ACOG: Updated Recommendations for Influenza Vaccination During Pregnancy

pregnant woman receiving influenza vaccine
pregnant woman receiving influenza vaccine
This updated Committee Opinion includes more recent data on the safety and efficacy of influenza vaccination during pregnancy, as well as recommendations for treatment and postexposure chemoprophylaxis.

The American College of Obstetricians and Gynecologists (ACOG) has released an updated Committee Opinion providing the latest evidence-based recommendations for influenza vaccination during pregnancy.

The following recommendations were made in collaboration with the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices:

  • All adults should be vaccinated against influenza, using the inactivated formulation; the inactivated vaccine is safe throughout pregnancy.
  • Given the importance of immunization in expecting mothers and their fetuses, obstetrician-gynecologists should advocate for influenza vaccination.
  • Obstetrician-gynecologists should have the vaccine available for administration during clinic visits. Furthermore, they should maintain an up-to-date influenza vaccination status.
  • If obstetrician-gynecologists do not stock the influenza vaccine at their clinic, they should provide referrals to appropriate centers.
  • Office staff should also maintain up-to-date influenza vaccination status.
  • Individuals who have experienced hives from egg exposure may receive influenza vaccinations without restriction.
  • Individuals who have had serious allergic reactions to eggs should receive the vaccine in a medical setting.
  • Patients with possible influenza, assessed by clinical evaluation, should be treated immediately with appropriate antiviral medications, regardless of whether they have received the influenza vaccine. Awaiting test results should not delay administration.
  • Women who are pregnant or postpartum (up to 2 weeks) should receive postexposure antiviral chemoprophylaxis, if necessary. Oseltamivir 75 mg or zanamivir inhalations, each once per day for 10 days, may be administered.

This report endorsed the safety and efficacy of influenza vaccinations for pregnant women, based on recent studies.

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“[I]nfluenza vaccination is an integral element of prepregnancy, prenatal, and postpartum care,” the report iterates. “It is imperative that obstetrician-gynecologists, other health care providers, health care organizations, and public health officials continue efforts to improve the rate of influenza vaccination among pregnant women.”


Committee on Obstetric Practice. ACOG Committee Opinion No. 732: Influenza vaccination during pregnancyObstet Gynecol. 2018;131(4):e109-e114.