Pregnancy Vaccines in 2026: What ACOG Recommends and Why CDC Feels Mixed

If you are pregnant in the United States in July 2026, the simplest answer comes from the American College of Obstetricians and Gynecologists: its June 10, 2026 maternal immunization schedule still lists four routine vaccines to discuss during pregnancy — influenza, COVID-19, Tdap, and maternal RSV.

The reason many readers are confused is that CDC pages do not all sound the same on COVID-19. CDC’s adult immunization schedule table uses a symbol meaning No Guidance/Not Applicable in the pregnancy row for COVID-19, while still listing Tdap during each pregnancy and seasonal RSV during pregnancy. But CDC’s pregnancy-specific COVID-19 page, updated February 10, 2026, says the 2025-2026 COVID-19 recommendation is now based on individual decision-making, notes that pregnancy raises the risk of severe illness, and says people can receive a COVID-19 vaccine at any point in pregnancy.

The practical takeaway

If your question is which vaccines are still on the pregnancy list in 2026, ACOG‘s answer is straightforward:

Flu: ACOG recommends inactivated or recombinant influenza vaccine during pregnancy at any gestational age. The live nasal-spray flu vaccine is not recommended during pregnancy.
COVID-19: ACOG still treats COVID-19 vaccination as a routine maternal vaccine that may be given at any gestational age. CDC’s pregnancy page is less direct, but it still says vaccination can be given at any point in pregnancy and may offer the greatest benefit to people at higher risk for severe illness, including pregnant patients.
Tdap: One dose is recommended during every pregnancy, timed at 27 through 36 weeks of gestation.
RSV: Pfizer’s Abrysvo is the maternal RSV vaccine used in pregnancy. ACOG places it at 32 weeks 0 days through 36 weeks 6 days, given seasonally in a first eligible pregnancy. In later pregnancies, repeat maternal RSV vaccination is not currently indicated; infant protection may instead rely on a monoclonal antibody after birth.

Where ACOG and CDC line up — and where they do not

There is not much disagreement on Tdap or maternal RSV timing. The main difference is COVID-19 wording.

ACOG’s 2026 schedule presents COVID-19 as a routine pregnancy vaccine alongside flu, Tdap, and RSV. CDC’s pregnancy-specific COVID-19 page still says vaccination during pregnancy has not been linked to increased health risks for pregnant women or babies, and it says pregnancy increases the risk of severe COVID-19 disease. But CDC now frames the 2025-2026 COVID-19 vaccine recommendation as an individual decision based on benefits and risks rather than as a simple blanket recommendation for every pregnant patient.

The adult CDC schedule is even terser. In that table, the dot symbol means No Guidance/Not Applicable. That is different from the symbol used for vaccines that are contraindicated or not recommended during pregnancy. So the table does not say COVID-19 vaccine is contraindicated in pregnancy. It does, however, read less clearly than ACOG’s pregnancy-focused schedule.

Why Tdap remains one of the clearest recommendations

Tdap is backed by years of use and a large evidence base. A 2025 meta-analysis indexed in PubMed found that pertussis vaccination during pregnancy was effective at protecting infants younger than 3 months and did not show a clear increase in serious adverse events in pregnant patients or infants. That said, it was a pooled analysis of studies with different designs and settings, so it strengthens existing guidance more than it settles every remaining question on its own.

What is still not routinely given during pregnancy

This article is about what remains recommended, but it also helps to know what is still generally avoided during pregnancy. ACOG’s 2026 schedule lists measles-mumps-rubella and varicella as contraindicated during pregnancy and places HPV in the postpartum or breastfeeding category rather than routine use during pregnancy. CDC’s adult schedule also marks the live nasal-spray flu vaccine as not recommended during pregnancy.

What this means for prenatal visits

Ask early which vaccines fit your trimester, due date, and respiratory-virus season.
Bring any vaccine record you have, especially if you are unsure whether you received Tdap in a prior pregnancy or maternal RSV in an earlier pregnancy.
If COVID-19 guidance feels hard to follow, ask your prenatal clinician to walk through your personal risk factors and local virus activity using the current CDC and ACOG pages.
If you get sick during pregnancy with fever or respiratory symptoms, contact your prenatal clinician promptly. Seek urgent care for emergency symptoms such as trouble breathing, chest pain, or severe worsening illness.

Bottom line: As of July 3, 2026, ACOG’s pregnancy-specific schedule is more direct than CDC’s current COVID-19 messaging. For most U.S. readers, that means influenza, COVID-19, Tdap, and, when timing fits, maternal RSV are still the core vaccines to discuss during prenatal care — while recognizing that CDC now describes COVID-19 vaccination in pregnancy as an individualized decision.

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.