ACOG Releases First-Ever 2026 Maternal Immunization Schedule, Breaking from CDC Guidance
The American College of Obstetricians & Gynecologists (ACOG) issued its first standalone 2026 maternal immunization schedule, outlining which vaccines are advised before, during, and after pregnancy.
ACOG released the 2026 maternal immunization schedule as an accessible reference for clinicians, public health agencies, and patients nationwide. The schedule is the first from ACOG to differ from federal guidance and follows the organization’s February 2026 withdrawal as a liaison from the CDC’s Advisory Committee on Immunization Practices over concerns about scientific integrity in vaccine policy.
ACOG’s schedule recommends four routine vaccines during pregnancy: influenza, COVID-19, Tdap (tetanus, diphtheria, pertussis), and RSV (respiratory syncytial virus), each with specific timing guidance. Influenza and COVID-19 vaccines are recommended in any trimester and at any time of year, though early fall is preferred for flu and as early as possible in pregnancy for COVID-19, while Tdap is advised in every pregnancy between 27–36 weeks’ gestation.
For RSV, ACOG recommends vaccination between 32–36 weeks’ gestation, typically from September through January in most of the United States, and only in one pregnancy, with monoclonal antibody protection preferred for infants in subsequent pregnancies.
The schedule also outlines risk-based use of pneumococcal, meningococcal, hepatitis A, and hepatitis B vaccines for pregnant patients with specific medical or exposure risks.
ACOG clarifies that certain vaccines, including human papillomavirus (HPV), measles-mumps-rubella (MMR), and varicella, are not recommended during pregnancy but should be given before conception or in the postpartum period.
The 2026 maternal immunization schedule has been endorsed by 13 medical societies and health organizations, including the American Academy of Pediatrics, the American Academy of Family Physicians, the National Association of Nurse Practitioners in Women’s Health, and the American College of Nurse-Midwives. ACOG states that the recommendations are based on peer‑reviewed data and evidence‑based medicine.
