This Phoenix doctor is seeing more refused vitamin K shot for newborns — and the consequences

As a wave of anti-vaccine sentiment sweeps the nation, more parents are choosing to forgo a shot that most babies get just after birth — a shot of vitamin K. It helps a baby’s blood clot, and without it, babies across the country are dying — they start bleeding and cannot stop.

That includes here in Arizona, where Dr. Jon McGreevy said he’s seen it happen.

McGreevy is the division chief of pediatric emergency medicine at Phoenix Children’s Hospital as well as a board member of the Arizona Chapter of the American Academy of Pediatrics.

Full conversation

LAUREN GILGER: What are you seeing here? Parents denying the vitamin K shot, the results of it. You know, are you seeing evidence of this? Is this something that’s apparent in your work?

DR. JON MCGREEVY: Yes. You know, I think we have seen a rise in parents that refuse the vitamin K shot at birth. It’s not a part of my practice because I’m not typically there at delivery or at birth.

But when we see our patients in the emergency department, we ask them about their routine care that they typically received at birth, and that could be things from eye ointment in the eyes to the vitamin K shot to the hepatitis B vaccine, and even standard sort of newborn care or prenatal care that we ask them about.

And I think over the last several years, we’ve seen declines in all of those categories.

LAUREN GILGER: Right. And this does come, this vitamin K shot, along with a couple of these things that you’re sort of offered at birth you can opt out of, if you’re having a baby, right?

There’s, as you mentioned, that antibiotic eye ointment, a hepatitis B vaccine, and then this vitamin K shot. Do you think that they’re kind of getting lumped together and people are assuming, I’ll be extra safe and not do any of these right now?

DR. JON MCGREEVY: I think so. I think that there’s definitely, and the studies, which show this, that it tends to be an all or none. But most people aren’t selecting menu items, but selecting either all of it or none of it.

Seems to be, if there is one thing that they do, most feel like the eye ointment is the least invasive, and so that seems to be the one thing they do if they don’t do everything.

But I think it makes sense that vitamin K is a shot, and so it’s associated with a vaccine, which is also a shot. And I think that there’s a lot of confusion probably around those points.

LAUREN GILGER: Right, because I’m sure part of your job is to try to educate people, even if it maybe is after the fact since you’re in the emergency department. But I mean, these are very different things, right?

Like a vitamin K shot that they get at birth is not a vaccine, even if someone is skeptical of vaccines, as we’re seeing so many more people are today. They’re not the same.

DR. JON MCGREEVY: Correct, they’re not the same. But they do have the same ultimate goal, which is, you know, preventing something else from happening later in life.

LAUREN GILGER: Right. So, tell us, what does this vitamin K shot do? It’s about clotting the blood, essentially.

DR. JON MCGREEVY: Yeah, vitamin K is important in the body’s cascade of events that leads to forming a blood clot. And you don’t get enough vitamin K through the placenta, so during pregnancy. And then after birth, it isn’t transferred through maternal breast milk as well as some of the other vitamins. And so, we need to supplement that to avoid some of these other complications later in life.

LAUREN GILGER: Right. So, what might happen to a baby, an infant often, if they do not get this shot? They don’t have that vitamin K right away. What are the results? I mean, we’re seeing reports of deaths.

DR. JON MCGREEVY: Correct. There’s early onset disease, which is really in the first 24 hours of life that they can have bleeding. More classically, it’s in the first like two days to one week, and this can be anything from bleeding around the umbilical cord, but also things that include bleeding into the stomach or the intestines. It can include bleeding that occurs around the brain, or it could just be bruising on the body.

LAUREN GILGER: So, a baby might start bleeding and not be able to stop, essentially?

DR. JON MCGREEVY: Exactly.

LAUREN GILGER: Have you heard about deaths of infants because of this?

DR. JON MCGREEVY: Yes. Yes. We have in my practice for the last 15 years, I have seen this happen, even when vitamin K shots were more prevalent in our communities. But we have definitely seen more incidents of this over the last several years as we’ve seen it decline.

LAUREN GILGER: Right. So, I mean, how rare is this? Is this something like you’d have to have pretty bad luck to have happen, or if you’ve opted out of this shot at birth, it could very likely happen?

DR. JON MCGREEVY: The hard part in this is it is a pretty rare outcome, right? So, typically we think about those early cases of bleeding, that happens in about one in 60 to 250 births. So, probably less than 1%. When we talk about the late onset, these are the ones that happen really anywhere between 1 week and 6 months of age, and that could be somewhere between one in 10,000, one in 25,000. So, it’s pretty rare.

LAUREN GILGER: OK. But if this has happened, right? Like you’ve seen this happen, and you know that it could have been prevented. I wonder how frustrating that is for a physician like yourself to watch happen?

DR. JON MCGREEVY: Yeah, I mean, I think ultimately we’re here to take care of children and want a long, healthy life for children, just like the parents do. And I think it is certainly heartbreaking to see something that could have been prevented.

And I can’t imagine what it would feel like to be a parent to have one of these devastating outcomes with something that they could have prevented.

LAUREN GILGER: I wonder, I mean, this obviously is happening at a time in which we’re seeing increased vaccine skepticism, we’re seeing even from the federal level with Health Secretary Robert F. Kennedy Jr. like the federal systems changing in terms of recommendations about vaccines, and many more people feeling like this isn’t a good thing or just general skepticism of the medical establishment.

What do you think folks need to know? Like is this on the hospital, the provider, the doctor who’s there at birth to sort of make sure that parents understand the implications of their decisions?

DR. JON MCGREEVY: Yes. I mean, yes, in some ways that is an important case, but it’s hard to have that conversation with a family the minute after their baby’s been delivered. These are conversations that have to start well in advance.

I think in the moment, I’ve not given birth, but I’ve been there for the birth of both of my daughters, and I can tell you I was probably not in the state of mind to be able to make some of those decisions.

LAUREN GILGER: So, I mean, what would you like to see change here? What do you think you can do or, you know, the medical establishment, for lack of a better phrase, can do to make sure that parents understand this is something that matters and can have very grave consequences if they reject it at birth?

DR. JON MCGREEVY: I think there are lots of different strategies that we can think about using. But I think that one of the most important things is understanding the patient or the parent perspective. If we understand what their concerns are, then we’re better able to address how we might mitigate those concerns or those risks or the questions that they have.

LAUREN GILGER: Do you think that’s a conversation that hasn’t happened enough maybe in the past that’s sort of contributed to this misinformation, this mistrust of the medical system?

DR. JON MCGREEVY: You know, I think we’re transitioning from a phase where there was blind acceptance for what your healthcare provider recommended to a place where that’s not always the case. And I think it’s, you know, I think as physicians and healthcare providers, we’re scientists at heart. We question things. That’s what we do.

So, you know, I’m not concerned that patients and families have questions or also questioning. That’s the same behavior that we have. We just have to work together.

LAUREN GILGER: OK. Dr. Jon McGreevy, division chief of pediatric emergency medicine at Phoenix Children’s Hospital, as well as a board member of the Arizona chapter of the American Academy of Pediatrics, joining us. Dr. McGreevy, thank you for taking the time to come on The Show. I appreciate it.

DR. JON MCGREEVY: Thank you.