This Practice Advisory was developed by the American College of Obstetricians and Gynecologists in collaboration with Kevin A. Ault, MD, FACOG, and Laura E. Riley, MD, FACOG.
This Practice Advisory serves as an update to the American College of Obstetricians and Gynecologists (ACOG) Committee Opinion No. 741, Maternal Immunization, originally published in 2018 1 .
Immunization is an essential part of care for adults, including pregnant individuals. Since the publication of Committee Opinion No. 741, Maternal Immunization, the Centers for Disease Control and Prevention (CDC) has continued to release annual immunization schedules for children, adolescents, and adults. The CDC’s 2022 adult immunization schedule 2 includes several updates to immunization recommendations impacting pregnant individuals.
These updates include a universal recommendation for hepatitis B vaccination for all unvaccinated adults, including pregnant adults; changes to pneumococcal vaccine recommendations to reflect newly available vaccines; and added recommendations for COVID-19 vaccination.
Updated ACOG Recommendation
Based on the CDC’s 2022 adult immunization schedule and its supporting evidence of benefit, ACOG recommends hepatitis B vaccination for all unvaccinated pregnant adults 3 . Additionally, ACOG recommends pneumococcal vaccination for pregnant individuals at increased risk of severe pneumococcal disease 4 .
ACOG recommends COVID-19 vaccination for all pregnant individuals who were not vaccinated prior to pregnancy. Pregnant and recently pregnant people up to 6 weeks postpartum should receive a bivalent mRNA COVID-19 vaccine booster dose following the completion of their last COVID-19 primary vaccine dose or monovalent booster. COVID-19 vaccines are recommended for postpartum and lactating individuals who were not vaccinated prior to or during pregnancy 5 Table 1 .
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These materials are for information purposes only and are not meant to be comprehensive. Referral to these resources does not imply ACOG's endorsement of the organization, the organization’s website, or the content of the resource. The resources may change without notice.
The American College of Obstetricians and Gynecologists recognizes and supports the gender diversity of all patients who seek obstetric and gynecologic care. In original portions of this document, authors seek to use gender-inclusive language or gender-neutral language. When describing research findings, this document uses gender terminology reported by investigators. To review ACOG's policy on inclusive language, see www.acog.org/clinical-information/policy-and-position-statements/statements-of-policy/2022/inclusive-language.
A Practice Advisory is a brief, focused statement issued to communicate a change in ACOG guidance or information on an emergent clinical issue (eg, clinical study, scientific report, draft regulation). A Practice Advisory constitutes ACOG clinical guidance and is issued only on-line for Fellows but may also be used by patients and the media. Practice Advisories are reviewed periodically for reaffirmation, revision, withdrawal or incorporation into other ACOG guidelines. This information is designed as an educational resource to aid clinicians in providing obstetric and gynecologic care, and use of this information is voluntary. This information should not be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. It is not intended to substitute for the independent professional judgment of the treating clinician. Variations in practice may be warranted when, in the reasonable judgment of the treating clinician, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology. The American College of Obstetricians and Gynecologists reviews its publications regularly; however, its publications may not reflect the most recent evidence. Any updates to this document can be found on www.acog.org/clinical.
While ACOG makes every effort to present accurate and reliable information, this publication is provided “as is” without any warranty of accuracy, reliability, or otherwise, either express or implied. ACOG does not guarantee, warrant, or endorse the products or services of any firm, organization, or person. Neither ACOG nor its officers, directors, members, employees, or agents will be liable for any loss, damage, or claim with respect to any liabilities, including direct, special, indirect, or consequential damages, incurred in connection with this publication or reliance on the information presented.
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The American College of Obstetricians and Gynecologists (ACOG), is the nation's leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of more than 58,000 members, ACOG strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women's health care. www.acog.org