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Influenza infection is associated with an increase of cardiovascular events and hospitalizations due to cardiovascular disease. Influenza vaccination is in turn associated with a reduction or mitigation of cardiovascular complications of influenza. For this reason, influenza vaccination represents an additional pillar for cardiovascular prevention and protection. Recent randomized studies conducted in a very large European population have shown that high-dose influenza vaccination provides significant advantages when compared to standard-dose vaccination. These new data derived from the FLUNITY-HD pooled analysis strongly suggest that high-dose vaccination may be appropriate in elderly patients as well as in patients with cardiovascular disease in whom strengthening the immune response may provide better protection. The present consensus document has been promoted by five Italian cardiovascular or internal medicine scientific societies committed to promote cardiovascular prevention with the aim to update current knowledge on influenza vaccination and promote call-to-action initiatives in Italy to enhance the use of influenza vaccination and overcome current hesitancy and relatively low uptake in the population at risk.