All pregnant people should get the COVID-19, respiratory syncytial virus (RSV), influenza, and Tdap vaccines, according to new recommendations from the American College of Obstetricians and Gynecologists (ACOG.)
These recommendations are in line with ACOG’s previous guidance. But it marks the first time the organization has released an immunization schedule independent of the US Centers for Disease Control and Prevention (CDC.)
ACOG publishing its own schedule is evidence of the growing rift between the professional health society and the CDC, which last May dropped its recommendation that pregnant women receive the COVID-19 vaccine.
The relationship further deteriorated in August, when the CDC removed ACOG experts from its Advisory Committee on Immunization Practices (ACIP) workgroups, and in January, when it overhauled childhood vaccine recommendations in a way that deviated from the standard administrative process. (The new recommendations have been temporarily blocked by a federal judge.
ACOG withdrew from the ACIP as a liaison organization in February, citing concerns that the committee’s scientific integrity and evidence-based approach were being compromised.
We are all about the science.
The CDC still recommends that pregnant women receive the RSV vaccine and Tdap vaccines—a combination of shots to protect against tetanus, diphtheria, and pertussis (whooping cough). It also advises that pregnant women get flu shots that are free of thimerosal, a preservative. ACOG says vaccines that contain thimerosal are safe during pregnancy.
ACOG’s 2026 vaccine recommendations are an attempt to clear up confusion, said Laura Riley, MD, chair of ACOG’s Immunization, Infectious Disease, and Public Health Preparedness Expert Work Group, during today’s press briefing.
“We are all about the science,” said Riley, explaining that the recommendations come after a rigorous review of efficacy and safety data to ensure patients receive only evidence-based interventions.
Pregnancy is an opportunity to build trust with patients
Newborns have underdeveloped immune systems because, according to the American Society of Microbiology, they’re transitioning from the near-sterile environment of the womb to a world full of new pathogens.
Maternal vaccinations ensure babies enter the world with antibodies, said Andrew Racine, MD, PhD, president of the American Academy of Pediatrics (AAP.)
“It’s the one generation essentially protecting the next generation,” he said.
AAP is among 13 professional medical societies and health organizations that have endorsed the ACOG’s immunization schedule. Others include the American Academy of Family Physicians (AAFP), the Infectious Diseases Society of America, and the American College of Nurse-Midwives.
The alignment between ACOG and AAFP reflects what’s best for pregnant patients and families, said AAFP chief medical officer Margot Savoy, MD, MPH. She said her organization is dedicated to ensuring every pregnant patient has access to these lifesaving vaccines.
Racine, Savoy, Riley and other experts who joined the press briefing agreed that more patients are voicing concerns around the safety and necessity of vaccines.
OB-GYNs caring for maternity patients have a unique opportunity to address vaccine skepticism, said Riley, because these patients have roughly a dozen prenatal appointments before giving birth. This allows her to build trust and share a little bit of information about vaccines at a time.
“We have to take advantage of that,” she said.