A study published in the Journal of the American Medical Association found that 6.8% of U.S. newborns did not receive the vitamin K injection in 2025, a figure more than double the 3.1% rate recorded in 2017.
The rise in refusals coincides with a measurable increase in dangerous bleeding events among infants. Children who did not get the shot had a significantly higher risk of bleeding by 6 months old, including hemorrhages in the brain and gastrointestinal tract, and were more than twice as likely to die during birth hospitalizations involving bleeding, the study found.
Researchers led by Kevin Dysart of the Children’s Hospital of Philadelphia’s division of neonatology tracked 5.2 million infants from all 50 states to reach their conclusions.
The Bleeding Risk in Numbers
For every 114 newborns who skip the vitamin K shot, one will develop bleeding in the first six months of life, according to the study. Vitamin K deficiency bleeding can be fatal in about 20% of cases and can lead to neurological disabilities because the deficiency hinders blood clotting.
Why Parents Are Declining the Shot
Some parents who want a “natural” alternative reject the injection over concerns that it will not benefit their children, is toxic, will cause pain, or could trigger an allergic reaction, the researchers found. While vitamin K is not an immunization, it is among the injections given during the first hours of a newborn’s life.
“These are real numbers of children who are impacted by a bleed of some sort who also had not received vitamin K, and that’s pretty devastating,” said Anna Morad, a doctor who runs the newborn nursery at the Monroe Carell Jr. Children’s Hospital at Vanderbilt in Nashville.
Six Decades of Universal Protection
Universal administration of the vitamin K shot began in 1961 to prevent newborns from developing severe vitamin K deficiency bleeding. The Centers for Disease Control and Prevention notes that the shots are safe for newborns but does not currently track cases of vitamin K deficiency bleeding.
An editorial released with the study called on pediatricians, public health agencies, and manufacturers to work together to educate families and create accessible pathways for oral alternatives.
“This is known, established science, so this study adds to the abundance of evidence for it,” Morad said. “My question is, what’s going to move the needle for families?”
Questions Parents Are Asking
Is the vitamin K shot a vaccine? No. While it is given during the first hours of life alongside other newborn care, vitamin K is not an immunization.
Are oral alternatives available? An editorial accompanying the study called for accessible oral alternatives to be created, though the CDC currently recommends the injection and does not track deficiency bleeding cases.
The 2025 refusal rate represents a more than twofold increase from 2017, shifting away from the near-universal administration established in 1961.
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