The first step from a medical and scientific perspective is to acknowledge increased rates of thromboembolic complications (heart attacks, stroke, pulmonary embolism) since the beginning of the COVID-19 pandemic.
Our next challenge is to understand the reasons for these changes.
The most obvious reason is secondary to severe COVID-19 (would have required oxygen in hospital) with ongoing immune activation. These patients would have been in hospital and may continue to suffer with longer term issues after discharge.
Long Covid is also associated with immune activation, however the specific macrophages involved (intermediate monocytes) are not targeting atherosclerotic plaques, or there is no clear evidence at present that these individuals have increased cholesterol deposits in arteries.
Post vaccination immune activation involving macrophages can occur on its own or augment the response in previously activated macrophage immunity for COVID-19 or long Covid.
Below are some scientific links to plaque disease which are more fully delineated.