Preheat the oven to 350°F. Arrange the prosciutto in a single layer on a parchment-lined baking sheet and bake for about 15 minutes, or until crisp. Set aside to cool, then break into small pieces.
Bring a large pot of salted water to a boil and cook the pasta until just al dente—it will finish cooking in the sauce. Before draining, reserve ½ cup of the starchy pasta water.
While the pasta cooks, heat the olive oil in a large pan over medium heat. Sauté the onion for about 5 minutes, until soft and translucent.
Add in the minced garlic and red pepper flakes and stir for another minute.
Stir in the tomato paste and let it cook for about 5 minutes, stirring occasionally, until it deepens in colour and becomes slightly caramelized.
Pour in the vodka to deglaze the pan, letting it simmer for a few minutes so the alcohol cooks off.
Stir in the heavy cream and bring to a gentle simmer. Add the Parmesan and stir until melted and smooth.
Add the drained pasta directly to the sauce, tossing to coat. Use the reserved pasta water, as needed, to loosen the sauce until glossy and silky.
Serve into bowls then garnish with the crispy prosciutto and some fresh Italian parsley or basil!