FAQ: What you need to know about ACOG's new maternal immunization schedule

On June 10, 2026, the American College of Obstetricians & Gynecologists (ACOG) released its 2026 Maternal Immunization Schedule, marking the first time the organization has issued its own immunization recommendations that differ from federal vaccine guidance.²

The schedule was developed by ACOG's Immunization, Infectious Disease, and Public Health Preparedness Expert Work Group and is adapted from ACOG's Committee Statement No. 26, Maternal Immunizations.²^,³ It has been formally endorsed by 13 medical and health organizations, including the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), the American College of Nurse-Midwives (ACNM), and the National Association of Nurse Practitioners in Women's Health (NPWH).¹^,³

The release follows ACOG's earlier withdrawal from the CDC's advisory committee on vaccines, a decision the organization tied to changes in federal vaccine recommendations under the current administration and Health Secretary Robert F. Kennedy Jr.¹ ACOG President Camille A. Clare, MD, MPH, CPE, FACOG, said the schedule is intended to give clinicians and patients a consistent, evidence-based resource amid shifting national guidance.² For ob-gyn’s, family physicians, and midwives, the schedule offers specific administration windows for routinely recommended vaccines and outlines additional vaccines to consider based on comorbidities or risk factors.³

1. What prompted ACOG to release its own immunization schedule instead of following federal guidance?

ACOG cited confusion among patients and clinicians stemming from changing national vaccine recommendations and vaccine misinformation.² Earlier in 2026, ACOG had withdrawn from the CDC's advisory committee on vaccines over changes made to federal recommendations.¹ The organization described the new schedule as an "easily accessible resource for clinicians, public health agencies, and patients across the United States."¹

"Changing national recommendations coupled with rampant vaccine misinformation are resulting in confusion for both patients and health care professionals. It is incredibly important for the public to have access to reliable, evidence-based information on maternal immunizations from a trusted source. ACOG is proud to be that source."
— Camille A. Clare, MD, MPH, CPE, FACOG, ACOG President²

2. How does the new schedule differ from current federal recommendations?

The most notable divergence concerns COVID-19 vaccination. ACOG's schedule places COVID-19 vaccination in the "Routinely Recommended During Pregnancy" category, to be administered at any time of year and at any gestational age.¹ This contrasts with current CDC guidance, which states that COVID-19 vaccines are no longer recommended for healthy pregnant women and children.¹

3. Which vaccines are routinely recommended during every pregnancy under the new schedule?

Four vaccines fall into this category³:

• Inactivated or recombinant influenza — administered at any time of year, at any gestational age
• COVID-19 — administered at any time of year, at any gestational age
• Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) — administered at 27–36 weeks of gestation
• Maternal RSV (Abrysvo) — administered seasonally in the first eligible pregnancy, at 32 weeks 0 days–36 weeks 6 days of gestation

These 4 vaccines can be safely co-administered.³

4. What is the recommended timing and product guidance for the Tdap vaccine?

Any Tdap vaccine product may be administered.³ ACOG recommends a dose preferably during the early part of gestational weeks 27 through 36, during each pregnancy, regardless of the patient's prior Tdap vaccination history.³

5. What is ACOG's guidance on influenza vaccination timing and product selection?

Only inactivated influenza vaccine (IIV) or recombinant influenza vaccine (RIV) products should be administered during pregnancy.³ ACOG recommends vaccination before the start of flu season, ideally by the end of October, though vaccination at any point during flu season is encouraged to ensure protection while the virus is circulating in the community.³

6. What are the specifics of the maternal RSV vaccine recommendation?

Only Pfizer's RSV vaccine (Abrysvo) should be administered, as a one-time dose.³ It should be given only between 32 weeks 0 days and 36 weeks 6 days of gestation, during September through January in most of the continental United States, for patients not previously vaccinated.³ In subsequent pregnancies after a patient has already received Abrysvo, repeat vaccination is not indicated; instead, infants should receive a monoclonal antibody as an alternative.¹^,³ Jurisdictions with differing seasonality, such as Alaska or tropical climates, should follow state, local, or territorial guidance on timing.³

7. Which vaccines are recommended only for specific groups based on comorbidities or risk factors, and which are contraindicated?

