The American College of Obstetricians and Gynecologists (ACOG), the principal professional body for obstetricians and gynaecologists in the United States, has taken the unprecedented step of publishing its own maternal vaccination schedule. This marks a significant divergence from recent federal health recommendations in the US, which under the leadership of Robert F Kennedy Jr., the US Secretary of Health and Human Services and a known vaccine critic, have omitted advice for flu and Covid vaccinations.
ACOG's newly released schedule advises four key immunisations for all pregnant individuals: influenza; Covid; tetanus, diphtheria, and pertussis (Tdap); and respiratory syncytial virus (RSV). For those with pre-existing health conditions or at higher risk of specific infections, additional vaccines such as hepatitis B and measles, mumps, rubella (MMR) may also be recommended. This comprehensive guidance is designed to serve as an accessible resource for healthcare providers, expectant parents, and pharmacists, seeking to offer clear, evidence-based information amidst growing vaccine misinformation.
The organisation highlighted that the decision to issue its own schedule was driven by a need to counteract confusion arising from conflicting advice. Dr. Laura Riley, chair of obstetrics and gynaecology at Weill Cornell Medicine and an ACOG member, stated that the evidence supports ACOG's recommendations, not the federal administration's. This sentiment was echoed by Christopher Zahn, ACOG's chief of clinical practice and health equity and quality, who emphasised that immunisations protect not only the pregnant individual but also the infant and the wider community.
The schedule has received broad support, with around 13 medical societies endorsing the initiative, including the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP). Andrew Racine, AAP president, underscored the importance of maternal vaccinations in protecting infants, who are highly susceptible to vaccine-preventable diseases in their early months before they can develop their own immunity. He described maternal vaccines as a "key element" of protection, commencing well before birth.
While vaccination rates for Tdap and RSV in pregnant individuals in the US are around 70%, uptake for flu and Covid vaccines is considerably lower, at approximately 30% and even less respectively, according to Kevin Ault, a professor of obstetrics and gynaecology at Western Michigan University and an ACOG member. These figures also reveal disparities, with variations in vaccination rates and infant outcomes observed between individuals on public versus private insurance.