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The American College of Obstetricians & Gynecologists (ACOG) has published a simplified immunization schedule for pregnant, breastfeeding, and postpartum individuals that it said represents the best evidence for four routinely recommended vaccines.

“ACOG has made the decision to formally release its own immunization schedule to provide and communicate clear evidence-based guidance and to address the growing vaccine misinformation that is circulating,” said Christopher Zahn, MD, chief of clinical practice and health equity and quality at the organization, in a briefing with reporters.

The new ACOG schedule is endorsed by 13 medical societies and health organizations, and, for the first time, differs from recommendations issued by the CDC’s Advisory Committee on Immunization Practices (ACIP) for use during pregnancy.

Notably, the agency in 2025 removed its recommendation for the COVID-19 vaccine in pregnancy and replaced it with “no guidance.” That decision is the subject of an ongoing lawsuit against the federal government that is being led by the American Academy of Pediatrics (AAP).

The ACOG schedule urges vaccination at any point during pregnancy or while breastfeeding or in the postpartum period.

“The evidence supports our recommendation,” said Laura E. Riley, MD, chair in the ACOG’s Immunization, Infectious Disease and Public Health Preparedness Expert Work Group, during the briefing. It is based “on very clear data that shows that the vaccine will reduce the risks of COVID to a newborn,” said Riley, chair in ob/gyn at Weill Cornell Medical College in New York City.

Riley and other clinicians on the briefing said that maternal vaccination is especially important. “Babies are among the most vulnerable to vaccine-preventable diseases,” said Andrew Racine, MD, PhD, president of the AAP. “Maternal vaccines are one of the most effective ways to protect not only the mother but her newborn as well,” said Racine.

Riley said “there’s a fair amount of confusion out there,” around vaccinating during pregnancy. “Our desire was to bring it all together on one piece of paper that everyone could read and understand.”

ACOG has developed immunization guidance for decades in collaboration with ACIP, said Zahn. But he noted that ACOG withdrew from ACIP in early 2026, “due to concerns about recent changes that undermine the committee’s scientific integrity and evidence-based approach to vaccine policy.”

The ACOG employed a “tremendously rigorous process,” to come up with its new recommendations, said Zahn.

In addition to the COVID vaccine, the schedule urges vaccination for influenza (inactivated or recombinant) and Tdap at any point in pregnancy or during the postpartum or breastfeeding period. The schedule also recommends the vaccine against respiratory syncytial virus (RSV) seasonally during the first eligible pregnancy, and that infants should receive an anti-RSV monoclonal antibody.

The schedule also has separate recommendations for patients with comorbidities or disease risk factors.

Kevin Ault, MD, a member of the ACOG’s Immunization, Infectious Disease, and Public Health Preparedness Expert Work Group, and a professor of ob/gyn at Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, said that the Tdap vaccine was backed by 20 years of safety and effectiveness data. “It protects newborns from a disease that has a significant amount of morbidity and mortality associated with a whooping cough during childhood,” Ault told reporters.

The recommendation was informed by a systematic review published by the Vaccine Integrity Project at the University of Minnesota, said Ault.

All the clinicians who participated in the briefing said they had encountered increased vaccine hesitancy and distrust.

“There’s just sort of an increase in distrust in science in general and questioning behavior around science,” said American Academy of Family Physicians Chief Medical Officer Margot Savoy, MD, MPH.

“You’re allowed to have questions, and you’re allowed to want to have a conversation with your clinician during your visit,” she said. “In fact, we hope you will ask them and not just take them back home.”

When there’s a conversation, there’s an opportunity “to be able to share with you why we’re so confident that the vaccines are safe and effective,” said Savoy.

Riley noted that clinicians have more opportunity with pregnancy “because we see people 10 times in nine months.”

By 32 weeks, patients might understand that vaccines are in their best interest, she said.

The ACOG disclosed that it had neither solicited nor accepted any commercial involvement in the development of the content of this published product. The organization added that all ACOG committee members and authors have submitted a conflict-of-interest disclosure statement related to this published schedule and all its clinical guidelines. Any potential conflicts have been considered and managed strictly in accordance with ACOG’s Conflict of Interest Disclosure Policy.

Alicia Ault is a Saint Petersburg, Florida-based freelance journalist whose work has appeared in many health and science publications, including Smithsonian.com. You can find her on X @aliciaault and on Bluesky @aliciaault.bsky.social.