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In a large skillet over medium heat, melt butter. Add shallot and garlic and cook, stirring frequently, until softened, 4 to 5 minutes.
Add tomato paste and red pepper flakes and cook, stirring frequently, until paste has coated shallots and garlic and is beginning to darken, about 5 minutes.
Add vodka and stir to incorporate, scraping up any browned bits from bottom of pot. Remove from heat.
Meanwhile, in a large pot of boiling salted water, cook pasta, stirring occasionally, until al dente according to package instructions. Drain, reserving 2 c. pasta water.
Return sauce to medium heat and add cream and ¼ c. pasta water, stirring to combine. Add half of Parmesan and stir until melted. Remove from heat and stir in cooked pasta. Fold in remaining Parmesan, adding more pasta water (about 1 Tbsp. at a time) if the sauce is looking dry; season with salt, if needed.
Divide pasta among bowls. Top with Parmesan and basil.