Why Parents Are Refusing the Vitamin K Shot

Refusals of the vitamin K shot, which is predominantly given at birth to support newborn blood clotting, are increasing.¹ Many clinicians believe the trend may stem from broader vaccine hesitancy, even though the shot is not a vaccine. Parents who refuse the shot at birth increase their child's risk of vitamin K deficiency bleeding (VKDB), a condition associated with internal bleeding, which, in turn, can lead to stroke, brain damage, and death.¹ To further understand this increase in refusals, Jaspreet Loyal, MD, MS, section chief for pediatric hospital medicine at Yale School of Medicine, sat down with The American Journal of Managed Care®.

Overall, vitamin K refusals rose 77%, from 2.92% in 2017 to 5.18% in 2024,¹ and although refusals remain relatively uncommon, the increase is enough to warrant concern from clinicians, especially pediatricians and neonatologists who already carry the brunt of broader vaccine hesitancy. Loyal described VKDB as a low-likelihood but high-risk event. She explained that her hospital updated its newborn nursery templates to clearly document refusals, so if the infant later presents with bleeding elsewhere, such as an emergency department, clinicians know to consider VKDB. Loyal also said her colleagues have told her that counseling families who refuse the shot has prolonged their workdays and taken time away from other newborn care topics.

“We're doing our best one-on-one, trying to figure out people's reasons, working on building trust, rapport, and being this guide, but on a large scale it's a heavy lift, and we're not only talking about vitamin K,” she said. “We're talking about hepatitis B vaccine. We're talking about nirsevimab [Beyfortus; Sanofi and AstraZeneca]. We're talking about refusing the hearing screen and just like routine newborn things.”

This trend is also not new; prior research analyzed refusals from 2013 to 2019.¹ However, Loyal said the COVID-19 pandemic could, in theory, explain part of the growing mistrust she sees among parents who decline the shot.

“I'm just afraid that something dramatic needs to happen for people to see that this is important,” she concluded.

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References

1. McCrear S. Vitamin K refusals are rising: what payers need to know. AJMC®. September 18, 2026. Accessed October 6, 2026. https://www.ajmc.com/view/vitamin-k-refusals-are-rising-what-payers-need-to-know