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In a large sauté pan, heat olive oil over medium heat; add onions and garlic and cook until soft, about 3-4 minutes. Add red pepper flakes and cook for 1 minute.
Stir in tomatoes and vodka and continue cooking the mixture for 5-7 minutes until slightly reduced, stirring occasionally.
Then stir in the tomato paste, balsamic vinegar, salt, and black pepper to taste. Reduce heat to low and simmer partially covered for 20 minutes until reduced by half, stirring occasionally.
In the meantime, cook pasta in salted water according to package directions. Drain and set aside.
Transfer tomato mixture to a food processor or blender, add basil, and purée until smooth. Return sauce to the pan and stir in half and half. You want creamy and slightly sweet consistency. Start with 1/2 cup of half and half, taste, and add more if needed. Cook until warmed through, about 2-3 minutes. Stir in parmesan cheese and then the cooked pasta. Toss to combine.
Serve immediately with additional sprinkle of cheese and basil, if desired.