More parents are declining hepatitis B vaccination and vitamin K prophylaxis for infants, and female infants are less likely than males to receive either, according to a research letter published Aug. 31 in JAMA.
Researchers at Children’s Hospital of Philadelphia and University of Pennsylvania, also in Philadelphia, set out to determine whether a infant’s sex was associated with a parent’s acceptance of vitamin K prophylaxis and hepatitis B vaccines.
The retrospective study analyzed live births from January 2018 to December 2025 at three University of Pennsylvania hospitals. Across 93,163 infants, 777 — or 8.3 infants per 1,000 births — did not receive vitamin K prophylaxis. For all infants, the rate of vitamin K prophylaxis declines doubled between 2018 and 2025.
A larger number, 9,400, did not receive the hepatitis B vaccine, according to the study. The rate equals 100.9 infants per 1,000 births. Parental declines increased between 2018 and 2025.
Compared to infant males, infant females were less likely to receive either the vitamin K or hepatitis B vaccine, the researchers found.
The findings land as federal vaccine guidance splinters. In December, the CDC ended its 34-year-old recommendation that all infants receive the hepatitis B vaccine within 24 hours of birth, instead endorsing shared decision-making for infants whose mothers test negative for the virus and allowing the first dose to be delayed until at least 2 months of age.
The American Academy of Pediatrics and children’s hospitals have rejected the change and continue to recommend the universal birth dose. Vitamin K prophylaxis, which is not a vaccine and sits outside the CDC panel’s purview, remains recommended for all infants by the AAP.
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