News|Articles|February 18, 2026 (Updated: February 18, 2026)

ACOG updates maternal immunization guidance

Fact checked by: Benjamin P. Saylor

The updated Committee Statement reaffirmed the safety and benefits of influenza, COVID-19, Tdap, and RSV vaccines during pregnancy while addressing misinformation and disparities.

Key takeaways:

  • ACOG recommended routine assessment of vaccination status and administration of indicated vaccines during pregnancy.
  • Influenza, COVID-19, Tdap, and RSV vaccines were recommended for routine use during pregnancy, with additional vaccines based on individual risk.
  • The guidance addressed misinformation, disparities in vaccine uptake, and the influential role of obstetric care professionals in improving maternal immunization rates.

The American College of Obstetricians & Gynecologists (ACOG) released updated guidance on maternal immunizations, reinforcing the importance of routine vaccination during pregnancy to protect both pregnant individuals and their infants. The Committee Statement was published February 18, 2026, in Obstetrics & Gynecology.1,2

The guidance was developed by ACOG’s Immunization, Infectious Disease, and Public Health Preparedness Expert Work Group and emphasized that obstetrician–gynecologists and other obstetric care professionals should routinely assess patients’ vaccination status and recommend indicated vaccines.

“We developed this Committee Statement to provide clinicians with evidence-based information to facilitate accurate, informative, and transparent conversations with their patients about the benefits and limited potential risks of vaccines,” said Mark Turrentine, MD, FACOG, author of the guidance. “Vaccines have been proven to reduce hospitalizations and deaths, and we want to ensure that our pregnant patients are protected from vaccine-preventable diseases.”2

“Maternal immunization is important to protect against severe respiratory illnesses during pregnancy, and vaccines like Tdap protect newborns,” Kevin Ault, MD, told Contemporary OB/GYN. Ault is a co-author on the Committee Statement and vice president of the National Foundation for Infectious Diseases (NFID), professor of obstetrics and gynecology at the Western Michigan University Homer Stryker MD School of Medicine, and former member of the Advisory Committee on Immunization Practices (ACIP).

“There are numerous studies about the safety and effectiveness of each of the recommended vaccines, and ACOG uses this evidence to make clinical recommendations,” Ault said.

Routine vaccines during pregnancy

The Committee Statement reaffirmed that immunization is an essential component of preventive care for adults, including pregnant individuals. Vaccination against influenza, pertussis, COVID-19, and respiratory syncytial virus (RSV) was described as a safe and effective public health strategy that benefits both the pregnant individual and newborn through passive antibody transfer across the placenta.1

ACOG noted that pregnant individuals faced increased risks of maternal morbidity and mortality from influenza, as well as fetal risks including congenital anomalies, spontaneous abortion, preterm birth, and low birth weight. The statement reported no evidence of adverse fetal effects from mRNA-derived vaccines, inactivated virus vaccines, bacterial vaccines, or toxoids and cited growing safety data supporting their use during pregnancy.

In addition to influenza, COVID-19, Tdap, and RSV vaccines, the statement addressed screening for hepatitis B using a triple panel screen in pregnant patients aged 18 years or older if not previously completed. Other vaccines could be recommended based on age, comorbidities, prior immunization status, or disease risk factors, with certain vaccines administered postpartum when indicated.

Addressing disparities and misinformation

The updated guidance also addressed disparities in vaccine uptake. ACOG reported that maternal vaccination rates remained suboptimal and that outbreaks of vaccine-preventable diseases were increasing. Barriers included misinformation and disinformation on social media, limited awareness of recommended vaccines, and a lack of trust in the medical system—particularly among communities of color affected by historical and ongoing systemic racism.

“Vaccine misinformation and disinformation is on the rise, and it’s unfortunately affecting people’s decisions about whether or not to get vaccinated and ultimately protect themselves and their pregnancies from preventable illness,” said Christopher M. Zahn, MD, FACOG, chief of clinical practice at ACOG.2

“The growing misinformation and disinformation and changing national recommendations are resulting in confusion for both patients and clinicians. It’s our duty at ACOG to ensure that ob-gyns and other clinicians who treat pregnant patients are equipped with evidence-based information to counsel their patients about which vaccines they need, and clinicians can find that essential information in this guidance,” added Zahn.

ACOG highlighted that studies consistently demonstrated higher vaccine acceptance when recommendations came directly from an obstetrician or obstetric care professional, with odds of acceptance 5-fold to 50-fold higher when clinicians both recommended and offered vaccination.1

Recommendations from the Committee Statement

Based on the principles from the Committee Statement, ACOG made the following recommendations:

  • Obstetrician–gynecologists and other obstetric care professionals should routinely assess their pregnant patients' vaccination status.
  • Obstetrician–gynecologists and other obstetric care professionals should recommend and, when possible, administer needed vaccines to their pregnant patients.
  • Individuals who are or will be pregnant during the fall/winter respiratory illness season should receive annual influenza and coronavirus disease 2019 (COVID-19) vaccines.
  • All pregnant individuals should receive a Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) vaccine during each pregnancy, as early in the 27–36 gestational-week window as possible.
  • All eligible pregnant individuals who meet criteria should receive the respiratory syncytial virus (RSV) vaccine.
  • Other vaccines may be recommended during pregnancy depending on the patient's age, prior immunizations, comorbidities, or disease risk factors.

References:

  1. Maternal Immunizations. Obstetrics & Gynecology ():10.1097/AOG.0000000000006230. February 18, 2026. Accessed February 18, 2026. doi:10.1097/AOG.0000000000006230
  2. ACOG releases updated guidance on maternal immunizations. American College of Obstetricians & Gynecologists. Published February 17, 2026. Accessed February 18, 2026. https://www.acog.org/news/news-releases/2026/02/acog-releases-updated-guidance-maternal-immunizations