Fill a large pot with water, add a pinch of salt, and bring to a boil. Add the penne pasta and cook until al dente, about 10 minutes. Reserve 1/2 cup of pasta water before draining the pasta.

In a large skillet over medium heat, warm the olive oil. Add the chopped onion and minced garlic and cook until soft, about 3-4 minutes. Stir in the red pepper flakes and cook for another minute.

Add the whole peeled tomatoes (with their juice) and vodka to the skillet. Cook for 5-7 minutes until the liquid reduces slightly. Stir in the tomato paste, balsamic vinegar, kosher salt, and a few grinds of black pepper. Allow the sauce to simmer partially covered for 20 minutes.

Pour the sauce into a blender along with the fresh basil and blend until smooth. Return the blended sauce to the skillet. Stir in the heavy cream and cook for 2-3 minutes until warmed through. Mix in the grated Parmesan cheese until the sauce is smooth and creamy.

Add the drained pasta to the sauce, tossing to coat evenly. If the sauce is too thick, add some of the reserved pasta water until you reach the desired consistency. Taste and adjust the seasoning with more salt or pepper if needed, then serve hot with extra Parmesan.