ACOG Releases 2026–27 Respiratory Virus Immunization Guidance, Extending RSV Vaccination Window for Pregnant Individuals
核心洞察
ACOG (搜索) released updated 2026–27 guidance strongly recommending COVID-19 (搜索), RSV (搜索), and influenza (搜索) vaccination for all pregnant, postpartum, and pregnancy-contemplating individuals.
The RSV (搜索) vaccination eligibility window now extends from September 1 through March 1, reflecting later and more severe RSV seasons.
Only 11.1% of pregnant women received the COVID-19 (搜索) vaccine in the 2025–26 season, a 25.7% decline from the prior year, with lowest uptake among Hispanic and Black pregnant women.
The American College of Obstetricians & Gynecologists (ACOG (搜索)) has released updated guidance that continues to strongly recommend vaccination against COVID-19 (搜索), RSV (搜索), and influenza (搜索) ahead of the 2026–27 respiratory virus season for all women who are pregnant, postpartum, or contemplating pregnancy. The three separate guidance documents reinforce the overall importance of maternal immunization and are based on the latest safety and efficacy data.
"Vaccination is standard preventive care, and complications can occur in pregnancy as a result of not being vaccinated that are completely preventable," said ACOG (搜索) President Camille A. Clare, MD, MPH, CPE, FACOG. "Unfortunately, we are living in challenging times when it comes to the large amount of vaccine misinformation and disinformation that exists today, so even more responsibility falls to ob-gyns to combat that and make sure patients know the facts."
ACOG (搜索) continues to collaborate with the Vaccine Integrity Project (VIP), which completed a rigorous, updated vaccine evidence review for 2026–27 that informed recommendations from participating medical organizations, including ACOG, the American Academy of Pediatrics, the American Academy of Family Physicians, and the Infectious Diseases Society of America. ACOG is also partnering with the American Medical Association this year on activities to boost vaccine confidence among patients.
COVID-19 Vaccination
Research continues to demonstrate that vaccination reduces the risk of severe disease in pregnancy, hospitalization, and adverse outcomes such as stillbirth and preterm birth, according to ACOG (搜索)'s Practice Advisory "COVID-19 (搜索) Vaccination Considerations for Obstetric–Gynecologic Care." However, in the 2025–26 respiratory virus season, only 11.1% of pregnant women received the COVID-19 vaccine, down 25.7% from the previous year. Additional data show the lowest vaccination rates are among Hispanic and Black pregnant women, reflecting continued inequities in access, distribution, and uptake.
ACOG (搜索)'s strong recommendation for vaccination and updated booster doses is now based on more than five years of research and millions of administered doses. The evidence has found no increased risk of miscarriage, stillbirth, preterm birth, small-for-gestational-age birth, or birth defects.
"It has been well established that COVID-19 (搜索) vaccination does not cause pregnancy loss even when administered in the first trimester," said Mark Turrentine, MD, FACOG, lead author of the guidance. "This has been further reinforced by yet another study published this year examining data from the CDC's vaccine pregnancy registry. The true risk to pregnant people and their pregnancies is from COVID-19 infection, especially for those with preexisting health conditions. Vaccination remains the best way to mitigate that risk."
There are currently four COVID-19 (搜索) FDA-approved vaccines that people may choose from, all of which are safe in pregnancy.
RSV Vaccination
One of the most notable changes to the RSV (搜索) guidance is that ACOG (搜索) now recommends pregnant individuals receive a single dose of the bivalent RSV PreF vaccine Abrysvo from September 1 through March 1, instead of through January 31. According to the Practice Advisory "Maternal Respiratory Syncytial Virus Vaccination," recent RSV disease seasons have occurred later in the spring and have become more severe, so the extension of the eligibility window will help clinicians provide pregnant people and their infants with additional protection. Current data show that 41.6% of eligible pregnant individuals have received the maternal RSV vaccine.
