In a new study, researchers at Children’s Hospital of Philadelphia (CHOP) uncovered an alarming trend – the proportion of newborn infants not receiving preventative vitamin K shots has increased by 77% since 2017. The findings were reported in the Journal of the American Medical Association (JAMA).
Newborns receive a vitamin K intramuscular shot at birth to prevent a rare but serious condition called vitamin K deficiency bleeding (VKDB). This bleeding disorder can occur because newborns naturally have low levels of vitamin K, which is essential for blood clotting. Without enough vitamin K, their blood might not clot properly, leading to dangerous bleeding in various parts of the body, including the brain.
Since 1961, routine administration of intramuscular vitamin K to newborns has significantly reduced the incidence of VKDB in the United States. However, recent anecdotal reports noted a rise in parental refusal, potentially increasing VKDB cases. This study is the first to document nationwide decreases in administration rates of intramuscular vitamin K since 2018.
“There may be a growing perception among parents that vitamin K is unnecessary,” said Kristan Scott, MD, the study’s lead author and a neonatologist in the Division of Neonatology at Children's Hospital of Philadelphia. “Unfortunately, opting out of Vitamin K for a newborn is akin to gambling with a child's health, forgoing a straightforward and safe measure that effectively prevents severe complications.”
The retrospective cohort study utilized data from Epic Cosmos, a comprehensive database of de-identified inpatient and outpatient records from healthcare organizations using Epic's electronic health record system, spanning January 2017 to December 2024. Participants included newborns from healthcare systems with at least 10 births per year and gestational ages of 35-43 weeks.
Among the records of more than five million newborns analyzed, researchers found that about 3.92% did not receive a vitamin K shot, with the percentage increasing 77% from 2.92% in 2017 to 5.18% in 2024. This trend could indicate a significant increase in parental vitamin K refusal, with public health implications.
Kevin Dysart, MD, a senior author, and attending neonatologist at CHOP, noted the health system is working to educate parents to reverse vaccine misperceptions and promote best practices in care. In addition, he highlighted that in 2025, CHOP joined Epic Cosmos, which acts as a learning healthcare system so providers and researchers can study collective patient experiences to discover insights and improve care, helping to facilitate research and understand emerging trends.
“There are always steps we can take to optimize our children’s health. We use car seats, we make sure they wear seatbelts, and we hold our kids’ hands when we cross the street. Another step we take to keep our children safe is to give them newborn Vitamin K,” added Heather H. Burris, MD, MPH, a study author and attending neonatologist at CHOP.
Dr. Scott’s time was supported by a National Institutes of Health training grant (T32HD060550) and co-author Dr. Sara Handley’s time by the National Institute of Child Health and Human Development Grant (K23HD109426).
Scott et al. “Trends in Vitamin K Administration Among Infants.” JAMA. Online December 8, 2025. DOI: 10.1001/jama.2025.21460.
Featured in this article
Experts
Specialties & Programs
In a new study, researchers at Children’s Hospital of Philadelphia (CHOP) uncovered an alarming trend – the proportion of newborn infants not receiving preventative vitamin K shots has increased by 77% since 2017. The findings were reported in the Journal of the American Medical Association (JAMA).
Newborns receive a vitamin K intramuscular shot at birth to prevent a rare but serious condition called vitamin K deficiency bleeding (VKDB). This bleeding disorder can occur because newborns naturally have low levels of vitamin K, which is essential for blood clotting. Without enough vitamin K, their blood might not clot properly, leading to dangerous bleeding in various parts of the body, including the brain.
Since 1961, routine administration of intramuscular vitamin K to newborns has significantly reduced the incidence of VKDB in the United States. However, recent anecdotal reports noted a rise in parental refusal, potentially increasing VKDB cases. This study is the first to document nationwide decreases in administration rates of intramuscular vitamin K since 2018.
“There may be a growing perception among parents that vitamin K is unnecessary,” said Kristan Scott, MD, the study’s lead author and a neonatologist in the Division of Neonatology at Children's Hospital of Philadelphia. “Unfortunately, opting out of Vitamin K for a newborn is akin to gambling with a child's health, forgoing a straightforward and safe measure that effectively prevents severe complications.”
The retrospective cohort study utilized data from Epic Cosmos, a comprehensive database of de-identified inpatient and outpatient records from healthcare organizations using Epic's electronic health record system, spanning January 2017 to December 2024. Participants included newborns from healthcare systems with at least 10 births per year and gestational ages of 35-43 weeks.
Among the records of more than five million newborns analyzed, researchers found that about 3.92% did not receive a vitamin K shot, with the percentage increasing 77% from 2.92% in 2017 to 5.18% in 2024. This trend could indicate a significant increase in parental vitamin K refusal, with public health implications.
Kevin Dysart, MD, a senior author, and attending neonatologist at CHOP, noted the health system is working to educate parents to reverse vaccine misperceptions and promote best practices in care. In addition, he highlighted that in 2025, CHOP joined Epic Cosmos, which acts as a learning healthcare system so providers and researchers can study collective patient experiences to discover insights and improve care, helping to facilitate research and understand emerging trends.
“There are always steps we can take to optimize our children’s health. We use car seats, we make sure they wear seatbelts, and we hold our kids’ hands when we cross the street. Another step we take to keep our children safe is to give them newborn Vitamin K,” added Heather H. Burris, MD, MPH, a study author and attending neonatologist at CHOP.
Dr. Scott’s time was supported by a National Institutes of Health training grant (T32HD060550) and co-author Dr. Sara Handley’s time by the National Institute of Child Health and Human Development Grant (K23HD109426).
Scott et al. “Trends in Vitamin K Administration Among Infants.” JAMA. Online December 8, 2025. DOI: 10.1001/jama.2025.21460.
Contact us
Amanda DiPaolo Bradley
Division of Neonatology