Clinical Guidance

ACOG Releases 2026 Maternal Immunization Schedule

Anthony Calabro, MA

Key Highlights

  • ACOG’s 2026 maternal immunization schedule recommends influenza, COVID-19, Tdap, and RSV vaccination during pregnancy, with vaccine-specific timing guidance.
  • The schedule includes risk-based recommendations for pneumococcal, meningococcal, hepatitis A, and hepatitis B vaccines in pregnant patients.
  • The guidance is endorsed by 13 medical societies and health organizations and follows ACOG’s February 2026 withdrawal from the CDC Advisory Committee on Immunization Practices.

The American College of Obstetricians & Gynecologists (ACOG) has released its 2026 maternal immunization schedule, outlining the recommended vaccines to be administered before, during, and after pregnancy.

The schedule is endorsed by 13 medical societies and health organizations and marks the first time ACOG has formally issued an immunization schedule that differs from federal vaccine recommendations.¹ The release follows ACOG’s February 2026 withdrawal as a liaison organization from the CDC Advisory Committee on Immunization Practices, a decision ACOG said reflected concerns about changes that undermined the committee’s scientific integrity and evidence-based approach to vaccine policy.²

“Changing national recommendations coupled with rampant vaccine misinformation are resulting in confusion for both patients and health care professionals,” Camille A. Clare, MD, MPH, CPE, FACOG, president, ACOG, said in a press release. “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.”¹

Key recommendations from the schedule include routine vaccination against influenza, COVID-19, tetanus, diphtheria, and pertussis (tdap), and respiratory syncytial virus (RSV) during pregnancy, as well as risk-based guidance for additional vaccines and clarification on vaccines not recommended during pregnancy.

Influenza
ACOG’s schedule recommends influenza vaccination during any trimester, at any time of year, although early fall is preferred.3

COVID-19
COVID-19 vaccination is also recommended during any trimester and at any time of year, with ACOG noting that it is best administered as soon as possible during pregnancy.³

Tdap
Tdap vaccination is recommended during every pregnancy, preferably as early as possible between 27 and 36 weeks’ gestation, regardless of season.³

RSV
RSV vaccination is recommended only between 32 and 36 weeks’ gestation in a patient’s first pregnancy, from September through January in most parts of the United States.³ According to the schedule, patients who received RSV vaccination during a previous pregnancy do not need another maternal RSV vaccine dose, but their infant should receive monoclonal antibody protection after birth. The infant can also receive monoclonal antibody protection instead of maternal RSV vaccination.³

Additional vaccines
The schedule also notes that pneumococcal, meningococcal, hepatitis A, and hepatitis B vaccines may be indicated for pregnant patients with certain risk factors, and clinicians should individualize recommendations based on patient history and risk profile.³

Not recommended
Vaccines not recommended during pregnancy include human papillomavirus, measles-mumps-rubella, and varicella vaccines. ACOG notes that these vaccines are recommended before pregnancy or after birth, and that current data show no safety concerns if one of these vaccines is administered before a patient knows they are pregnant.³

Clinical takeaway
For clinicians, the schedule provides a practical framework for reviewing vaccination status during prepregnancy, prenatal, and postpartum care. According to ACOG, obstetric care professionals should assess vaccination status, evaluate risk factors for vaccine-preventable diseases, and recommend indicated vaccines as part of routine preventive care.¹

Christopher Zahn, MD, FACOG, chief of clinical practice, ACOG, noted the role of obstetrician-gynecologists (OBGYN) in counseling patients. “Immunizations are an essential part of prepregnancy, prenatal, and postpartum care,” Dr. Zahn said in a press release. He added that the schedule can help OB-GYNs begin conversations with patients about protecting themselves and their infants from vaccine-preventable diseases.¹

References

  1. American College of Obstetricians & Gynecologists. ACOG releases 2026 maternal immunization schedule. Press release. June 10, 2026. Accessed June 11, 2026. https://www.acog.org/news/news-releases/2026/06/acog-releases-2026-maternal-immunization-schedule
  2. American College of Obstetricians & Gynecologists. ACOG withdraws from CDC Advisory Committee on Immunization Practices. Published February 24, 2026. Accessed June 11, 2026. https://www.acog.org/news/news-releases/2026/02/acog-withdraws-from-cdc-advisory-committee-on-immunization-practices
  3. American College of Obstetricians & Gynecologists. 2026 maternal immunization schedule. Accessed June 11, 2026. https://www.acog.org/clinical-information/maternal-immunization-schedule