ACOG

New ACOG guidance urges maternal vaccination to shield infants from respiratory viruses

August 25, 2025

ACOG has released updated guidance strongly recommending maternal immunization against COVID-19, influenza, and RSV during pregnancy. The recommendations emphasize the safety and efficacy of these vaccines in preventing severe maternal illness and improving neonatal outcomes.

COVID-19 vaccination during pregnancy is associated with reduced risks of severe maternal morbidity, preterm birth, and stillbirth, and provides passive immunity to infants—who remain highly vulnerable to hospitalization. Notably, infants born to vaccinated mothers show greater antibody persistence than those whose mothers were infected but unvaccinated.

For influenza, ACOG continues to recommend inactivated or recombinant vaccines during any trimester. The live-attenuated, intranasally administered influenza vaccine, which has recently been OK'd for home self-administration after having been exclusively prescribed and administered in a medical setting or a pharmacy, is not approved for use in pregnant individuals.

Regarding RSV, ACOG advises administering the bivalent RSVpreF vaccine between 32 0/7 and 36 6/7 weeks gestation, unless delivery is imminent or monoclonal antibody therapy is planned for the infant.

All three vaccines may be coadministered.

Clinicians are urged to offer strong, evidence-based recommendations to counter vaccine hesitancy and protect maternal and infant health during respiratory virus season.

Sources:

(2025, August 22). The American College of Obstetricians and Gynecologists. ACOG releases updated maternal immunization guidance for COVID-19, influenza, and RSV. [News release]. https://www.acog.org/news/news-releases/2025/08/acog-releases-updated-maternal-immunization-guidance-covid-influenza-rsv

The American College of Obstetricians and Gynecologists. “COVID-19 vaccination considerations for obstetric-gynecologic care.” Updated August 2025. Accessed August 25, 2025. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/covid-19-vaccination-considerations-for-obstetric-gynecologic-care

The American College of Obstetricians and Gynecologists. “Influenza in Pregnancy: Prevention and Treatment.” Updated August 2025. Accessed August 25, 2025. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2025/08/influenza-in-pregnancy-prevention-and-treatment

The American College of Obstetricians and Gynecologists. “Maternal respiratory syncytial virus vaccination.” Updated August 2025. Accessed August 25, 2025. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2023/09/maternal-respiratory-syncytial-virus-vaccination