The American College of Obstetricians & Gynecologists took an unprecedented step this week, releasing its first-ever independent immunization schedule for pregnant, postpartum, and breastfeeding women. The move marks a significant moment in American public health: for the first time, a major medical society representing OB-GYNs has formally published its own vaccine guidance, breaking from government recommendations and directly addressing what Dr. Christopher Zahn, the group's chief of clinical practice, describes as "growing vaccine misinformation that is circulating."
The new schedule aligns with what the CDC recommended before recent changes made under the Trump administration and Health Secretary Robert F. Kennedy Jr.—changes that sparked legal challenges and prompted ACOG to withdraw from a CDC advisory committee earlier this year. The decision to go it alone reflects a broader pattern: other professional medical societies, including the American Academy of Pediatrics, have also published their own vaccine schedules this year that diverge from current federal guidance.
ACOG's recommendations are notably detailed and practical. Four immunizations are routinely advised during pregnancy: the flu vaccine (which can be given in any trimester but is ideally received in early fall), the COVID-19 shot (recommended as soon as possible during pregnancy, though it can be given anytime), a tetanus, diphtheria, and pertussis vaccine preferably between 27 and 36 weeks, and a respiratory syncytial virus vaccine between 32 and 36 weeks during first pregnancies, or between September and January in most U.S. regions. For RSV, if a woman received the vaccine during a previous pregnancy, she does not need it again, though her baby should receive an antibody shot after birth. The group also notes that four additional vaccines—pneumococcal, meningococcal, hepatitis A, and hepatitis B—may be needed for women with certain risk factors and should be discussed with a doctor. Three other vaccines, protecting against human papillomavirus, measles/mumps/rubella, and chickenpox, are recommended before pregnancy or after birth.
The most striking difference between ACOG's guidance and current CDC policy involves COVID-19. Last May, Kennedy announced that COVID-19 vaccines are no longer recommended for healthy pregnant women and children—a position that immediately drew questions from public health experts.
The need for clear, evidence-based guidance has become urgent. Healthcare providers report significant vaccine hesitancy on the ground. Carol Hayes of the American College of Nurse Midwives noted at the announcement event that "vaccine hesitancy is huge in this country right now," with patients frequently arriving at appointments claiming to have done their own research, only to reveal they've encountered misinformation. Sarah Vaillancourt of the National Association of Nurse Practitioners in Women's Health reported her members are witnessing similar patterns, with social media fueling much of the confusion. In this landscape, Vaillancourt said, it is "really useful" for ACOG to provide accurate information that patients can trust.
The recommendations have already gained traction beyond ACOG. Thirteen other professional and medical societies have endorsed the new schedule, signaling broad consensus among healthcare providers about what pregnant women need to know. For millions of women navigating pregnancy decisions, the guidance offers clarity grounded in evidence rather than speculation.