Cook the pasta: Bring a large pot of salted water to a boil and cook the pasta according to package direction, until al dente. Reserve 1/2 cup pasta water, then drain and set aside.
Cook the sausage: Heat olive oil in a large pan over medium heat. Add the sausage and cook for 4–5 minutes, until browned and fully cooked. Remove from pan.
Build the flavor base: Add the diced shallots and cook for 2–3 minutes until softened. Stir in the garlic and cook for another 30 seconds until fragrant.
Add the seasoning: Add the tomato paste, Calabrian chili and red pepper flakes. Cook for 2–3 minutes, stirring frequently, until the paste deepens in color and becomes slightly caramelized.
Deglaze with vodka: Pour in the vodka and let it simmer for 1–2 minutes, allowing the alcohol to cook off.
Make it creamy: Reduce heat to low and stir in the heavy cream. Add a splash of reserved pasta water and mix until smooth and silky.
Combine everything: Return the cooked sausage to pan. Add the cooked pasta and Parmesan cheese. Toss until the pasta is evenly coated. Add more pasta water as needed to loosen the sauce.
Final touches: Season with salt and black pepper to taste. Garnish with fresh basil and extra Parmesan.