The American College of Obstetricians and Gynecologists (ACOG) recently released its 2026 Maternal Immunization Schedule. The schedule focuses on routinely recommended vaccines during pregnancy and recommended vaccines based on comorbidities or disease risk factors. The schedule includes vaccine recommendations for COVID-19, maternal RSV, Tdap, HVP, and more. The schedule also highlights what is contraindicated during pregnancy and what can be given during pregnancy, including what can be given to specific groups during pregnancy.

Below, we outlined the vaccines included in the ACOG 2026 Maternal Immunization Schedule regarding routinely recommended vaccines during pregnancy and recommended vaccines based on comorbidities or disease risk factors. View the full-text version of the schedule for the most complete look at the recommendations.

Routinely Recommended Vaccines During Pregnancy
  • Inactivated or Recombinant Influenza:
    • Given during every pregnancy; Administer at any time of the year, at any gestational age.
    • Can be initiated while breastfeeding and while postpartum.
  • COVID-19:
    • Given during every pregnancy; Administer at any time of the year, at any gestational age.
    • Can be initiated while breastfeeding and while postpartum.
  • Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis (Tdap):
    • Given during every pregnancy; Administer at any time of the year, at 27-36 weeks of gestation.
    • Can be initiated while breastfeeding and while postpartum.
  • Maternal RSV (Abrysvo):
    • Given during every pregnancy; Administer seasonally in first eligible pregnancy, at 32 weeks 0 days-36 weeks 6 days of gestation; In subsequent pregnancies, repeat vaccination not indicated and infants should receive a monoclonal antibody.
Recommended Vaccines Based on Comorbidities or Disease Risk Factors
  • Pneumococcal:
    • Given to specific groups during pregnancy.
    • Can be initiated while breastfeeding and while postpartum.
  • Meningococcal Conjugate (MenACWY or MenABCWY) and Meningococcal Serogroup B:
    • Given to specific groups during pregnancy.
    • Can be initiated while breastfeeding and while postpartum.
  • Hepatitis A:
    • Given to specific groups during pregnancy.
    • Can be initiated while breastfeeding and while postpartum.
  • Hepatitis B:
    • Given to specific groups during pregnancy.
    • Can be initiated while breastfeeding and while postpartum.
  • Human Papillomavirus (HPV):
    • Can be initiated while breastfeeding and while postpartum.
  • Measles-Mumps-Rubella (MMR):
    • Contraindicated during pregnancy.
    • Can be initiated while breastfeeding and while postpartum.
  • Varicella
    • Contraindicated during pregnancy.
    • Can be initiated while breastfeeding and while postpartum.

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