What are the American College of Obstetricians and Gynecologists (ACOG) guidelines on COVID-19 booster vaccinations 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 that all pregnant individuals receive the COVID-19 vaccine, including booster doses, as the benefits of vaccination in preventing severe illness, ICU admission, mechanical ventilation, and death from COVID-19 outweigh the risks. Pregnant patients should receive the COVID-19 booster regardless of which trimester they are in, and the vaccine can be administered simultaneously with other vaccines like the influenza vaccine 1. For the primary series, pregnant patients should complete the initial vaccination schedule (two doses of Pfizer or Moderna, or one dose of Johnson & Johnson). For boosters, ACOG recommends following the CDC's updated guidance for the most current formulation targeting circulating variants. The booster is recommended at least 2 months after the primary series or previous booster.

Key Considerations

  • COVID-19 vaccination during pregnancy is particularly important because pregnant individuals face increased risks of severe illness, ICU admission, mechanical ventilation, and death from COVID-19 compared to non-pregnant individuals 1.
  • COVID-19 during pregnancy is associated with increased risks of preterm birth and other adverse pregnancy outcomes 1.
  • The vaccines have been shown to be safe in pregnancy, with no increased risks of miscarriage, birth defects, or other pregnancy complications among vaccinated individuals 1.

Recommendations for Administration

  • Pregnant women who choose to wait for more data should be supported and updated with evidence by their trusted healthcare provider 1.
  • A comprehensive risk-benefit discussion regarding the lack of safety data before COVID-19 vaccine administration in pregnant women with preferential administration for pregnant women at highest risk of more severe infection-related diseases until safety and efficacy of these novel COVID-19 vaccines are ensured 1.

From the Research

COVID-19 Booster Guidelines for Pregnant Patients

There are no direct guidelines from the American College of Obstetricians and Gynecologists (ACOG) regarding COVID-19 booster shots for pregnant patients in the provided studies. However, the following information is available:

  • The ACOG recommends influenza vaccination for pregnant individuals, but this does not directly address COVID-19 booster shots 2.
  • Studies have shown that COVID-19 mRNA vaccines are safe and effective in inducing immune responses in healthy adults 3, 4.
  • Booster doses with viral vector and mRNA vaccines have been found to achieve significant immune responses in individuals who received full doses of inactivated vaccines 4.
  • The timing and frequency of COVID-19 vaccine boosters are crucial in reducing the public health burden and health system risk, especially with the emergence of new variants 5.
  • mRNA booster vaccination has been shown to overcome waning immunity and provide antibodies that neutralize omicron variants, as well as induce a T-cell response 6.

Key Considerations

  • The provided studies do not specifically address ACOG guidelines for COVID-19 booster shots in pregnant patients.
  • However, the studies suggest that mRNA vaccines and booster doses can be effective in inducing immune responses and reducing the risk of severe disease.
  • Healthcare professionals should consider the latest recommendations and guidelines from reputable sources, such as the ACOG and the Centers for Disease Control and Prevention (CDC), when making decisions about COVID-19 vaccination and booster shots for pregnant patients.

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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