COVID-19 Vaccination During Pregnancy in 2026: What the Latest U.S. Guidance Says About Safety, Protection, and Newborn Benefits

Why COVID-19 Still Matters in Pregnancy in 2026

COVID-19 is no longer the emergency it was in 2020, but it still poses real risks—especially during pregnancy. Updated vaccines are now part of routine seasonal respiratory protection in the United States, similar to flu shots.

The bottom line for pregnant people: U.S. health authorities continue to recommend COVID-19 vaccination during pregnancy, postpartum, and while breastfeeding. The goal is to lower the risk of severe illness in the mother and help protect newborns in their first months of life.

Here’s what current guidance and research show—and what we’re still learning.

What CDC and ACOG Currently Recommend

The Centers for Disease Control and Prevention (CDC) states that COVID-19 vaccination is recommended for people who are pregnant, trying to become pregnant, recently pregnant, or breastfeeding. This includes updated seasonal doses designed to better match currently circulating variants.

The American College of Obstetricians and Gynecologists (ACOG) supports vaccination in any trimester and does not recommend delaying vaccination because of pregnancy.

According to ACOG’s updated practice advisory:

COVID-19 vaccines can be given at the same visit as other routine prenatal vaccines, including influenza and Tdap.
Vaccination is recommended even if someone has had COVID-19 before.
Vaccination should not be withheld because of concerns about fertility.

These recommendations are based on accumulated safety monitoring and observational studies involving tens of thousands of pregnancies.

How Pregnancy Changes COVID-19 Risk

Pregnancy changes the immune, heart, and lung systems. That can make respiratory infections more serious.

CDC surveillance data and peer-reviewed studies published in journals such as JAMA have consistently shown that pregnant people with COVID-19 are more likely than nonpregnant peers of the same age to:

Be admitted to an intensive care unit (ICU)
Need mechanical ventilation
Experience complications such as preterm birth

While the absolute risk for any individual may still be low—especially if healthy and vaccinated—pregnancy itself is considered a risk factor for severe COVID-19.

Vaccination reduces the likelihood of hospitalization and severe outcomes, though it does not eliminate risk entirely.

What the Safety Data Show So Far (and Study Limitations)

COVID-19 vaccines were not initially tested in large randomized trials that included pregnant people. Most of what we know comes from observational studies and national safety monitoring systems.

CDC systems such as:

v-safe pregnancy registry
VAERS (Vaccine Adverse Event Reporting System)
Vaccine Safety Datalink

have monitored outcomes including miscarriage, stillbirth, birth defects, and preterm birth.

Across these systems and multiple published analyses, researchers have not found an increased risk of miscarriage or major birth defects associated with COVID-19 vaccination during pregnancy. Rates of adverse pregnancy outcomes have been similar between vaccinated and unvaccinated groups in large observational cohorts.

However, it’s important to understand the limits:

Most data are observational, meaning researchers compare outcomes between groups rather than randomly assigning vaccination.
Rare side effects may be difficult to detect immediately.
Long-term follow-up into later childhood is still ongoing.

Safety monitoring continues nationwide.

Protection for Newborns: What We Know

One of the strongest arguments for vaccination during pregnancy is newborn protection.

Studies published in CDC’s Morbidity and Mortality Weekly Report (MMWR) and other journals suggest that maternal COVID-19 vaccination during pregnancy reduces the risk of COVID-19–related hospitalization in infants during their first few months of life.

This protection likely occurs because antibodies generated during pregnancy cross the placenta and enter the baby’s circulation before birth.

Important context:

Most infant-protection studies are observational.
Protection appears strongest in the first few months of life.
We do not yet know exactly how long infant protection lasts.

Even partial protection can matter, since infants under 6 months are not eligible for vaccination and can be vulnerable to respiratory infections.

When to Get the Updated Vaccine—and How It Fits With Flu, Tdap, and RSV

For the 2025–2026 respiratory season, updated COVID-19 vaccines are formulated to target currently circulating variants.

General timing guidance:

Most people should receive the updated seasonal COVID-19 vaccine when it becomes available, typically in late summer or early fall.
If you recently had COVID-19, CDC guidance allows waiting about 3 months from infection before vaccination, though individual risk factors may affect timing.
COVID-19 vaccines can be given at the same visit as flu and Tdap vaccines.

In pregnancy, Tdap is recommended between 27 and 36 weeks to protect against pertussis. Flu vaccination is recommended in any trimester during flu season. COVID-19 vaccination does not need to be spaced apart from these routine shots.

If you are also eligible for maternal RSV vaccination during RSV season (32–36 weeks gestation), your obstetric clinician can help coordinate timing.

Common Questions: Fertility, Miscarriage, Preterm Birth, and Breastfeeding

Does COVID-19 vaccination affect fertility?
No credible evidence shows that COVID-19 vaccines cause infertility. Major medical organizations, including ACOG, state that vaccination does not impair fertility.

Does vaccination increase miscarriage risk?
Large observational studies and CDC safety monitoring have not found increased miscarriage rates among vaccinated pregnant people compared with expected background rates.

Does vaccination prevent all preterm births?
No. Vaccination reduces the risk of severe COVID-19, which itself is associated with higher preterm birth risk. But it does not eliminate preterm birth risk entirely.

Is it safe while breastfeeding?
Yes. CDC recommends COVID-19 vaccination during breastfeeding. Antibodies generated after vaccination can pass into breast milk, which may provide some protection to infants.

What Scientists Are Still Studying

Several important questions remain under study:

How long infant protection from maternal vaccination lasts
How new variants may affect vaccine effectiveness over time
Long-term developmental outcomes beyond early childhood
Optimal booster timing for high-risk pregnant individuals

So far, the evidence supports vaccination as a way to reduce severe maternal illness and provide early-life infant protection. But surveillance continues, and recommendations may evolve as new data emerge.

What This Means for Readers

If you are pregnant in 2026, COVID-19 vaccination remains recommended in the United States. Pregnancy increases the risk of severe COVID-19, and vaccination lowers that risk. Large safety monitoring systems have not found increased miscarriage or birth defect risk. Maternal vaccination may also help protect newborns in their first months of life.

Talk with your obstetric clinician about timing—especially if you recently had COVID-19 or are due for flu, Tdap, or RSV vaccination. Vaccination is one layer of protection. During surges, additional steps like testing when sick, improving indoor air quality, and seeking early antiviral treatment if eligible can further reduce risk.

Clear information, regular prenatal care, and a personalized discussion with your healthcare team remain the best way to make an informed decision.

Sources

This article is for general informational purposes only and is not medical advice. Research findings can be early, limited, or subject to change as new evidence emerges. For personal guidance, diagnosis, or treatment, consult a licensed clinician. For current outbreak or public health guidance, follow your local health department, the CDC, or another relevant public health authority.