The American College of Obstetricians and Gynecologists (ACOG) releases an immunization schedule for pregnancy and the postpartum period that, for the first time, differs from guidance issued by the Centers for Disease Control and Prevention (CDC). In its recommendations, ACOG calls for four vaccines during pregnancy: an influenza (flu) vaccine, a COVID-19 vaccine, and Tdap (tetanus, diphtheria, and pertussis). ACOG also recommends a vaccine to help protect against respiratory syncytial virus (RSV) for the developing fetus. The two organizations’ positions differ on at least one component of this maternal vaccine timing and/or selection, with ACOG breaking from the CDC schedule for pregnant patients. The announcements are presented as recommendations specific to pregnancy and related care, including coverage for postpartum immunizations. The updates are intended to guide clinicians and pregnant patients on immunization choices during pregnancy rather than follow the federal schedule as written. Both reports describe the ACOG update as a new departure from CDC guidance and note the inclusion of flu, COVID-19, Tdap, and an RSV-protective option.