ACOG has released its first formal maternal vaccination schedule, recommending seasonal influenza, COVID-19, Tdap and RSV vaccines during pregnancy and allowing additional shots (like hepatitis B and MMR) for people with specific risks. The college published the schedule to provide clear, evidence-based guidance after recent federal shifts in vaccine recommendations and a pause in ACIP activities. A JAMA Network Open study cited by ACOG found maternal RSV vaccination reduced infant hospitalizations under three months by 68%. The schedule—endorsed by about 13 medical societies—aims to counter misinformation and improve vaccination conversations during prenatal care.
ACOG Issues First Official Maternal Vaccine Schedule, Breaking With CDC Guidance
Vaccines in pregnancy provide ‘critical protection’, said Margot Savoy, chief medical officer at AAFP.Photograph: Halfpoint Images/Getty Images(Photograph: Halfpoint Images/Getty Images)
The American College of Obstetricians and Gynecologists (ACOG) has published its first formal maternal vaccination schedule and for the first time publicly diverged from recent federal guidance from the Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC).
ACOG’s consolidated schedule recommends that all pregnant people be offered four routine vaccines: seasonal influenza, COVID-19, tetanus‑diphtheria‑acellular pertussis (Tdap), and respiratory syncytial virus (RSV). Additional vaccines—such as hepatitis B and measles-mumps-rubella (MMR)—may be advised for people with specific medical conditions or exposure risks.
Why ACOG Moved Now
ACOG said the new schedule is intended to provide a clear, evidence-based clinical resource for obstetricians, family physicians, pediatricians, pharmacists and patients amid growing confusion about federal vaccine guidance. The move follows actions by HHS leadership that removed some prior federal recommendations for influenza and COVID-19 vaccination in certain groups, and a judicial pause that halted some Advisory Committee on Immunization Practices (ACIP) activities.
Evidence and Debate
ACOG cited recent evidence in support of maternal vaccination. A U.S. real-world study published in JAMA Network Open found maternal RSV vaccination reduced hospitalization of infants under three months by 68%. The college also highlighted data showing maternal COVID-19 vaccination lowers the risk of severe maternal illness, hospitalization and preterm birth.
"The evidence, I think, does not support their recommendation. The evidence supports our recommendation," said Dr. Laura Riley, chair of obstetrics and gynecology at Weill Cornell Medicine and an ACOG member, in a press briefing announcing the schedule.
The announcement comes amid controversy surrounding some critics of vaccination policy. For example, Dr. Tracy Beth Høeg, who led a vaccine review at the FDA before departing in May, has raised concerns about RSV vaccine safety in infants; several experts have questioned the strength of the evidence behind those claims. ACOG and peer-reviewed studies counter that maternal RSV vaccination provides substantial protection to young infants.
Endorsements, Uptake, And Equity Concerns
About 13 professional societies endorsed ACOG’s schedule, including the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP). ACOG emphasized that immunization during pregnancy protects the pregnant person, the infant, and the broader community.
Uptake varies by vaccine: roughly 70% of pregnant people receive Tdap and RSV vaccines in the U.S., while influenza coverage has declined to about 30% and COVID-19 vaccine uptake during pregnancy is lower. Experts noted persistent disparities in vaccination rates and infant outcomes between people with public versus private insurance.
Policy Rift With ACIP
In early 2026, ACOG withdrew from participation with ACIP, citing concerns that recent changes undermined the committee’s scientific integrity and evidence-based approach to vaccine policy. ACOG leaders said the organization will take a different approach to advising clinicians and patients while continuing to review evolving evidence.
Addressing Misinformation and Patient Conversations
ACOG framed the schedule as a tool to counter vaccine misinformation circulating on social media and elsewhere. Clinicians emphasized the unique opportunity that obstetric care provides to discuss vaccination: repeated prenatal and postpartum visits create multiple touchpoints to answer questions and build trust.
"Babies are among the most susceptible populations for vaccine-preventable diseases," said AAP President Andrew Racine. "Maternal vaccination is a key element of protection during the first months of life."
ACOG said the recommendations were informed by a comprehensive review of available evidence, including analyses by the Vaccines Integrity Project, and that the schedule is intended to be an accessible, evidence-based resource for clinicians, pharmacists and patients.
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