A new study published Monday in the Journal of the American Medical Association shows that the percentage of newborns missing a routine vitamin K shot has climbed from less than 3% in 2017 to over 5% in 2024, a rise that could put babies at risk of life‑threatening bleeding.
Study Overview
The research, led by Dr. Kristan Scott, a neonatologist at Children’s Hospital of Philadelphia, analyzed electronic medical records from Epic Systems’ Cosmos database. The data set included more than 5 million babies born in 403 hospitals across all 50 states between 2017 and 2024. About 4% of these infants—roughly 200,000 babies—did not receive a vitamin K shot. The rate increased steadily, rising from under 3% in 2017 to over 5% in 2024.
Dr. Scott noted that the increase was not surprising, but the degree of the rise “did catch me off guard.” He added that the trend was most pronounced among non‑Hispanic white babies. The uptick began in 2019, accelerated during the COVID‑19 pandemic, and has continued afterward.
Why Parents Are Refusing the Shot
No major policy changes or new recommendations from medical organizations explain the decline. “There haven’t been any large policy changes regarding vitamin K shots from hospitals, nor changes in recommendations from medical organizations,” Scott said, concluding that the rise is almost certainly due to parental refusal.
Widespread misinformation on social media and rising vaccine skepticism are likely driving the trend. Dr. Tiffany McKee‑Garrett, an associate professor of pediatrics at Texas Children’s Hospital in Houston who was not involved in the study, said parents “are equating vitamin K injections to vaccines.” She clarified that a vitamin K shot is not a vaccine; it is a supplement derived from a plant.
Dr. Ivan Hand, director of neonatology at NYC Health + Hospitals Kings County in Brooklyn, also observes the pattern. “I think this comes from general mistrust in authority that started probably in the later part of the 2010s,” Hand said. He co‑authored a 2022 American Academy of Pediatrics policy statement on parents refusing vitamin K shots.
Medical Consequences of Skipping the Shot
According to the Centers for Disease Control and Prevention, newborns who do not receive a vitamin K shot are more than 80 times more likely to experience bleeding from vitamin K deficiency than those who do receive the shot. Bleeding can occur up to six months after birth.
Scott warned that the lack of the shot “creates a population of newborns who are at risk of bleeding,” which can range from bruising and blood loss when the umbilical cord is cut to gastrointestinal bleeding and, most concerningly, brain bleeding that can lead to death.
Whether the drop in shot administration correlates with a rise in bleeding cases is unclear. Hand has not seen an increase in his practice, but he only sees infants immediately after birth. Scott believes that further research will uncover more bleeding events.
At Children’s Hospital of Philadelphia, there has been an increase in both vitamin K refusal and bleeding incidents, Scott said. In Houston, Dr. McKee‑Garrett has heard reports of vitamin K deficiency bleeding—an event that had become extremely rare after the U.S. began widespread vitamin K administration.
Alternatives and Their Limitations
Some countries give oral vitamin K supplements, but the formulations can be inconsistent, and each baby’s digestive system absorbs different amounts. Breast milk alone does not provide enough vitamin K to prevent deficiency. Oral supplements also require multiple doses, whereas a single shot is sufficient.
European studies show that while oral vitamin K may be effective in the first week of life, it is much less effective at preventing late‑onset vitamin K deficiency bleeding, which can occur up to six months after birth. Late‑onset bleeding carries a mortality rate of 20% and can reach 50% in some studies.
Hand explained that because vitamin K shots have been so effective for over 60 years, parents may not understand the risk of forgoing the prophylaxis. “These treatments have been so effective that people don’t understand the consequences. They have never seen babies with severe bleeding, so they think it doesn’t exist,” he said.
Key Takeaways
- The percentage of newborns missing a vitamin K shot rose from under 3% in 2017 to over 5% in 2024.
- The trend is driven largely by parental refusal, linked to misinformation and vaccine skepticism.
- Babies who skip the shot face an 80‑fold increase in the risk of bleeding, which can occur up to six months after birth.
The study underscores the importance of maintaining routine newborn care and highlights the need for clear communication about the safety and necessity of vitamin K injections.
