The American College of Obstetricians and Gynecologists (ACOG) has recently reaffirmed its strong support for COVID-19 vaccination during pregnancy. This announcement comes as the second major professional medical association to diverge from the current recommendations issued by the U.S. Centers for Disease Control and Prevention (CDC) this week. ACOG’s updated practice advisory emphasizes the importance of vaccination for pregnant and lactating individuals, despite the CDC's recent changes.
According to ACOG's updated advisory, “While the CDC recently removed its recommendation that pregnant and lactating individuals receive updated COVID-19 vaccines, ACOG’s recommendations have not changed.” The organization continues to advocate for the use of updated COVID-19 vaccines among individuals planning for pregnancy, as well as those who are currently pregnant, recently pregnant, or lactating.
In May, U.S. Health and Human Services Secretary Robert F. Kennedy Jr. declared that COVID-19 vaccines will no longer be included in the CDC's immunization schedules for pregnant women and healthy children. This abrupt decision bypassed the traditional governmental process for evaluating vaccine recommendations and lacked the scientific evidence necessary to justify such a significant change.
ACOG's latest guidelines state that “all clinicians should provide a strong recommendation for updated COVID-19 vaccination to their pregnant and lactating patients.” Vaccination is encouraged at any trimester, with a focus on the “earliest opportunity to maximize maternal and fetal health.” Importantly, any of the available COVID-19 vaccines can be administered simultaneously with other vaccines recommended during pregnancy, such as those for influenza and respiratory syncytial virus (RSV).
ACOG’s advisory references numerous studies, including multiple sources from the CDC, that highlight the safety and efficacy of COVID-19 vaccination during pregnancy. It also points out the heightened risks that pregnant women and infants face from COVID-19 infections.
On Tuesday, the American Academy of Pediatrics (AAP) also released updated recommendations endorsing COVID-19 vaccinations for children. The AAP directly criticized the federal vaccine advisory committee, the CDC’s Advisory Committee on Immunization Practices, citing concerns over its members’ history of spreading vaccine misinformation following recent changes led by Kennedy.
There has been ongoing tension between ACOG and federal health policymakers. ACOG announced that it is no longer accepting federal funding due to recent changes that significantly impact its program goals, policy positions, and its ability to provide timely, evidence-based guidance for care. Furthermore, in July, ACOG partnered with an independent group known as the Vaccine Integrity Project to develop maternal immunization guidance, filling the gap left by the absence of the government’s historically robust annual reviews of data.
Dr. Steven Fleischman, ACOG President, expressed concerns about the newly reconstructed Advisory Committee on Immunization Practices (ACIP), stating that the committee did not adhere to the long-standing tradition of a rigorous, unbiased review of credible scientific evidence by medical and public health experts. He noted that the data presented to ACIP supports why ACOG maintains its recommendation for safe and effective maternal vaccination.
In response to the abrupt federal changes in the COVID-19 vaccination schedule, numerous health and medical organizations—including ACOG and AAP—have advocated for continued access and insurance coverage for vaccines in an open letter. The CDC still recognizes pregnancy as a risk factor for severe illness from COVID-19, with substantial evidence indicating a “conclusive increase in risk” for pregnant women.
Pregnant women with COVID-19 are at a higher risk of requiring intensive care, being placed on ventilators, or facing mortality. They are also at increased risk for complications such as cesarean births, preeclampsia, and blood clots. Infants born to mothers who have contracted COVID-19 are similarly at increased risk.
The open letter from health organizations stresses the importance of ensuring that pregnant women have access to this crucial prevention tool, allowing them to protect themselves and their vulnerable infants who are not yet eligible for vaccination.
As of now, the HHS has not directly addressed ACOG’s recommendations or the supporting evidence. An agency spokesperson reiterated that “HHS and CDC will continue to be the official resource for any guidance.”
