Maternal Immunization Schedule

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Maternal Immunization Schedule

About the Schedule

This schedule differs from CDC’s immunization schedule and is endorsed by the following medical and health organizations:

Endorsed by: American Academy of Family Physicians (AAFP), American Academy of Pediatrics (AAP), American Academy of Physician Associates (AAPA), American College of Nurse-Midwives (ACNM), Association of Physician Associates in Obstetrics and Gynecology (APAOG), American Pharmacists Association (APhA), Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN), Council of Medical Specialty Societies (CMSS), Infectious Diseases Society of America (IDSA), Infectious Diseases Society for Obstetrics and Gynecology (IDSOG), National Medical Association (NMA), National Association of Nurse Practitioners in Women's Health (NPWH), Society for Maternal-Fetal Medicine (SMFM)

View the 2026 Maternal Immunization Schedule in the table below or download the PDF version.

How to Use the Schedule

An "X" indicates that the vaccine can be given in this window. An asterisk (*) indicates that the vaccine is contraindicated in pregnancy
This schedule was adapted from ACOG's Committee Statement No. 26, Maternal Immunizations
For additional information and clinical guidance for each vaccine, refer to the references

Table 1: 2026 Maternal Immunization Schedule

Category	Vaccine	Given During Every Pregnancy	Given To Specific Groups During Pregnancy	Contraindicated During Pregnancy	Can Be Initiated While Breastfeeding and While Postpartum
Routinely Recommended Vaccines During Pregnancy (use this table in conjunction with Table 2 below)	Inactivated or recombinant influenza	X¹ Administer at any time of the year, at any gestational age			X¹
	COVID-19	X² Administer at any time of the year, at any gestational age			X²
	Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap)	X³ Administer at any time of the year, at 27–36 weeks of gestation			X³
	Maternal RSV (Abrysvo)	X⁴ 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		X⁵		X⁵
	Meningococcal conjugate (MenACWY or MenABCWY) and meningococcal serogroup B		X^6,7		X^6,7
	Hepatitis A		X⁸		X⁸
	Hepatitis B		X^8,9		X^8,9
	Human papillomavirus (HPV)				X¹⁰
	Measles-mumps- rubella (MMR)			*¹¹	X¹¹
	Varicella			*¹²	X¹²

Table 2: Summary of Routinely Recommended Maternal Vaccines

Vaccine	Aug	Sep	Nov
Tdap	Can be administered at any time
COVID-19		Administer as soon as available	However, it can be administered at any time of the year to eligible individuals
Influenza		Ideally administer in the early fall	However, it can be administered at any time while the virus is circulating.
RSV		Administer September through January in most of the continental U.S.*

Tdap Vaccine

Vaccine Product: Any Tdap vaccine product may be administered.
Schedule: Administer a dose of Tdap, preferably during the early part of gestational weeks 27 through 36, during each pregnancy irrespective of the patient's prior Tdap vaccination history.
For more information, see Committee Opinion: Update on Immunization and Pregnancy: Tetanus, Diphtheria, and Pertussis Vaccination.

Influenza

Vaccine Product: Only administer inactivated influenza vaccine (IIV) or recombinant influenza vaccine (RIV) products.
Schedule: Administer a dose of IIV or RIV to people who are pregnant during any trimester or will be pregnant during influenza season.
Influenza vaccination should be given before the start of the influenza season, by the end of October, but vaccination at any time during the influenza season is encouraged to ensure protection during the period that virus is circulating in the community.
For more information, see Practice Advisory: Influenza in Pregnancy: Prevention and Treatment.

COVID-19

Vaccine Product: Any COVID-19 vaccine product may be administered.
Schedule: Vaccination may occur in any trimester, and emphasis should be on vaccine receipt as soon as possible to maximize maternal and fetal health.
For more information, see Practice Advisory: COVID-19 Vaccination Considerations for Obstetric–Gynecologic Care.

RSV

Vaccine Product: Only administer Pfizer’s RSV vaccine (Abrysvo), approved as a one-time dose. Infant monoclonal antibody may be administered to the infant as an alternative to vaccinating during pregnancy and in subsequent pregnancies after a patient has received Abrysvo in a previous pregnancy.
Schedule: Administer a dose of Pfizer’s RSV vaccine (Abrysvo) only between 32 weeks 0 days and 36 weeks 6 days of gestation during September through January in most of the continental United States if the patient was not previously vaccinated.
*In jurisdictions with seasonality that differs from most of the continental United States (eg, Alaska, jurisdictions with tropical climates), health care professionals should follow state, local, or territorial guidance on the timing of administration.
For more information, see Practice Advisory: Maternal Respiratory Syncytial Virus Vaccination.

Additional vaccines may be needed based on …

Patient’s age; health status; risk of exposure; and vaccination history such as hepatitis, meningococcal, and pneumococcal vaccines. Visit ACOG’s Immunization Tools and Resources for more information.

