What are the American College of Obstetricians and Gynecologists (ACOG) guidelines on COVID-19 vaccination for pregnant patients?

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Last updated: May 27, 2025View editorial policy

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From the Guidelines

The American College of Obstetricians and Gynecologists (ACOG) strongly recommends COVID-19 vaccination for all pregnant individuals, especially those with high-risk conditions, as outlined in their guidelines 1.

Key Recommendations

  • ACOG advises that pregnant patients receive any of the FDA-authorized COVID-19 vaccines (Pfizer-BioNTech, Moderna, or Johnson & Johnson/Janssen) at any point during pregnancy, without preference for a specific vaccine type.
  • The primary vaccination series typically involves two doses for mRNA vaccines (Pfizer or Moderna) given 3-4 weeks apart, or a single dose of Johnson & Johnson.
  • ACOG also recommends that pregnant individuals receive booster doses when eligible.
  • Vaccination can be administered simultaneously with other vaccines, including the influenza and Tdap vaccines routinely given during pregnancy.

High-Risk Conditions

The following conditions are considered high-risk and warrant preferential administration of the COVID-19 vaccine:

  • Women aged 35 years or older
  • Multiple gestation
  • Cancer
  • Chronic hypertension
  • Chronic kidney disease
  • Chronic obstructive pulmonary disease
  • Heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies
  • Immunocompromised state (weakened immune system) from solid organ transplant
  • Autoimmune diseases (systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, inflammatory bowel disease, graves’ disease, psoriasis or psoriatic arthritis, Addison’s disease)
  • Obesity (body mass index of 30 kg/m2 or higher)
  • Sickle cell disease
  • Smoking (current or history)
  • Type 1 or 2 diabetes mellitus

Contraindications

Contraindications to COVID-19 vaccination in pregnant women include:

  • Severe allergic reaction (e.g., anaphylaxis) after a previous dose of an mRNA COVID-19 vaccine or any of its components
  • Immediate allergic reaction of any severity to a previous dose of an mRNA COVID-19 vaccine or any of its components (including PEG)
  • Immediate allergic reaction of any severity to polysorbate (because of potential cross-reactive hypersensitivity with the vaccine ingredient PEG) As supported by recent studies 1, the benefits of COVID-19 vaccination in pregnant women outweigh the risks, and vaccination is recommended to prevent severe COVID-19 illness and adverse pregnancy outcomes.

From the Research

COVID-19 Vaccination Guidelines for Pregnant Patients

The American College of Obstetricians and Gynecologists (ACOG) provides guidelines for COVID-19 vaccination in pregnant patients. However, the provided studies do not directly address ACOG's guidelines on COVID-19 vaccination for pregnant patients.

Available Information on COVID-19 Vaccines

  • The studies discuss the efficacy and safety of various COVID-19 vaccines, including mRNA vaccines developed by Pfizer and Moderna 2, 3, 4, 5.
  • These vaccines have been shown to be effective in preventing symptomatic SARS-CoV-2 infection and have tolerable safety profiles 2, 3, 4, 5, 6.
  • The studies also discuss the emergence of new variants and subvariants of SARS-CoV-2 and the need for continued research and development of new vaccines and vaccination strategies 2, 3, 4, 6.

Limitations of Available Information

  • The provided studies do not specifically address ACOG's guidelines for COVID-19 vaccination in pregnant patients.
  • Therefore, it is not possible to provide a direct answer to the question based on the available information.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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