ACOG Breaks from CDC on Maternal Vaccines in 2026

The American College of Obstetricians and Gynecologists released its first-ever independent maternal immunization schedule in the week of June 10–16, 2026, recommending four routine shots for all pregnant individuals and explicitly contradicting Trump administration federal guidance on vaccine safety. Thirteen major medical societies have endorsed the new schedule.

How Federal Vaccine Policy Was Dismantled Over Thirteen Months

The ACOG schedule did not arrive without warning. Its release is the final step in a sustained institutional rupture between obstetric medicine and the federal public health apparatus under the current HHS leadership.

The sequence began in May 2025, when the Trump administration — with HHS Secretary Robert F. Kennedy Jr. in a central role — dropped long-standing federal recommendations advising influenza and COVID-19 vaccinations for pregnant individuals and children. Three months later, in August 2025, the CDC removed ACOG experts from its Advisory Committee on Immunization Practices workgroups. That removal effectively stripped one of the nation's leading obstetric bodies from the table where vaccine guidance is formally made.

In January 2026, the CDC overhauled childhood vaccine guidelines through a process that bypassed normal administrative procedure; a federal judge later temporarily blocked those changes. By February 2026, ACOG had seen enough. The organization formally withdrew as an ACIP liaison, stating that the committee's scientific integrity and evidence-based approach to vaccine policy were being compromised.

The policy environment deteriorated further in May 2026, when Dr. Tracy Beth Høeg, a sports medicine physician working on vaccine review for the FDA, was dismissed and publicly claimed — without rigorous supporting data — that the RSV vaccine poses a lethal risk to infants. Days later, a real-world U.S. study published in JAMA Network Open found RSV vaccination during pregnancy to be 68 percent effective at preventing hospitalization in infants under three months of age. The schedule ACOG released weeks after that finding incorporates RSV as one of four routine recommendations.

The chart below maps the key policy events from May 2025 through the schedule's release.

What the New Schedule Recommends — and Where It Contradicts Federal Guidance

The ACOG schedule recommends four routine vaccines for all pregnant individuals, regardless of individual risk factors: influenza, COVID-19, Tdap (tetanus, diphtheria, and pertussis), and RSV. A second tier of conditional recommendations covers hepatitis B and MMR (measles, mumps, and rubella), which ACOG advises only for individuals with specific comorbidities or elevated exposure risk.

The schedule was built on a clinical data review conducted by the Vaccines Integrity Project. Its most pointed departure from current federal guidance concerns thimerosal, a mercury-based preservative used in some multi-dose flu vaccine vials. The CDC currently advises that pregnant individuals receive thimerosal-free formulations. ACOG's new guidance explicitly states that flu vaccines containing thimerosal are safe during pregnancy — a direct scientific contradiction of CDC's standing position, and one that clinicians will now need to address when patients raise the question.

Dr. Laura Riley, who chairs the OB-GYN department at Weill Cornell Medicine and led the ACOG workgroup behind the schedule, described the evidence basis plainly: the data supports ACOG's recommendations, not those currently promoted by HHS. Dr. Christopher Zahn, ACOG's chief of clinical practice, said the schedule is intended to deliver clear, evidence-based guidance and to address the growing circulation of vaccine misinformation.

That misinformation has had measurable clinical consequences. While approximately 70 percent of pregnant individuals are still receiving Tdap and RSV vaccines, influenza uptake has fallen to roughly 30 percent, and COVID-19 uptake is lower still. Significant disparities exist between patients on public insurance and those on private insurance, both in vaccination rates and in infant clinical outcomes. The chart below illustrates the current gap in maternal vaccine uptake across the four routine recommendations.

Why the Clinical Access Window May Be as Significant as the Schedule Itself

The ACOG schedule arrives at a moment when its member clinicians have something no federal advisory body currently possesses in the same form: direct, repeated, trusted contact with the patients it is trying to reach. Pregnant individuals typically see their clinician between 10 and 12 times across nine months. That cadence offers a sustained, structured opportunity to address vaccine hesitancy in a way that a single advisory recommendation or public health campaign cannot replicate.

Clinicians have noted that social-media-driven skepticism rarely collapses in a single conversation. The prenatal care model — where a patient returns every few weeks, trusting the same provider with increasingly personal medical decisions — creates a platform for accumulating trust and gradually working through specific concerns. Dr. Andrew Racine, president of the American Academy of Pediatrics, framed the stakes directly: the adults around an infant in the first months of life are the only mechanism of protection available before that infant can mount its own immune response. Maternal vaccination is, in his framing, one generation protecting the next.

The 13 societies endorsing ACOG's schedule — including the American Academy of Family Physicians, the Infectious Diseases Society of America, and the National Association of Nurse Practitioners in Women's Health — represent essentially the full clinical infrastructure surrounding pregnancy and infant care in the United States. Their joint endorsement means that the ACOG schedule will reach patients not only through OB-GYN visits but through family medicine, infectious disease consultations, and midwifery practice. The uptake disparities between public and private insurance patients remain a limiting factor; the schedule alone does not resolve barriers tied to access, cost, or institutional capacity. But it does give clinicians across disciplines a unified, evidence-grounded framework to work from when patients arrive with questions shaped by the past thirteen months of federal messaging. The figures below summarize the core numerical anchors of the new schedule and its backing coalition.