ACOG recommends discussing the following vaccines with patients based on comorbidities or disease risk factors¹^,³:

• Pneumococcal
• Meningococcal (MenACWY or MenABCWY, and meningococcal serogroup B)
• Hepatitis A
• Hepatitis B

HPV, MMR, and varicella (chickenpox) vaccines are contraindicated during pregnancy under the schedule, as ACOG recommends these be administered prior to pregnancy or after birth.¹^,³

8. How did clinical leadership describe the role of maternal immunization in protecting both patients and infants?

Multiple endorsing organizations emphasized that maternal vaccination protects both the pregnant patient and the newborn during a period when infants are too young to be vaccinated themselves.

"Maternal immunization is one of the most effective ways we can protect both pregnant patients and babies during some of the most vulnerable stages of life. Vaccines recommended during pregnancy help safeguard pregnant patients from serious illness while also providing critical early protection to newborns before they are old enough to be vaccinated themselves. Family physicians care for patients across generations, which puts us in a unique position to counsel families, build trust, and ensure that pregnant patients have access to evidence-based preventive care. Supporting maternal immunization means healthier pregnancies, healthier infants, and stronger communities."
— Margot Savoy, MD, MPH, FAAFP, Chief Medical Officer, AAFP²

"Babies are among the most vulnerable to vaccine-preventable diseases. Their immune systems are still developing, and in those first months of life, they rely on us—the adults around them—to help keep them safe. Maternal vaccines are one of the most effective ways to protect not only the mother but her newborn as well."
— Andrew Racine, MD, PhD, FAAP, President, AAP²

9. What guidance did ACOG leadership offer clinicians on using the schedule in patient counseling?

ACOG's Chief of Clinical Practice framed the schedule as both a clinical tool and a means of addressing vaccine misinformation directly with patients.

"Immunizations are an essential part of prepregnancy, prenatal, and postpartum care. ACOG's maternal immunization schedule is a tool that ob-gyns can use to start a dialogue with their patients about the importance of protecting themselves and their infants from vaccine-preventable diseases that can lead to poor health outcomes. As ob-gyns, we have the power to combat vaccine misinformation on our own platforms, help our patients make educated decisions, and increase confidence in vaccination overall."
— Christopher Zahn, MD, FACOG, Chief of Clinical Practice, ACOG²

10. Beyond physician groups, which other clinical disciplines endorsed the schedule, and why does that matter for care teams?

Nurse practitioners and midwives were among the endorsing voices, reflecting the schedule's intended use across the full spectrum of maternal care providers.

"As the professional community for women's health nurse practitioners and other nurse practitioners providing women's and gender-related health care services nationwide, the National Association of Nurse Practitioners in Women's Health sets a standard of excellence by generating, translating, and promoting evidence-based clinical guidance for various topics, including maternal health care. The National Association of Nurse Practitioners in Women's Health is honored to collaborate with ACOG and endorse their updated maternal immunization schedule, which integrates the most updated evidence with important patient-centered considerations to support clinicians in providing strong recommendations for immunizations in pregnancy and postpartum as a fundamental intervention."
— Jessica Wells, PhD, RN, WHNP-BC, FAAN, President, NPWH²

"Midwives have long understood that the health of a community begins before birth, and the midwifery model centers the whole health and well-being of the pregnant person and their family as the foundation for lifelong health. By endorsing the ACOG maternal immunization guidelines, the American College of Nurse-Midwives affirms that immunization during pregnancy is a safe, effective, and essential tool to improve birth outcomes; protect newborns from severe illness and hospitalization; and strengthen the health of entire communities through early, shared protection."
— Michelle Monroe, DNP, APRN, CNM, FACNM, FAAN, CEO, ACNM²

References:

1. Fitch J. ACOG releases own maternal immunization schedule, breaking from federal recommendations. Contemporary OB/GYN. Published June 16, 2026. Accessed June 25, 2026. https://www.contemporaryobgyn.net/view/acog-releases-own-maternal-immunization-schedule-breaking-from-federal-recommendations
2. American College of Obstetricians and Gynecologists. ACOG Releases 2026 Maternal Immunization Schedule. Published June 10, 2026. Accessed June 25, 2026. https://www.acog.org/news/news-releases/2026/06/acog-releases-2026-maternal-immunization-schedule
3. American College of Obstetricians and Gynecologists. 2026 Maternal Immunization Schedule. Published online June 10, 2026. https://www.acog.org/-/media/project/acog/acogorg/files/pdfs/programs/immunization/maternal-immunization-schedule.pdf