Overview
- ACOG published the 2026 Maternal Immunization Schedule on June 10, 2026, and 13 other medical societies have endorsed the guidance.
- The schedule recommends four routine vaccines in pregnancy: COVID-19, influenza, RSV and a single Tdap dose each pregnancy, with additional vaccines advised for people with specific risk factors.
- ACOG specifies COVID-19 and influenza may be given in any trimester and urges vaccination as soon as possible, while advising Tdap preferably in early gestational weeks 27 through 36.
- For RSV, ACOG limits maternal use to Pfizer’s Abrysvo as a one-time dose given between 32 weeks 0 days and 36 weeks 6 days during typical RSV season, and presents an infant monoclonal antibody as an alternative.
- The move follows ACOG’s February withdrawal as a liaison to the CDC’s vaccine advisory committee and directly conflicts with recent HHS/CDC changes that removed universal pregnancy recommendations for flu and COVID-19, creating a split in national vaccine guidance that could affect clinician advice and patient choices.