Countering Vitamin K Misinformation: Joanna Parga-Belinkie, MD

Rising refusals of the newborn vitamin K shot are tied to broader vaccine hesitancy and to misinformation that targets parents' fears.

Addressing them requires public health messaging that meets families on the platforms where they get their information, said Joanna Parga-Belinkie, MD, attending physician in the division of neonatology at Children's Hospital of Philadelphia (CHOP).

Vitamin K shot refusals among US newborns rose from 2.92% in 2017 to 5.18% in 2024, according to a recent study.¹ In this Q&A with The American Journal of Managed Care^® (AJMC^®), Parga-Belinkie discusses what's fueling the increase, how she frames the vitamin K conversation with hesitant parents, and the changes in counseling and public health messaging she believes are needed if refusal rates keep climbing.

For more on the trend, read: Vitamin K Refusals Are Rising: What Payers Need to Know

This interview has been edited for clarity and length.

AJMC: What's your read on what's fueling this increase—is it coming from broader vaccine hesitancy, specific misinformation about vitamin K, or gaps in how it's introduced to parents?

Parga-Belinkie: That is such a great question. I actually think it is tied into vaccine hesitancy. I think, in particular, misinformation of this sort targets parents, because parents are genuinely trying to do what's best for their children. They want to make the best decision possible, and a lot of times those decisions are based on emotion and not science.

I have 3 kids, and I know that when my own kids get a broken bone or an ear infection, any evidence-based science goes out the window. And I feel like this misinformation specifically targets their fears and makes them feel like they need to act out of fear instead of out of what we know is established preventive medicine.

I think the internet plays a role. I think it's all tied into preventive care and understanding preventive care, and also an understanding of risk, which is hard for people to conceptualize.

AJMC: By the time a family reaches your nursery, is it often too late to change their minds? Where do you see the biggest missed opportunity for earlier education—during prenatal visits, birth classes, or elsewhere?

Parga-Belinkie: I don't think so. I think, again, all parents are trying to make decisions on what is best for their baby, and if they've gotten bad information, I don't fault them for that, because I think this starts at the highest levels of public health messaging.

I think we need to have good public health messengers at the highest levels. I think we need to rethink how we do public health messaging and utilize what people actually use to get their public health messaging—things like social media and TikTok. A lot of my families are getting information there to make their medical decisions, so I think we should be meeting families more in those places.

And I always point families to good resources when I'm talking to them, too, because even if I don't change their mind in the moment, I want them to look at the American Academy of Pediatrics or at the CHOP resources. I don't want them looking at a random influencer on TikTok. So I want to provide them with the resources that I think are going to help them make informed and empowered decisions for their child's future.

And I do, again, think we need this education. It's nice to think about it happening in clinics, with doctors, and in prenatal visits. I work in the newborn world, so we always say, "If only this was talked about in prenatal care." But I think the issue is bigger than that. It's messaging. It's how we message, and it's how we meet families on the forms of media that they're using to get this kind of information.

AJMC: How do you personally frame the vitamin K conversation with a hesitant parent—what's your opening approach, and how do you know when you're building trust vs pushing them away?

Parga-Belinkie: I always tell families, "I heard that you did not want the vitamin K shot this admission," and they'll say, "Yeah, I don't want it." And I'll say, "That's okay. I just want to be able to talk about it with you. Can we have a conversation about it?" I always start with, "This is a strong recommendation from me, and I really believe that it's in the best interest of your child, and knowing how strongly I feel about it, I want to have this conversation with you." So I kind of come out of the gate with, "I am strongly recommending this."

Then I ask them if it's okay for us to have a conversation about how they think and feel about it, and that can help me get to what their real concern is. Sometimes when they're refusing it, it's that they just don't trust medicine at all;. They have a distrust of the health care system. But at the end of the day, they're in the hospital having a baby, right? So they came into the medical system for that reason, and they want to hear what an expert has to say about these things. If I can, I'll ask them where they got their information about it from and really try to have a back-and-forth.

I'll often tell them, "I'm not trying to change your mind. What I really want to get at is that you have good information to make good decisions for your baby." Sometimes something that's really grounding for families, too, and for me, is to just state openly, "You know, there is really bad information on the internet." Usually, we can ground ourselves in that: there’s bad information on the internet, and it's not always right.

So it's not important to me to change your mind. It's just important to me, and it is my job, to give you good information to make your decisions and give you my recommendation for what I think is going to help protect your baby.

AJMC: Beyond the individual conversation, do you think there's a role for hospital policy or health plan guidance in standardizing how this is addressed—or does it need to stay a case-by-case clinical judgment call?

Parga-Belinkie: I think we're already taking some steps from the vaccine hesitancy literature, where we say to parents, "Okay, baby's just born; we're going to give the vitamin K shot now." We don't ask; we just say, "This is what's recommended care; this is preventive care." And that normalizes it, right? Because the majority of parents are still getting the vitamin K shot and understand that it doesn't have high risk. So we're talking about a smaller but growing minority of families that are really refusing the shot, and I think there are steps we can take, as I was mentioning earlier, to really streamline our counseling for this.

I think there are communication strategies. You mentioned getting in early, so pre-bunking the rumors, so that when parents go online and they hear the boxed warning rumor that this is going to hurt the baby, they understand that's a rumor. There's a lot that can be done there to pre-bunk. You could debunk in the moment, and I think that's what most people are forced to do, but it doesn't get you the same traction as doing a more motivational interviewing style, where you start with really listening and asking questions and trying to understand so you can address the direct worries of the family.

But I also think we really need more research into what topics of misinformation circulate within our communities when it's related to pediatric health in particular, because if we were actually to keep track of what the rumors are and in what pockets of communities and have a better sense, then we could do all of these strategies better, and we could make public health tools that are targeted to what our communities are really lacking and really feeling like they need in terms of education to make their decisions for their children.

AJMC: If refusal rates keep rising, what changes—in nursery protocol, clinician training, or public health messaging—do you think are most needed in the next few years?

Parga-Belinkie: What I'll add to that is I think we do need to be more cognizant of short-form video for public health messaging. Again, I think that's just the future. I don't think, unfortunately, some of these platforms are going to go away. So we need to be cognizant of really where people are getting the information that they're consuming to make these decisions for their children, and we also need to be tracking the rumors so we can head them off at the pass.

Reference

1. McCrear S. Vitamin K refusals are rising: what payers need to know. AJMC. September 18, 2026. Accessed October 7, 2026. https://www.ajmc.com/view/vitamin-k-refusals-are-rising-what-payers-need-to-know