ACOG2026 maternal immunisation schedule
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ACOG 2026 maternal immunization schedule recommendations pregnancy
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https://www.infectiousdiseaseadvisor.com/features/acog-2026-…
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Here is a full breakdown of the ACOG 2026 Maternal Immunization Schedule, published June 10, 2026 - the first time ACOG has issued its own independent schedule, departing from federal (CDC/HHS) guidance. It is endorsed by 14 professional medical organizations.
ACOG 2026 Maternal Immunization Schedule
Published: June 10, 2026 | Source: ACOG official page
PART 1 - Routinely Recommended During Every Pregnancy
These four vaccines are recommended for all pregnant patients. They can be safely co-administered.
| Vaccine | Timing / Gestational Age | Frequency | Postpartum / Breastfeeding |
|---|---|---|---|
| Influenza (IIV or RIV - inactivated/recombinant only) | Any trimester; ideally before flu season (by end of October), but any time flu is circulating | Every pregnancy | Yes - can continue/initiate |
| COVID-19 | Any trimester, any time of year | Every pregnancy | Yes - can continue/initiate |
| Tdap (tetanus, diphtheria, acellular pertussis) | 27-36 weeks gestation, preferably early in that window | Every pregnancy, regardless of prior Tdap history | Yes - can continue/initiate |
| RSV (Abrysvo) | 32 weeks 0 days - 36 weeks 6 days, seasonally (Sept-Jan in most of continental US) | First eligible pregnancy only - not repeated in subsequent pregnancies | Not applicable (pregnancy-specific) |
RSV note: Infants born from subsequent pregnancies (where the mother was not re-vaccinated) should receive a monoclonal antibody (nirsevimab) for RSV prevention. Infant monoclonal antibody is also an acceptable alternative to maternal RSV vaccination in any pregnancy.
PART 2 - Recommended Based on Comorbidities or Risk Factors
These are not routine for all pregnant patients but are indicated for specific groups:
| Vaccine | Pregnancy Use | Postpartum / Breastfeeding |
|---|---|---|
| Pneumococcal | Specific groups only | Yes |
| Meningococcal Conjugate (MenACWY or MenABCWY) | Specific groups only | Yes |
| Meningococcal Serogroup B | Specific groups only | Yes |
| Hepatitis A | Specific groups only | Yes |
| Hepatitis B | Specific groups only | Yes |
| HPV | Not initiated during pregnancy | Yes - postpartum/breastfeeding OK |
PART 3 - Contraindicated During Pregnancy (safe postpartum)
| Vaccine | Status |
|---|---|
| MMR (measles-mumps-rubella) | Contraindicated during pregnancy; give postpartum |
| Varicella | Contraindicated during pregnancy; give postpartum |
Key Points and Context
Why ACOG broke from federal guidance:
- ACOG acted in response to what its president Dr. Camille Clare called "changing national recommendations coupled with rampant vaccine misinformation" causing confusion among patients and clinicians.
- The most significant divergence: ACOG continues to recommend COVID-19 vaccination during pregnancy, unlike the current HHS Secretary RFK Jr.'s position, which had announced COVID-19 vaccination is no longer recommended for pregnant women. However, as of the schedule's publication, online CDC and HHS schedules still listed it.
Who developed it: ACOG's Immunization, Infectious Disease, and Public Health Preparedness Expert Work Group, based on review of available scientific evidence.
Live/attenuated vaccines: MMR and varicella remain contraindicated in pregnancy because of theoretical risk to the fetus; both should be given postpartum (and are safe with breastfeeding).
Tdap timing rationale: The 27-36 week window is optimal for transplacental transfer of pertussis antibodies to the neonate before birth, providing passive immunity in the first weeks of life.
For the full schedule document, see ACOG.org - Maternal Immunization Schedule (published June 10, 2026). The Contemporary OB/GYN article also has a good clinical summary.
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