ACOG Releases Maternal Immunization Schedule, Differing From Previous CDC Schedule

The American College of Obstetricians and Gynecologists (ACOG) released its 2026 Maternal Immunization Schedule on June 10, 2026, providing a roadmap for the protection of pregnant, postpartum, and lactating patients and their infants. This schedule arrives at a time of unprecedented friction between leading medical societies and federal health agencies.¹

Notably, the schedule is endorsed by 13 major health organizations, including the American Pharmacists Association (APhA) and the American Academy of Pediatrics (AAP), signaling a unified front among clinicians even as they distance themselves from the CDC’s Advisory Committee on Immunization Practices (ACIP) schedule.¹

Updates on Maternal Vaccine From ACOG

For pharmacists, the ACOG schedule serves as another clinical resource, recommending routine administration of several key vaccines during pregnancy regardless of prior history. The 2026 guidelines emphasize the tetanus, diphtheria, and pertussis vaccine, preferably administered between 27 and 36 weeks of gestation, and the inactivated or recombinant influenza vaccine, which should ideally be given by the end of October. Additionally, the schedule supports COVID-19 vaccination at any point during pregnancy and highlights the seasonal administration of Pfizer’s respiratory syncytial virus vaccine, Abrysvo, between 32 and 36 weeks of gestation for those who have not been previously vaccinated. Because ACOG encourages clinicians to stock and administer these vaccines, pharmacists are increasingly on the front lines of ensuring these evidence-based protocols are followed.¹

“Specifically in pharmacies, we're not looking at all childhood vaccines being given, but those ones, like flu, maybe COVID, those are the ones that we've seen changing more often. Pharmacists really need to stay up to date with where we are now and looking at those guidelines and recommendations,” Gretchen Garofoli, PharmD, BCACP, CTTS, FAPhA, clinical professor at the West Virginia University School of Pharmacy, said.²

The release of this independent schedule follows ACOG’s announcement on February 24, 2026, that it was withdrawing as a liaison organization from ACIP. Steven J. Fleischman, MD, president of ACOG, cited concerns that recent changes had undermined the committee’s scientific integrity and evidence-based approach.³

According to ACOG, the Department of Health and Human Services (HHS) bypassed established clinical processes to make unilateral changes to vaccine recommendations, a move that Fleischman described as a “fundamental departure from the scientific rigor” that has defined the committee for 60 years. This withdrawal was spurred by the committee's recent tendency to ignore peer-reviewed safety reports and use "cherry-picked" data, which ACOG argues threatens to erode public confidence in life-saving immunizations.³

Ongoing Confusion Surrounding Vaccine Schedules

This divide in public health policy is further complicated by an intense legal battle, American Academy of Pediatrics et al. v. Kennedy et al., which has significant implications for pharmacy practice. The litigation stems from a June 2025 decision by HHS Secretary Robert F. Kennedy Jr. to dismiss all 17 members of the ACIP and replace them with individuals who share his skepticism toward vaccine technology.^4,5

In March 2026, US District Judge Brian Murphy issued a preliminary injunction that froze the administration’s attempts to radically alter the national childhood immunization schedule, including the removal of routine recommendations for the hepatitis B birth dose and COVID-19 vaccines. The court found that these changes were reviewable because they directly affect pharmacist authority to administer vaccines and impact provider liability.^4,5

For the pharmacy profession, which now administers a substantial share of vaccinations in the United States, this instability creates both operational and legal challenges. Many insurance benefits are legally tied to ACIP recommendations, meaning that the administration’s decision to bypass formal committee processes has threatened the stability of vaccine coverage.⁵

Pharmacists must navigate a landscape where federal recommendations may conflict with the evidence-based guidelines of professional societies like ACOG and the AAP. Legal experts note that when a vaccine shifts from "routine" to "shared clinical decision-making" without clear CDC guidance, it raises questions about a pharmacist's authority under state law and introduces significant liability concerns.⁵

As the legal case moves toward a potential Supreme Court review, pharmacists are being advised to stay closely informed of their specific state’s scope of practice to ensure they are operating within the law. Although the federal government moved toward a more limited schedule for several vaccines, ACOG and other health organizations remain committed to developing and endorsing their own evidence-based guidance based on peer-reviewed scientific data.^1,3,5

Conclusion

For now, the messaging from these medical organizations is clear: although the political landscape has shifted, the underlying science supporting maternal and childhood immunizations has not changed, and the 2026 ACOG schedule stands as the definitive clinical standard for obstetric and gynecologic care.^1,3

“It's very state specific, for whenever all the changes were going back and forth. Some of the states, for example, Pennsylvania—where I hold one of my licenses—they started to follow the American Academy of Pediatrics’ (AAP) guidelines. They followed the American College of Obstetricians and Gynecologists (ACOG) and American Academy of Family Physicians guidelines,” Garofoli said.

READ MORE: Women’s Health Resource Center

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REFERENCES

1. ACOG. 2026 Maternal Immunization Schedule. Accessed June 11, 2026. https://www.acog.org/clinical-information/maternal-immunization-schedule

2. Nowosielski B, Garofoli G. Q&A: Why Pharmacists Staying Informed on Evolving Vaccine Guidelines is Critical. Drug Topics. March 26, 2026. Accessed June 11, 2026. https://www.drugtopics.com/view/why-pharmacists-staying-informed-on-evolving-vaccine-guidelines-is-critical

3. ACOG Withdraws from CDC Advisory Committee on Immunization Practices. February 24, 2026. Accessed June 11, 2026. https://www.acog.org/news/news-releases/2026/02/acog-withdraws-from-cdc-advisory-committee-on-immunization-practices

4. Gallagher A. AAP Releases Updated Childhood Vaccine Schedule Amid Recent HHS Overhaul. Drug Topics. January 28, 2026. Accessed June 11, 2026. https://www.drugtopics.com/view/aap-releases-updated-childhood-vaccine-schedule-amid-recent-hhs-overhaul

5. Gallagher A. Ongoing AAP, HHS Legal Battle Will Determine Future Health Care Action. Drug Topics. June 4, 2026. Accessed June 11, 2026. https://www.drugtopics.com/view/ongoing-aap-hhs-legal-battle-will-determine-future-health-care-action