As respiratory illness season approaches, state health agencies and clinicians are actively encouraging pregnant patients to receive COVID-19 vaccinations, despite the U.S. Department of Health and Human Services (HHS) no longer recommending them.
Pregnancy itself is a recognized risk factor for severe COVID-19. Pregnant individuals face higher vulnerability to serious illness, preterm labor, and stillbirth. Medical experts overwhelmingly agree that vaccination is safe, effective, and far safer than contracting the virus.
Yet in May, HHS Secretary Robert F. Kennedy Jr. announced that the agency would no longer recommend COVID-19 vaccination for pregnant women. Ahead of his June congressional testimony, Kennedy circulated a document citing higher fetal loss rates after vaccination—a claim disputed by the original study authors, who said their research had been misrepresented.
Experts warn that this federal reversal shifts responsibility to state health departments to strengthen outreach and guidance. Clinicians and public health organizations are focused on combating misinformation and ensuring that vaccine information reaches low-income communities and people of color, who experienced disproportionately high maternal death rates during the pandemic. Federal data show COVID-19 contributed to a quarter of maternal deaths in the first two pandemic years.
“We are severely disappointed,” said Dr. Neil Silverman, professor of clinical obstetrics and gynecology at UCLA’s David Geffen School of Medicine. He described the federal shift as a “public health tragedy on a grand scale.”
Vaccinations benefit both pregnant individuals and their newborns, who cannot be vaccinated. Through passive immunity, antibodies from vaccinated mothers are transferred to babies via the placenta and breast milk.
“State public health agencies may have to implement guidance that differs from federal recommendations, which could create significant challenges,” said Dr. Mark Turrentine, professor of obstetrics at Baylor College of Medicine. Turrentine highlighted the confusion among patients when federal guidance changes abruptly.
Public health organizations, including the Society for Maternal-Fetal Medicine, have been reinforcing the safety of COVID-19 vaccines alongside RSV and influenza shots. Vaccination rates among pregnant patients remain low: less than a third received the COVID-19 vaccine, 38% received RSV vaccination, and 47% received flu shots during the 2023–2024 season.
“The complications from infection far outweigh the minor, rare side effects of vaccination,” said Sabra Klein, a molecular microbiology professor at Johns Hopkins Bloomberg School of Public Health.
In June, the American College of Obstetricians and Gynecologists and 30 other professional organizations urged insurers to maintain coverage for COVID-19 vaccines for pregnant women. Major pharmacy benefit managers and several state Medicaid programs, including Arizona, California, and North Carolina, continue to cover the vaccine.
Dr. Kimberly Fortner, president-elect of the Infectious Diseases Society for Obstetrics and Gynecology, expressed hope that coordinated messaging by medical groups will reinforce vaccine access.
Federal changes have disrupted established outreach programs, particularly those targeting communities of color, threatening to exacerbate maternal health disparities. Black, Indigenous, and Latina women faced heightened mortality rates during the pandemic, with Latina maternal deaths rising from 12 per 100,000 in 2018 to 28 per 100,000 in 2021.
“The politicization of vaccine access is the greatest concern,” said Dr. Yvette Martas, Connecticut OB-GYN and board chair of the Hispanic Health Council.
Kennedy’s replacement of all 17 CDC vaccine advisory committee members with some vaccine skeptics has introduced additional uncertainty, affecting state laws and vaccine coverage statutes tied to federal guidance.
State health officials, including representatives from Alabama, Connecticut, and Washington, D.C., have reaffirmed their commitment to recommending vaccination. Alabama’s Dr. Scott Harris emphasized the critical role of clinicians in providing reliable information to patients.
“Consistent messaging from respected organizations like the American College of Obstetrics and Gynecology should reassure families,” said Dr. Ayanna Bennett, director of the D.C. Department of Health.
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