The bivalent RSV (搜索) PreF vaccine remains the only vaccine approved by the FDA for use in pregnancy. Unlike the COVID-19 (搜索) and influenza (搜索) vaccines, which can be administered during any trimester and during each pregnancy, pregnant people should receive the RSV vaccine only once, as there is no data on effectiveness in subsequent pregnancies.
ACOG (搜索) recommends the vaccine be administered between 32 0/7 and 36 6/7 weeks of gestation for those who do not have a planned delivery within two weeks. If the vaccine is not administered during pregnancy, infants should receive one of the two available monoclonal antibodies, clesrovimab or nirsevimab, at birth.
"All pregnant patients should take RSV (搜索) seriously," said Brenna Hughes, MD, FACOG, lead author of the Practice Advisory. "Every year we see as many as 80,000 children under the age of five being hospitalized because of RSV, and the highest rate is among babies that are 6 months old or younger. It is imperative that either patients are vaccinated or infants receive one of the monoclonal antibodies. We recommend that clinicians consider which option is most readily available and easily accessible when counseling patients."
Influenza Vaccination
Vaccination for influenza (搜索) remains an essential part of prepregnancy, prenatal, and postpartum care, according to ACOG (搜索)'s Practice Advisory "Influenza in Pregnancy: Prevention and Treatment." Pregnant and postpartum individuals have a significantly higher risk of developing serious complications from infection compared with nonpregnant people and should be vaccinated generally between September and April as soon as vaccines are available, before the onset of influenza circulation in their community.
This year's guidance contains a table with recommendations for appropriate usage of all FDA-approved influenza (搜索) vaccines. Although the table includes the new mRNA vaccine approved last month, mRNA-1010 is not approved for use in pregnancy, and there is currently no data on its use for lactating individuals. The inactivated or recombinant influenza vaccines remain the only vaccines recommended for use in pregnancy in any trimester.
"As physicians, we cannot overemphasize the importance of passive immunity for newborns when it comes to influenza (搜索), COVID-19 (搜索), and RSV (搜索)," said lead guidance author Kevin Ault, MD, FACOG. "Maternal vaccination protects infants from serious illness and hospitalization in their first few months of life when they are unable to be vaccinated. Maternal flu vaccination after birth does provide antibodies through breast milk, but the infant does not get the full benefit of passive protection from vaccine-induced maternal antibodies that would have been transferred through the placenta."
Coadministration and State Endorsement
ACOG (搜索)'s Practice Advisories note that all vaccines for COVID-19 (搜索), RSV (搜索), and influenza (搜索) approved for use in pregnancy can be administered at the same time with no impact on efficacy. Coadministered vaccination is safe for pregnant people and has the added benefit of increasing rates of vaccine uptake.
"An ob-gyn remains one of the most trusted messengers for pregnant patients when it comes to vaccination," said Dr. Clare. "And when the vaccines are available in the office at the time that the patient is being counseled, the odds of vaccine acceptance and receipt are five to 50 times higher. So, the opportunity is there to change our current trajectory and prevent the devastating consequences that come from not being protected."
The New York State Department of Health and the New York City Department of Health and Mental Hygiene announced their endorsement of the 2026 Maternal Immunization Schedule released by ACOG (搜索), encouraging health care providers to incorporate the recommendations into routine care for pregnant, postpartum, and breastfeeding patients. The schedule recommends routine vaccination during pregnancy against influenza (搜索) and COVID-19 (搜索), as well as vaccines protecting infants against pertussis (whooping cough) and RSV (搜索), plus additional vaccines for pregnant people at increased risk for diseases including pneumococcal pneumonia, meningococcal meningitis, and hepatitis A and B.
"Vaccination during pregnancy provides critical protection for both pregnant people and their babies during a time when they may be especially vulnerable to serious illness," said State Health Commissioner Dr. James McDonald. The ACOG (搜索) Maternal Immunization Schedule is based on peer-reviewed scientific data and evidence-based medicine and has been endorsed by 13 leading medical organizations. The recommended vaccines continue to be covered by private health insurance plans, Medicaid, and the Vaccines for Children (VFC) Program.