Uptake of intramuscular vitamin K administration after birth and maternal and infant demographic variables: a national cohort study

Abstract

A long-acting monoclonal antibody against Respiratory Syncytial Virus (RSV), given as a one-off injection shortly after birth, is likely to be introduced soon. We hypothesised that carer acceptance of intra-muscular (IM) vitamin K, another injection given shortly after birth, might serve as a proxy indicator of likely acceptance of any such anti-RSV intervention, given previous associations described between IM vitamin K acceptance and subsequent non-immunisation. Using a national dataset of all postnatal health visitor visits in Scotland from 2018-2021 we explored demographic variables associated with non-acceptance of IM vitamin after birth. We found that in the time period 2019-2021 over 95.5% of carers were documented as consenting to this intervention, with only 1.1% requesting oral vitamin K and 0.9% refusing vitamin K altogether. Infant ethnicity, use of English as a first language at home, socio-economic position and maternal age were not associated with reduced uptake of IM vitamin K. We therefore did not identify any groups that might require increased engagement prior to the roll-out of a long-acting monoclonal antibody for RSV.

Competing Interest Statement

Thomas C Williams is Principal Investigator for the BronchStart project, which is funded by the Respiratory Syncytial Virus Consortium in Europe (RESCEU), with data collection supported by the National Institute for Health Research. Pia Hardelid has attended meetings (unpaid) with MSD and Pfizer. None of the other authors have any competing interests to declare.

Funding Statement

No specific funding was received for this project; TCW is funded by the Wellcome Trust. Research at UCL Great Ormond Street Institute of Child Health is supported by the NIHR GOSH Biomedical Research Centre.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

This analysis was undertaken on aggregate routinely-collected data obtained from Public Health Scotland via information request and released in accordance with PHS disclosure control procedures. More information on how PHS collects and processes health data is available via their privacy notice (https://www.publichealthscotland.scot/our-privacy-notice/organisational-background/)

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All data produced are available online at https://git.ecdf.ed.ac.uk/twillia2/vitk_administration_scotland/

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