Cardioprotective Vaccination Effects: Association Between Vaccination Knowledge, Risk Perception, and Vaccination Intention in Older Patients with Pre-Existing Conditions

Background/Objectives: Cardiovascular diseases (CVDs) remain a major contributor to morbidity, mortality, and healthcare costs worldwide. Acute respiratory infections such as influenza and pneumococcal disease can precipitate severe cardiovascular events, while vaccination against these pathogens offers both infection-related and cardioprotective benefits. The extent to which individuals are aware of these associations and how such knowledge shapes risk perception and vaccination intention remains unclear. Methods: In a cross-sectional survey conducted between July and September 2025 in Germany, 101 geriatric patients and individuals with pre-existing cardiovascular conditions were assessed regarding their knowledge of infection-related cardiovascular risks and cardioprotective vaccination benefits, risk perception, and vaccination intention. Results: While 64.4% of participants recognized the increased cardiovascular risk associated with acute respiratory infections, only 40.6% were aware of the cardioprotective benefits of vaccination. Knowledge of infection-related cardiovascular risk was linked to higher perceived disease severity, whereas awareness of cardioprotective vaccination effects was associated with greater perceived usefulness of influenza and pneumococcal vaccinations. Crucially, only knowledge of cardioprotective benefits (by(flu) = 0.46, by(pneu) = 0.45), but not knowledge of infection-related cardiovascular risk (by(flu) = 0.08, by(pneu) = 0.34) was significantly associated with higher vaccination intention. Conclusions: These findings highlight substantial knowledge gaps regarding the cardioprotective benefits of influenza and pneumococcal vaccination. These findings support further evaluation of whether communication emphasizing potential cardioprotective benefits can influence vaccination intentions and subsequent vaccine uptake in prospective or interventional studies: