The American College of Obstetricians and Gynecologists (ACOG) has introduced its first official maternal vaccination schedule, marking a departure from federal recommendations. This move comes as the Trump administration, led by Health and Human Services Secretary Robert F. Kennedy Jr., a known vaccine critic, dropped flu and COVID-19 shot recommendations for pregnant individuals.
New ACOG Schedule Details
The schedule recommends four vaccines for all pregnant people: influenza, COVID-19, Tdap (tetanus, diphtheria, pertussis), and RSV (respiratory syncytial virus). Additional vaccines like hepatitis B and MMR may be advised for those with comorbidities or high risk of exposure.
Endorsements and Scientific Basis
About 13 medical societies, including the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP), have endorsed the schedule. Margot Savoy, AAFP's chief medical officer, emphasized that vaccines in pregnancy provide "critical protection." Laura Riley, chair of obstetrics and gynecology at Weill Cornell Medicine and an ACOG member, stated that the evidence supports ACOG's recommendations, not the administration's.
Response to Misinformation and Federal Changes
ACOG's guidance aims to counter growing vaccine misinformation and confusion caused by conflicting federal statements. Andrew Racine, AAP president, noted that maternal vaccines are a "key element" of protection for infants before they can develop their own immunity. The schedule is designed to be accessible to providers, patients, and pharmacists.
Vaccination Rates and Disparities
Kevin Ault, professor at Western Michigan University and ACOG member, reported that while about 70% of pregnant people receive Tdap and RSV shots, rates drop to 30% for flu and even lower for COVID-19. Disparities exist between those on public versus private insurance, affecting both vaccination rates and infant outcomes.
ACOG's Shift from CDC
ACOG withdrew from the Advisory Committee on Immunization Practices (ACIP) in early 2026 due to concerns about scientific integrity. Christopher Zahn, ACOG's chief of clinical practice, noted that while the relationship with the CDC was vital for years, a different approach is now necessary. The recommendations were informed by a comprehensive review of data from the Vaccines Integrity Project.
Addressing Vaccine Hesitancy
Clinicians are seeing increased vaccine hesitancy and skepticism toward science. Sarah Vaillancourt, a board member of the National Association of Nurse Practitioners in Women’s Health, highlighted the role of social media in spreading misinformation. She emphasized that the new schedule helps patients navigate accurate information. Riley noted that OB-GYNs have a unique opportunity during pregnancy to build trust and address vaccine questions over multiple visits.
