to around 10 percent. Influenza vaccination coverage remains below the World Health Organization and EU targets and is on the decline across Europe. Programs for RSV are only just getting started. The result is predictable: avoidable exacerbations, preventable admissions and winter hospitalization peaks that crowd out other care. Most of these can be tackled through vaccination, which is recognized by the European Society of Cardiology as a foundational pillar of CVD prevention.
Health innovation now enables earlier identification of individuals at risk of developing CVD, making it possible to implement preventive interventions that slow or prevent disease progression.
The 2009 Council recommendation on influenza set a 75 percent target for older adults. Where countries meet it, hospital pressure drops, demonstrating the value of EU policy tools. Europe should replicate that model again to directly advance cardiovascular health. For example, through the upcoming Council recommendation on immunization against respiratory infections, updating and expanding EU vaccination targets for influenza, and re-establishing momentum on Covid-19. Clear ambitions must also be set for RSV while providing complementary goals for pneumococcal and shingles vaccination for at-risk groups. This is the single biggest, fastest lever to reduce winter hospitalizations and directly advance cardiovascular health.
The sunrise of a new prevention age in Europe
Prevention extends beyond vaccination. Early detection can transform the course of chronic and autoimmune diseases associated with increased CVD risk. Type 1 diabetes (T1D) is a clear example. Up to 80 percent of people with T1D are still diagnosed with diabetic ketoacidosis, a life-threatening complication. By the time symptoms appear, significant damage has occurred. Screening for T1D related autoantibodies makes it possible to detect the disease months to years before symptoms occur, reducing misdiagnosis, hospitalizations and cost, while enabling structured monitoring and coordinated care.
Momentum for early T1D detection is building across Europe, driven by scientific advances and growing advocacy from patient and clinical communities. Several member states are testing screening approaches, including under the EU-funded EDENT1FI initiative, which is generating real-world evidence on feasibility, uptake and socioeconomic benefits. The challenge now is scaling beyond pilots. EU coordination can support the integration of early detection into national prevention strategies, enable sustainable implementation and avoid fragmentation.
Screening for T1D related autoantibodies makes it possible to detect the disease months to years before symptoms occur.
Chronic respiratory diseases are also often underrecognized contributing factors to CVD. Chronic obstructive pulmonary disease (COPD) with frequent exacerbations is a common CVD comorbidity, and uncontrolled asthma increases CVD risk. Including these in health checks will strengthen integrated prevention protocols, combining spirometry for at-risk adults during cardiovascular checks with e-referrals to pulmonologists, alongside integrated cardiovascular risk management. The result: early identification of high-risk patients who have underdiagnosed COPD and asthma, resulting in early referral to a pulmonologist, ensured continuity of care and more precise targeting of CVD.
