The American College of Obstetricians and Gynecologists (ACOG), the main professional body for obstetricians and gynecologists in the US, has introduced its first-ever maternal vaccination schedule, marking a departure from previous federal guidelines.
Historically, ACOG has supported administering vaccines during pregnancy, but this is the first time they’ve formalized these recommendations into an official schedule.
During the Trump administration, under the influence of Robert F Kennedy Jr., who has been critical of vaccines, federal recommendations for flu and Covid vaccinations were removed. The Advisory Committee on Immunization Practices (ACIP) had intended to prioritize vaccine guidance for pregnant individuals but was interrupted by a judicial ruling.
Tracy Beth Høeg, a sports medicine physician who previously led vaccine investigations at the FDA until her dismissal in May, has controversially claimed that the RSV vaccine poses a danger to infants without robust evidence. A recent study published in Jama Network Open indicated that RSV vaccination during pregnancy has a 68% efficacy rate in preventing hospitalizations for infants under three months old.
Laura Riley, chair of obstetrics and gynecology at Weill Cornell Medicine and ACOG member, stated that the administration’s vaccine recommendations lack scientific backing: “The evidence does not support their recommendations. Our evidence shows otherwise.”
The new ACOG vaccination schedule advocates for four key shots for all pregnant individuals: influenza, Covid, Tdap (tetanus, diphtheria, and pertussis), and RSV. Additional vaccines, like hepatitis B and MMR (measles, mumps, rubella), may be advised for those with certain health risks.
The guidance aims to be a clear resource for healthcare providers, patients, and pharmacists to combat the rising tide of misinformation regarding vaccines, as explained by Christopher Zahn, ACOG’s chief of clinical practice and health equity.
About 13 medical societies, including the American Academy of Pediatrics and the American Academy of Family Physicians, have endorsed this new schedule.
Riley emphasized the need to clear up confusion stemming from HHS statements suggesting Covid vaccines aren’t essential for children or pregnant women. She referenced “very clear data” supporting the benefits of Covid vaccinations during pregnancy, which can reduce risks like hospitalization and preterm birth.
Andrew Racine, president of the AAP, noted that while many conversations about child safety focus on post-birth, these discussions should begin during pregnancy. He stressed how vulnerable newborns are to vaccine-preventable diseases, highlighting the importance of maternal vaccinations for their protection.
Margot Savoy, chief medical officer at AAFP, reiterated the critical protective role that vaccines play for both mothers and infants.
Zahn put forth that immunizations not only safeguard the pregnant individuals and their babies but also benefit public health at large.
Currently, about 70% of pregnant people receive their Tdap and RSV vaccinations in the US, but flu vaccination rates have dropped to around 30% and even lower for Covid shots, according to Kevin Ault, a professor at Western Michigan University and an ACOG member. He pointed out discrepancies in vaccination rates and outcomes based on insurance types, suggesting room for improvement.
ACOG members, including Riley and Ault, had previously participated in ACIP discussions but withdrew in early 2026, citing concerns over changes that risked the committee’s scientific integrity regarding vaccine policies. Zahn noted that their long-standing relationship with the CDC had faced challenges that necessitated a shift in approach.
While ACOG’s prior recommendations aligned with the CDC until 2025, Riley remarked that they must now act independently due to the evolving landscape. The new guidance is influenced by an extensive review from the Vaccines Integrity Project.
With increasing numbers of patients claiming to “do their own research” on vaccines, often via social media, it has become crucial for healthcare professionals to guide them towards accurate information. Sarah Vaillancourt from the National Association of Nurse Practitioners in Women’s Health emphasized that this schedule aims to provide reliable information for both providers and patients.
Many parents still wish to vaccinate their children, yet vaccine hesitancy has grown, posing challenges for pediatric practice, according to Racine. Delaying vaccinations increases the likelihood that children may ultimately miss them altogether.
Savoy observed that skepticism toward science is also on the rise among patients. Open conversations can help patients address their concerns and strengthen trust in medical guidance.
As trusted sources of information, OB-GYNs have unique opportunities to discuss vaccination, given the frequent visits during pregnancy and postpartum. Riley noted that these ongoing interactions allow providers to address questions about vaccines both for mothers and infants as they grow.
