ACOG led a coalition of pediatricians, family physicians, and midwives to publish the first consolidated U.S. maternal immunization guide, recommending four core shots during pregnancy and breaking with the CDC on COVID and flu.
Pregnant patients in the United States now have a vaccine schedule, and it was not written by the CDC. On Wednesday, the American College of Obstetricians and Gynecologists released the first consolidated U.S. maternal immunization guide, endorsed by 13 other medical organizations and built around four core shots during pregnancy. It also breaks with federal guidance on two of those vaccines.
The schedule recommends four shots during any pregnancy: Tdap between 27 and 36 weeks, RSV between 32 and 36 weeks for first-time pregnancies, a flu shot in any trimester, and a COVID-19 vaccine. The endorsing coalition includes the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Nurse-Midwives, according to the Scientific American report on the schedule. It also lists risk-factor vaccines (pneumococcal, meningococcal, hepatitis) and pre- or post-pregnancy vaccines (HPV, MMR, varicella), with the ACOG schedule explicitly allowing chickenpox vaccination while breastfeeding.
The divergence from federal guidance is concrete. The CDC withdrew its universal COVID-19 vaccine recommendation for pregnant people in May 2025 and currently recommends flu vaccination only during flu season, not year-round or in every trimester as the ACOG schedule now does. CDC's current ACIP COVID-19 vaccine page reflects that narrower stance, and ACOG's move is, in effect, a clinical rebuttal from the specialty that actually delivers those patients.
ACOG president Camille A. Clare framed the gap as a misinformation problem. "Rampant vaccine misinformation" and "confusion" from changing national recommendations have left pregnant patients and their providers without a clear answer, she said in the ACOG news release announcing the schedule. Andrew Racine, president of the American Academy of Pediatrics, made the clinical case in plainer terms: a newborn's immune system is too immature to mount strong defenses on its own, so maternal vaccination is what carries the baby through the first months of life. The newborn-protection logic, not the CDC dispute, is the spine the coalition is asking clinicians to lean on.
The trust environment is not on the coalition's side. A Harvard T.H. Chan School of Public Health and de Beaumont Foundation poll released Tuesday found that only 12% of Americans say they trust the CDC "a great deal." The same poll found 80% of Americans trust the American Heart Association "somewhat" or "a great deal." A coalition schedule from professional societies is, in part, an attempt to make up that ground by borrowing institutional credibility ACOG and AAP already have with their patients.
Two caveats sharpen the picture. The CDC's narrower stance reflects an evolving federal posture on COVID-19 vaccination in 2025 and 2026, and ACOG's clinical critique is targeted at the scope of federal recommendations, not at the underlying immunization science. The schedule itself is new, so uptake, insurance coverage, and any CDC response are the questions worth watching over the next several months.