To provide guidance for immunizations recommended for pregnant, postpartum, and lactating patients and their infants in the US.
Approach:
Maternal Vaccines: The schedule lists 4 routinely recommended maternal vaccines: inactivated or recombinant influenza, COVID-19, Tdap, and maternal RSV vaccine.
Endorsements: Thirteen medical and health organizations endorsed the document, including the American Academy of Pediatrics and the Society for Maternal-Fetal Medicine.
Vaccination Timing: Influenza and COVID-19 vaccines can be given at any gestational age; Tdap is recommended between 27-36 weeks of gestation.
RSV Vaccination: Only Pfizer’s Abrysvo is recommended for maternal vaccination, with specific timing guidelines.
Additional Vaccines: Pneumococcal, meningococcal, hepatitis A, and hepatitis B vaccines are recommended for patients with specific comorbidities.
Contraindications: MMR and varicella vaccines are contraindicated during pregnancy but may be initiated postpartum.
Key Findings:
ACOG's maternal immunization schedule differs from the CDC’s immunization schedule.
Influenza vaccination is advised before the end of October and at any time during the influenza season.
COVID-19 vaccination is recommended as soon as possible during any trimester.
Tdap vaccination is recommended during each pregnancy regardless of prior vaccination history.
The schedule is intended as an educational resource and should not be considered inclusive of all proper treatments or methods of care.
Interpretation:
The schedule serves as a tool for healthcare providers to discuss the importance of vaccinations with patients.
Limitations:
The schedule may not reflect the most recent evidence as it is reviewed regularly.
It should not be considered inclusive of all proper treatments or methods of care.
Conclusion:
The 2026 maternal immunization schedule aims to enhance maternal and infant health through recommended vaccinations.
Guideline recommends screening, diagnosis, positive airway pressure therapy, and postpartum reassessment while highlighting the very low certainty of available evidence.
A living clinical guideline outlines a treatment hierarchy for selected pharmacologic therapies in patients with obesity and selected patients with overweight.
Investigators found that adding pregnancy-related and female-specific factors modestly improved postpartum cardiovascular risk prediction compared with traditional risk factors alone.
