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Bring a large pot of salted water to a boil over high heat.
Meanwhile, in a large skillet over medium heat, combine the olive oil, butter, and a pinch of pepper flakes (if using). Cook, whisking to blend the fats together while the butter is melting. Add the garlic and tomato paste. Whisk until the tomato paste is deep red, about 3 minutes.
Add the rigatoni to the boiling water and cook until al dente according to the package directions. Reserve 1 cup of the pasta cooking water, then drain.
As soon as the pasta hits the water, add the heavy cream to the skillet and continue whisking until the cream is fully incorporated and the sauce color goes from neon orange to pumpkin spice, about 5 minutes. Add the vodka to the sauce and notice the smell of a tomato martini fill your kitchen. Cook, continuing to whisk, until the alcohol cooks out, the martini smell is gone, and the sauce is perfectly smooth, about 5 minutes more.
Add ½ cup of the reserved pasta water to the sauce. Continue to simmer and whisk until the sauce is thick enough to coat the back of a spoon without sliding off, about 20 minutes.
Add the pasta to the sauce and stir until coated and glossy. Divide among plates, top with Parmesan, and serve.