Marcie Weissman (right) comforts a child ahead of his shot in Houston, May 13. Three in 4 parents say their pediatrician will influence their decision about getting kids vaccinated against Covid-19.
CNN  — 

As back-to-school season approaches, parents are split when it comes to vaccinating their children against Covid-19.

Of parents with unvaccinated children, 3 in 4 say the recommendation of their child’s health care provider will be integral in their decision to vaccinate. However, 70% of parents with children ages 3 to 11 and 50% of parents with children ages 12 to 18 have not discussed the Covid-19 vaccine with their pediatrician, according to a new report.

To get more kids vaccinated, pediatricians must be more proactive in discussing Covid-19 vaccines with parents and addressing their legitimate concerns, said Sarah Clark, codirector of the C.S. Mott Children’s Hospital National Poll on Children’s Health, which conducted the survey.

“There is so much information that has come out about the Covid vaccine, and it’s coming fast, it’s coming from a lot of different sources, and it feels overwhelming,” Clark said. “You can see why people might feel worried, a little confused and uncertain about what really is the best thing to do.”

The report, published Monday, used data from a survey conducted with a national sample of 2,019 adults with at least one child age 3 to 18.

For parents with children ages 12 to 18, 39% said their child already got a Covid-19 vaccine, and 21% said they will likely vaccinate their child, the report found. Another 40% said that it’s unlikely they will vaccinate their child.

For parents of children in the younger age group, 49% said they will likely vaccinate their child against Covid-19 once approved for children under age 12, while 51% said they likely will not.

The report comes roughly two weeks before many schools around the country begin the school year. Only about 38% of adolescents ages 12 to 17 will have received at least one dose of the Covid-19 vaccine by then, according to a CNN analysis. About 30% of this population will be fully vaccinated at that time.

A lot of the hesitancy can come down to a lack of communication between parents and pediatricians, Clark said, who is also a research scientist in the department of pediatrics at the Susan B. Meister Child Health Evaluation and Research Center at the University of Michigan.

When the pandemic hit last year, routine checkups and appointments were largely put on hold, she said, so contact between parents and health care providers dropped off. Once in-person care began again, providers were focused on catching up with other vaccinations and services that were missed when medical offices were closed.

This need to catch up on other vaccines and treatment is coupled with the fact that pediatricians did not have access to the Covid vaccine. That means providers were not thinking about discussing the importance of the vaccine with parents early on, Clark added. Conversations about the vaccine should have started long before they became available, and for the younger age bracket, those conversations have to start now.

“I think they (pediatricians) may have under-appreciated how essential it is for them to have the conversations ahead of time, so when the vaccination does become available for different age groups, families are ready,” she said.

‘More parent-provider communication needed’

Parents whose children are not yet vaccinated cited that other important factors in their decision are side effects of the vaccine, testing in the child’s age group, the vaccine’s efficacy and parents’ own research, according to the report.

Lower-income parents appear to be more hesitant to vaccinate their children than wealthier parents, the study also found. Across both age groups, fewer parents with a household income of less than $50,000 reported their child already got or is likely to get a Covid vaccine than parents with a household income of more than $100,000.

Lower-income households often correlate to lower levels of education, Clark said, and people with less education can be more susceptible to mistrust or misinformation around vaccines. To address this, health care providers must make parents feel comfortable speaking about their concerns.

“For people of any income level, but especially people who may be low-income or maybe have lower educational status, the information that’s out there may be a little hard to put into context,” Clark said. “That’s where relying on your familiar child health provider is going to be really important.”

The big takeaway is that pediatricians have a responsibility to reach the parents who are hesitant, Clark emphasized. Pediatricians should talk about vaccination at every visit, even sick visits. They should also “get creative,” perhaps by setting up video chats that are open to all families in their practice where providers take questions, she said.

Hesitant parents have real questions and concerns, Clark said, and they need to feel comfortable bringing those concerns to their pediatricians and family physicians without feeling judged or labeled “anti-vaxxers.” The key is for information to come from trusted people who have cared for these families for a long time, she said.

“It is completely understandable that parents may have questions about the COVID-19 vaccine for their children and teens, especially given the amount of misinformation on social media,” said Dr. Lee Savio Beers, president of the American Academy of Pediatrics, via email.

“Pediatricians are trusted experts and are ready and eager to talk to families about any questions or concerns they may have about the COVID-19 vaccine, or other ways they can keep their family healthy and well during the pandemic. I encourage families to reach out to their pediatrician to have these and other important conversations.”

As an example, Clark offered that a parent might come to the pediatrician with concerns about the side effects being really serious. The pediatrician can then reference past vaccinations they have given to that child and point to the side effects that came from that – a fever, for example – and definitively show the vaccine was safe despite the short-term effects.

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The point is to put the vaccine in context and in a way that is easy to understand, Clark said.

“They (pediatricians) need to make sure that families know the door is open to conversation,” she said. “I think it’s unreasonable to expect parents to do this on their own.”