Declining newborn intramuscular vitamin K prophylaxis predicts subsequent immunisation refusal: A retrospective cohort study

J Paediatr Child Health. 2015 Sep;51(9):889-94. doi: 10.1111/jpc.12887. Epub 2015 Apr 14.


Aim: Low rates of childhood immunisation are linked to outbreaks of infectious disease. Identifying and addressing barriers to immunisation may lead to improved immunisation rates. Immunisation and newborn vitamin K prophylaxis have many similarities. We aimed to investigate whether parents who decline newborn vitamin K are also more likely to decline subsequent childhood immunisations.

Methods: We undertook a retrospective cohort study, examining the relationship between vitamin K administration and immunisation uptake by parents of babies born over a 2-year period (January 2010-December 2011) in Dunedin, New Zealand (NZ). Both written and electronic data from a single birthing unit and the NZ National Immunisation Register (NIR) were analysed to ascertain the relationship between declining newborn vitamin K prophylaxis and subsequent immunisation uptake.

Results: Records for 3575 babies were examined. Ninety-two per cent of infants received intramuscular, and 5% received oral vitamin K. An increased risk ratio for non-immunisation of 14.1 (95% confidence interval 7.8-25.9) for babies whose parents declined vitamin K was identified. Receiving oral vitamin K was also associated with subsequent non-immunisation, with a risk ratio of 3.5 (95% confidence interval 1.7-7.3).

Conclusions: Parents who decline newborn vitamin K are more likely to decline immunisation for their child. These parents, as well as those that elect for oral vitamin K, are a small but easily identifiable group to whom additional education about the benefits of immunisation could be offered. This is especially pertinent at a time when there is a resurgence of immunisation preventable diseases.

Keywords: immunisation; neonate; prophylaxis; vaccine; vitamin K.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Decision Making
  • Female
  • Hemorrhage / prevention & control*
  • Humans
  • Infant, Newborn
  • Male
  • New Zealand
  • Parents / psychology*
  • Retrospective Studies
  • Treatment Refusal*
  • Vaccination / statistics & numerical data*
  • Vitamin K / administration & dosage*


  • Vitamin K