Cook the pasta: Fill a large pot with water and bring it to a boil. Once the water is boiling, add a generous amount of salt. Drop in your pasta of choice and cook it until it reaches al dente consistency (check package instructions for exact timing). Before draining, reserve about 1 cup of the starchy pasta water. Drain the pasta and set it aside, but don’t rinse it to keep the starch that helps the sauce adhere.
Sauté the aromatics: While your pasta is cooking, heat the olive oil in a large skillet over medium heat. Once the oil shimmers, add the diced shallot (or onion) along with a pinch of salt and black pepper. Cook for about 3-4 minutes until the shallot softens and becomes fragrant. Add the chopped sage, garlic, and optional red pepper flakes, cooking for another 1-2 minutes until everything becomes aromatic.
Create the pumpkin vodka sauce: Turn the heat down to medium-low. Stir in the tomato paste and pumpkin purée, making sure everything is well mixed. Allow this to cook for 10-12 minutes, stirring occasionally, until the mixture darkens slightly and begins to cling to the bottom of the pan. Carefully pour in the vodka, stirring constantly to release any caramelized bits stuck to the pan. Let the vodka cook off almost entirely. Then, stir in the heavy cream, grated Parmesan cheese, and freshly grated nutmeg. Taste and adjust the seasoning, adding more salt or pepper if desired. Keep the sauce simmering gently.
Combine pasta and sauce: Add the cooked pasta into the sauce, tossing well to ensure the pasta is fully coated. If the sauce seems too thick, add a little of the reserved pasta water to loosen it up. If you want it thicker, add a bit more grated Parmesan cheese. Continue to cook everything together for an additional 1-2 minutes so the pasta and sauce meld together beautifully.
Serve: Plate the pasta in bowls and top with more freshly grated Parmesan or a few crispy fried sage leaves for extra flavour and texture. Serve immediately and enjoy the creamy, comforting goodness!