ACOG Launches Its Own Pregnancy Vaccine Schedule, Splitting With CDC

The leading U.S. professional organization for obstetricians released its own maternal immunization schedule on June 10, recommending four vaccines for routine use during pregnancy—including flu and COVID-19 shots that the federal government no longer endorses. It is the first time the American College of Obstetricians and Gynecologists has published a standalone pregnancy vaccine schedule rather than deferring to the Centers for Disease Control and Prevention.

The CDC's pregnancy vaccine guidance, under Health and Human Services Secretary Robert F. Kennedy Jr., currently lists only two routinely recommended vaccines: Tdap (tetanus-diphtheria-pertussis) and RSV. Both flu and COVID-19 were removed from the federal schedule for pregnant people last year. ACOG's new schedule restores all four. "Changing national recommendations coupled with rampant vaccine misinformation are resulting in confusion for both patients and health care professionals," said Dr. Camille Clare, the group's president.

The schedule was co-signed by 13 other medical societies, a sign of how broadly clinical medicine has aligned against the current federal stance. ACOG had previously withdrawn from the CDC's Advisory Committee on Immunization Practices, the expert panel that formally sets vaccine recommendations—meaning the organization no longer holds an official voice in that process. The new schedule is its answer to that absence.

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The Case for COVID-19 Vaccination During Pregnancy

The clinical argument for keeping COVID-19 on the pregnancy schedule rests on how maternal immunity works. "The COVID-19 vaccine helps protect the newborn from COVID-19 for the first six months of life, before they can be vaccinated themselves," said Dr. Laura Riley, chair of obstetrics and gynecology at Weill Cornell Medicine. Infants under six months are ineligible for COVID-19 vaccines, leaving antibodies transferred in utero and through breast milk as the primary protection during that window. The same structure applies to influenza: newborns cannot receive flu shots until age six months, and pregnant individuals are themselves at elevated risk of severe influenza.

ACOG's position, backed by the 13 co-signing societies, is that removing both vaccines from federal guidance creates a clinical gap not supported by the underlying evidence. Whether that argument moves HHS is a separate question. The department has not responded publicly to the June 10 release.

A federal court issued a preliminary injunction in March 2026 against portions of Kennedy's vaccine-related decisions; HHS is appealing that ruling, and the legal scope of a cabinet secretary's authority to override established ACIP recommendations is still being litigated. That context matters because ACOG's schedule carries clinical authority, not legal force. Insurance reimbursement for vaccines during pregnancy typically tracks federal CDC guidance, not professional society recommendations, which means coverage may not follow even if a physician follows ACOG's list.

What OB-GYNs Are Now Navigating

The practical problem for the roughly four million U.S. pregnancies each year is that the two schedules now give different instructions, and the one with federal authority behind it says less than the one backed by clinical consensus. An OB-GYN who recommends flu and COVID-19 vaccination in line with the evidence is acting within standard of care but outside current federal guidance. A patient who asks "what does the government say?" gets a different answer than one who asks "what does my doctor's professional organization say?"

ACOG said it plans to update the schedule annually. The publication of a parallel schedule does not fix the underlying problem—it documents it. Whether that documentation nudges federal policy, shapes insurer coverage decisions, or simply gives clinicians a defensible written standard, will become clearer over the rest of 2026.