Bring a large pot of water to a boil to cook pasta later. Season with salt.
In a deep pot, heat oil over medium-low heat. Add pancetta and onion, and cook for about 10 minutes, stirring often until the onion is softened and the pancetta is crispy.
Add garlic and red pepper flakes. Stir for 1-2 minutes or until fragrant.
Add vodka and simmer for 2-3 minutes, until it's almost gone.
Pour in the San Marzano tomatoes and simmer, uncovered for 20 minutes or until the sauce is thickened. Stirring occasionally.
While the sauce is simmering, cook the pasta in salted boiling water until al dente. Drain and reserve some of pasta water for the sauce.
Once the sauce is thickened, add heavy cream and stir until smooth.
Add cooked pasta and ¼ cup of pasta water (or more as needed). Toss to coat.
Add pecorino cheese and stir to combine.
Taste and season with salt and black pepper if necessary. Serve with fresh herbs of your choice and grated cheese.