Reducing the Frequency of Vaccine-Preventable Diseases

Immunization is an essential part of preventive care for people who are pregnant, postpartum, and lactating—and for their infants. Ob-gyns can reduce the frequency of vaccine-preventable diseases by …

Being aware of current vaccine recommendations
Counseling patients to receive appropriate vaccines
Integrating vaccination into routine clinical practice

ACOG encourages clinicians to stock and ideally administer all recommended vaccines in their offices.

Additional Resources for Clinicians

See ACOG Clinical for clinical guidance on maternal immunizations and FAQs on topics such as COVID-19, influenza, RSV, and Tdap
Immunization, Infectious Disease, and Public Health Preparedness Program
ACOG Immunization Tools and Resources

References

American College of Obstetricians and Gynecologists. Influenza in pregnancy: prevention and treatment. Practice Advisory. ACOG; 2025. Accessed January 23, 2026. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2025/08/influenza-in-pregnancy-prevention-and-treatment
American College of Obstetricians and Gynecologists. COVID-19 vaccination considerations for obstetric–gynecologic care. Practice Advisory. ACOG; 2020. Accessed January 23, 2026. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/covid-19-vaccination-considerations-for-obstetric-gynecologic-care
Update on immunization and pregnancy: tetanus, diphtheria, and pertussis vaccination. Committee Opinion No. 718. American College of Obstetricians and Gynecologists. Obstet Gynecol 2017;130:e153–7. doi: 10.1097/AOG.0000000000002301
American College of Obstetricians and Gynecologists. Maternal respiratory syncytial virus vaccination. Practice Advisory. ACOG; 2023. Accessed January 23, 2026. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2023/09/maternal-respiratory-syncytial-virus-vaccination
Dutra K, Berry H, Lazenby GB. Pneumonia vaccines: indications for use and current safety data in pregnancy. Am J Perinatol 2025;42:1809–18. doi: 10.1055/a-2505-5434
Folaranmi T, Rubin L, Martin SW, Patel M, MacNeil JR. Use of serogroup B meningococcal vaccines in persons aged ≥10 years at increased risk for serogroup B meningococcal disease: recommendations of the Advisory Committee on Immunization Practices, 2015. Centers for Disease Control (CDC) [published erratum appears in MMWR Morb Mortal Wkly Rep 2015;64:806]. MMWR Morb Mortal Wkly Rep 2015;64:608–12.
Amin AB, Collins JP, Dong X, Leidner AJ, Loehr J, Moser CA, et al. Use of the GSK MenACWY-CRM/MenB-4C pentavalent meningococcal vaccine among persons aged ≥10 years: recommendations of the Advisory Committee on Immunization Practices - United States, 2025. MMWR Morb Mortal Wkly Rep 2026;75:7–14. doi: 10.15585/mmwr.mm7501a2
Viral hepatitis in pregnancy. Clinical Practice Guideline No. 6. American College of Obstetricians and Gynecologists. Obstet Gynecol 2023;142:745–59. doi: 10.1097/AOG.0000000000005300
Sandul AL, Rapposelli K, Nyendak M, Kim M. Updated recommendation for universal hepatitis B vaccination in adults aged 19-59 years - United States, 2024. MMWR Morb Mortal Wkly Rep 2024;73:1106. doi: 10.15585/mmwr.mm7348a3
Human papillomavirus vaccination. ACOG Committee Opinion No. 809. American College of Obstetricians and Gynecologists. Obstet Gynecol 2020;136:e15–21. doi: 10.1097/AOG.0000000000004000
American College of Obstetricians and Gynecologists. Measles, mumps, rubella (MMR) vaccination and management of obstetric–gynecologic patients during a measles outbreak. Practice Advisory. ACOG; 2024. Accessed January 23, 2026. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2024/03/management-of-obstetric-gynecologic-patients-during-a-measles-outbreak
Cytomegalovirus, parvovirus B19, varicella zoster, and toxoplasmosis in pregnancy. Practice Bulletin No. 151. American College of Obstetricians and Gynecologists [published erratum appears in Obstet Gynecol 2016;127:405]. Obstet Gynecol 2015;125:1510–25. doi: 10.1097/01.AOG.0000466430.19823.53

The American College of Obstetricians & Gynecologists has neither solicited nor accepted any commercial involvement in the development of the content of this published product. Published online on June 10, 2026

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The American College of Obstetricians & Gynecologists (ACOG) reviews its publications regularly; however, its publications may not reflect the most recent evidence. A reaffirmation date is included in the online version of a document to indicate when it was last reviewed. The current status and any updates of this document can be found on ACOG Clinical at acog.org. This information is designed as an educational resource to aid clinicians in providing obstetric and gynecologic care, and use of this information is voluntary. This information should not be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. It is not intended to substitute for the independent professional judgment of the treating clinician. Variations in practice may be warranted when, in the reasonable judgment of the treating clinician, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology.

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2026 Maternal Immunization Schedule

Endorsed by 13 Other Medical and Health Organizations