Objective:

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.

Sources:

• ACOG