ACOG Issues First-Ever Vaccine Guidance for Pregnant Women

The American College of Obstetricians and Gynecologists (ACOG) has released its first-ever formal immunization schedule for pregnant, postpartum and breastfeeding women — a landmark departure from its traditional role of endorsing federal CDC guidelines, as reported by the Associated Press.

The new schedule, announced on June 10, recommends four routine vaccines during pregnancy: influenza, COVID-19, Tdap (tetanus, diphtheria and pertussis), and RSV (respiratory syncytial virus). It has been endorsed by 13 major medical societies, including the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Nurse-Midwives.

Why ACOG Issued Its Own Schedule

ACOG’s decision to issue independent guidance stems from growing concerns about changes to federal vaccine policy under the Trump administration and Health and Human Services Secretary Robert F. Kennedy Jr. In February 2026, ACOG withdrew as a liaison organization from the CDC’s Advisory Committee on Immunization Practices (ACIP), citing changes that “undermine the committee’s scientific integrity.”

“So now for the first time, ACOG has made the decision to formally release its own immunization schedule to provide and communicate clear evidence-based guidance and to address the growing vaccine misinformation that is circulating,” said Dr. Christopher Zahn, ACOG’s chief of clinical practice.

What the New Schedule Recommends

ACOG’s 2026 Maternal Immunization Schedule recommends four vaccines for routine administration during pregnancy:

• Influenza vaccine: Any trimester, at any time of year, ideally in early fall
• COVID-19 vaccine: Any trimester, as soon as possible during pregnancy
• Tdap: Preferably between 27 and 36 weeks of gestation, during each pregnancy
• RSV vaccine (Abrysvo): Between 32 and 36 weeks, September through January, for first pregnancies only

Additional vaccines — including pneumococcal, meningococcal, hepatitis A and hepatitis B — are recommended for women with certain risk factors. Three others — HPV, MMR and varicella — are advised before pregnancy or after birth.

How ACOG’s Guidance Differs from Federal Policy

The most significant divergence involves the COVID-19 vaccine. In May 2025, HHS Secretary Kennedy announced that COVID-19 vaccines were no longer universally recommended for healthy pregnant women and children — a shift that public health experts immediately questioned. ACOG’s schedule continues to recommend COVID-19 vaccination for all pregnant women, regardless of trimester.

ACOG’s guidance also maintains a universal recommendation for influenza vaccination during pregnancy, whereas HHS has moved that recommendation to “shared clinical decision-making.”

A Coordinated Medical Response

The schedule’s endorsement by 13 professional societies represents an unusually unified response from the medical community. ACOG President Dr. Camille A. Clare said the move was driven by “changing national recommendations coupled with rampant vaccine misinformation” that has created confusion for both patients and health care professionals.

“Vaccine hesitancy is huge in this country right now,” said Carol Hayes of the American College of Nurse Midwives. “Patients come in all the time saying I’ve done my own research, and sadly, they’re doing research and they’re getting information that is not scientifically based.”

Broader Implications

ACOG’s independent schedule is part of a broader fragmentation of U.S. vaccine policy. The American Academy of Pediatrics released its own childhood immunization schedule in January 2026, breaking from recent CDC changes. Other medical groups have similarly issued independent guidance, reflecting a growing divide between federal health agencies and professional medical societies.

Dr. Flor M. Munoz-Rivas, a member of the FDA’s Vaccines and Related Biological Products Advisory Committee, told Healio that clinicians should follow the guidance of professional medical societies “until clarity exists regarding ACIP.”

What to Watch For

The practical impact of ACOG’s schedule will depend on adoption by OB-GYNs across the country and how insurers and health systems respond. Legal challenges to HHS’s vaccine policy changes remain ongoing, and it remains unclear whether federal health agencies will issue a formal response to ACOG’s independent guidance. For now, the new schedule provides a unified, evidence-based reference point for clinicians and patients navigating an increasingly fragmented vaccine landscape.