Pregnant in 2026? What ACOG says about COVID, flu, Tdap, and RSV

If you’re pregnant in the United States in 2026 and feeling unsure about vaccine advice, the clearest new development is ACOG’s maternal immunization schedule, released in June 2026. It lists four vaccines as routine during pregnancy: inactivated or recombinant flu vaccine, COVID-19 vaccine, Tdap, and maternal RSV vaccine.

That does not mean every source uses the same wording. The biggest difference right now is COVID-19. ACOG treats COVID-19 vaccination as a routine part of pregnancy care. CDC’s pregnancy-specific COVID-19 page now says the 2025-2026 vaccine is based on individual decision-making, while also noting that pregnancy raises the risk of severe illness and that vaccination during pregnancy has not been linked to increased health risks for pregnant women or babies.

Quick answer: what ACOG calls routine in pregnancy

ACOG’s 2026 schedule lists these as routine vaccines during pregnancy:

Flu: inactivated or recombinant flu vaccine
COVID-19: at any gestational age
Tdap: during each pregnancy, at 27 to 36 weeks of gestation
Maternal RSV: a seasonal dose during the eligible late-pregnancy window

ACOG’s schedule is also meant to help guide care during the postpartum period and while breastfeeding, not just during pregnancy itself.

What is consistent across ACOG and CDC

Tdap: CDC says Tdap should be given during each pregnancy, preferably in the early part of the 27-to-36-week window. The goal is to help pass antibodies to the baby before birth.

Maternal RSV: CDC says only Pfizer’s Abrysvo should be used during pregnancy. It is given as a single dose from 32 weeks 0 days through 36 weeks 6 days, usually between September and January in most of the continental United States. Seasonal timing can differ in places such as Alaska, southern Florida, Puerto Rico, Guam, the U.S. Virgin Islands, and some U.S.-affiliated Pacific jurisdictions, so local guidance matters. CDC also says repeat maternal RSV vaccination is not currently recommended in later pregnancies; instead, the infant should usually receive nirsevimab.

Flu: CDC continues to recommend seasonal flu vaccination during pregnancy. It says flu vaccine can be given at any time during pregnancy while flu viruses are circulating. For many people in the first or second trimester, September or October is preferred. In the third trimester, July or August can also be considered because vaccination during pregnancy may help protect newborns during their first months of life.

Where the COVID-19 wording is different

The main 2026 difference is not that one group says pregnancy no longer matters for COVID-19. It is that ACOG and CDC are framing the recommendation differently. ACOG lists COVID-19 as a routine maternal vaccine. CDC’s pregnancy page says the 2025-2026 vaccine recommendation is based on individual decision-making and says the greatest benefit is for people at higher risk of severe illness, including people who are pregnant.

CDC also says pregnancy increases the risk of severe COVID-19 disease and that vaccination during pregnancy has not been linked to increased health risks for pregnant women or babies. Its page says vaccination during pregnancy can help protect babies younger than 6 months from hospitalization due to COVID-19.

One useful detail for readers: CDC’s safety summary is based mainly on observational studies and pregnancy registry data, including studies involving more than a million vaccinated pregnant women worldwide. That kind of evidence cannot answer every question as neatly as a randomized pregnancy trial would, but it is still the main safety evidence public health agencies use, and CDC says it has not shown increased risks such as miscarriage, stillbirth, preterm delivery, or birth defects.

Why timing matters in pregnancy

These vaccines are timed for specific reasons. Tdap is timed to improve antibody transfer before delivery. Maternal RSV has a narrower late-pregnancy window and seasonal timing. Flu and COVID-19 can be discussed earlier in pregnancy because they are aimed at protecting the pregnant patient during respiratory virus season, and in some cases may also help protect the baby after birth.

Trying to conceive, recently pregnant, or breastfeeding?

If you are trying to conceive, this is a practical time to review your vaccine record and ask whether anything should be updated before pregnancy rather than during it. That matters especially for vaccines that are not used during pregnancy.

If you are recently pregnant or breastfeeding, the picture is a little broader than “pregnant or not pregnant.” ACOG’s schedule covers pregnancy, postpartum, and lactation. CDC’s COVID-19 page also includes breastfeeding and says there is no evidence that COVID-19 vaccination is harmful during breastfeeding. It also says antibodies in breast milk could help protect babies.

A quick note on live vaccines such as MMR and varicella

CDC says MMR and varicella vaccines are contraindicated during pregnancy. If they are needed, they are usually handled before pregnancy or after delivery, not during pregnancy. CDC also says people should avoid becoming pregnant for 28 days after MMR vaccination and for 1 month after each varicella dose.

Questions to bring to your next prenatal visit

Which vaccines are due now based on my gestational age and due date?
If I am between 27 and 36 weeks, when is the best visit for Tdap?
If I will be 32 to 36 weeks during RSV season, am I eligible for maternal RSV vaccine?
If I already received maternal RSV vaccine in a prior pregnancy, should my baby receive nirsevimab this season instead?
How is this office handling COVID-19 counseling now that ACOG and CDC use different wording?
Are any vaccines better handled before pregnancy or after delivery, such as MMR or varicella if I am not immune?
Can I get recommended vaccines here, at a pharmacy, or through my primary care office?

Bringing your vaccine record, your due date, and any questions about prior RSV vaccination can make that conversation much easier. Vaccines are preventive, not a substitute for urgent medical evaluation. If you are pregnant and feel very sick or think something is wrong, contact your clinician or seek urgent care rather than waiting for a routine vaccine visit.

Coverage and access

HealthCare.gov says most health plans must cover a set of preventive services at no cost to patients, including many immunizations, when they are provided in network. But it also notes that coverage can vary and that zero-dollar cost is not guaranteed in every case. If you are unsure, check both your insurance plan and the place giving the vaccine before the appointment.

Bottom line: as of July 4, 2026, ACOG’s new schedule is one of the clearest pregnancy-vaccine references for readers hearing mixed messages. For flu, Tdap, and maternal RSV, the timing windows are fairly consistent with CDC guidance. For COVID-19, the main difference is how the recommendation is framed. If you have a prenatal visit coming up, a reasonable next step is to ask for a vaccine plan that matches your trimester, due date, local RSV timing, and access to vaccination where you live.

Sources

Editorial note: Weence articles are researched from cited public-health, medical, regulatory, journal, and reputable news sources and may be drafted with AI assistance. They are checked for source support, clarity, and safety guardrails before publication.

This article is for general informational purposes only and is not medical advice. Research findings can be early or incomplete, and health guidance can change. Always talk with a qualified healthcare professional about personal symptoms, diagnosis, medications, vaccines, screenings, or treatment decisions. If you think you may have a medical emergency, call emergency services right away.