Updated guidelines from ACOG recommend routine influenza, COVID-19, RSV, and Tdap vaccines during pregnancy to enhance protection for infants and streamline later immunisation discussions, with recent studies backing their effectiveness.
Kevin Ault, an obstetrician and co-author of the American College of Obstetricians and Gynaecologists’ updated respiratory virus guidance, says vaccination in pregnancy can do more than protect the parent: it can help shield the newborn and make later immunisation conversations easier for other clinicians.
Speaking to Contemporary OB/GYN, Ault said all four vaccines in ACOG’s 2026-27 recommendations , influenza, COVID-19, RSV and Tdap , have direct benefit for babies through maternal antibody transfer. He said the newer recommendations for COVID-19 and RSV sit alongside long-established advice on flu and pertussis vaccination, which has been used for years to protect infants in the earliest months of life.
ACOG’s updated guidance, released in February 2026, tells obstetric clinicians to routinely review vaccination status and recommend needed shots during pregnancy. The college says influenza and COVID-19 vaccination should be offered during the fall and winter respiratory virus season, Tdap should be given in each pregnancy between 27 and 36 weeks’ gestation, and RSV vaccination should be used in eligible pregnant patients. The guidance is backed by 14 other medical and health organisations.
Ault argued that beginning the conversation before delivery can have a knock-on effect after birth. “If you start talking about those vaccines during pregnancy, that makes the conversations a little easier for our colleagues in pediatrics and family medicine with those newborns,” he said. He added that multi-specialty practices are well placed to coordinate care and improve uptake across both maternal and childhood vaccination.
The evidence base behind the guidance continues to grow. According to ACOG’s materials, maternal RSV vaccination reduced infant hospitalisation risk by 51% to 70%, while maternal COVID-19 vaccination showed 50% to 54% effectiveness against COVID-related hospital contacts in the first two months of life. A July 2026 study in JAMA Network Open, led by Ault, also found that parents and pregnant patients tended to favour maternal immunisation over monoclonal antibodies for RSV prevention, with a strong clinician recommendation emerging as a major factor in acceptance.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
