With schools about to reopen, efforts to get more adolescents vaccinated against the coronavirus are facing a significant barrier: their parents, even those who are themselves vaccinated.
Just 40 percent of all parents of adolescents have gotten their children at least one shot of the vaccines, according to a new survey by the Kaiser Family Foundation. Among those parents who are themselves vaccinated, only 60 percent have chosen to have their teens inoculated, with 23 percent opting to “wait and see,” 4 percent permitting the shot “only if required,” and 5 percent refusing to have them vaccinated at all.
The top reservation among parents of unvaccinated teens was the lack of information about the long-term effects of the shot, followed by concerns about side effects and fertility — despite conclusive evidence that the vaccine has no negative impacts on reproduction. (The Centers for Disease Control and Prevention on Wednesday urged pregnant women to get vaccinated, citing rising infections and low inoculation rates among expectant mothers.)
Dr. Jill Kasper, a pediatrician at Cambridge Health Alliance, said she typically encounters “very little hesitancy” from parents about routine adolescent vaccinations. That hasn’t been the case with COVID-19.
Kasper said she is “shocked” by how low the vaccination rate is among adolescent patients in some of the communities served by the Health Alliance, which in addition to Cambridge has clinics in Somerville, Everett, Malden, and Revere.
“It was only a little over one-third,” she said. “I was thinking it would be more. I was hoping it would be more.”
Statewide, adolescent vaccination rates lag behind older populations. As of last week, 61 percent of those ages 12 to 15 and 66 percent those ages 16 to 19 in Massachusetts had received at least one dose of the vaccine.
To raise vaccination rates, pediatricians must contend with the fact that the choice to vaccinate belongs not to the teens but to their parents, whose consent is required under state law.
Currently, Pfizer is the only vaccine approved for 12-to-18-year-olds. Studies have overwhelmingly shown that it is both safe and effective at preventing COVID-19.
Still, parents fear the vaccine because it is new and was developed quickly, said Kasper. Some have bought into the baseless rumors that the shot harms future fertility, or fear the scattered cases of post-vaccine heart issues, which tend to be mild.
Dr. Robyn Riseberg, the founder of Boston Community Pediatrics, said she has encountered significant pushback from parents on the vaccine. She estimated that half of her adolescent patients are still unvaccinated.
“People are still really concerned about long-term side effects, as well as how the vaccine was developed so quickly,” she said.
That was the case for Lee Soto, 57, a parent from Boston who was at first hesitant to vaccinate his 12-year-old son.
“I was planning to wait to see what reports came back for children of his age, about the secondary effects and that kind of thing,” Soto said.
He only changed his mind because his son was headed to summer camp, where he’d be exposed to dozens of other children who might have the virus.
“Had it not been for that setting, I would probably be still waiting it out,” Soto said.
Soto was also persuaded by a conversation he had with his doctor, who told him that he himself had chosen to vaccinate his teen.
Riseberg said she also often talks about her children, and how she “got them vaccinated right away and how it made them feel more comfortable being in the world.” She strives to be “persistent yet gentle” as she asks parents about their concerns and responds with facts.
“There’s so much misinformation floating around, and people hang onto one thing that resonates with them, whether it’s reproductive side effects or that it could affect kid’s hearts,” Riseberg said. “If you give people the opportunity to ask questions and to have a conversation with a trusted provider like their pediatrician, people often feel differently by the end of our conversation.”
Some parents are more ambivalent than hesitant, and simply have not prioritized the vaccine, she said.
“For a lot of families that I take care of, the mom is working two jobs, the kids are in day care or camps, and it’s just not that easy to go online and find the place and figure out when to do it and then be able to get there,” she said.
To reduce the hassle, Riseberg chose to provide the vaccine in her office, often administering the shot to both parents and children at checkups, alongside other routine vaccinations.
“It’s so important that we’re offering it here just like we offer every other vaccine,” she said.
(That approach also found her some unlikely takers — like her mail carrier, who rang her office doorbell just after 5 p.m. and asked for a shot, explaining that he’d been unable to find a clinic open after work.)
Other parents, like Katie Steliga Roy of Sandwich, are staunch in their refusal of the shot, both for themselves and their children.
Roy, 42, is adamant that she is not an antivaxxer. Her sons, who are 14 and 13, had all the required shots before kindergarten. But they won’t be vaccinated against COVID-19 — and neither will she.
“We feel that there hasn’t been enough research and trials done to make a confident decision to choose to get it for ourselves and children,” she said.
Roy believes COVID-19 is real and knows it can be fatal. Still, she said, “we feel that our chances of overcoming COVID are higher than not having an adverse reaction to the COVID-19 shot.”
Dr. Paul Offit, the head of the Vaccine Education Center at Children’s Hospital of Philadelphia, said this is his message to parents such as Roy: “That vaccines work; that they’re safe; that children can get infected; that if you don’t believe me, come on rounds with me at my hospital.”
“We have children in our hospital now who have this virus,” he continued. “This virus can be quite harmful to children. It can be fatal to children.”
Since the start of the pandemic, millions of children have been infected with COVID-19, he said. At least 40,000 have been hospitalized, and at least 400 have died. Other risks to children who contract COVID-19 include multisystem inflammatory syndrome — a condition where organs like the lungs, heart, liver, and kidneys become inflamed — and long COVID.
Those risks far exceed any possible risks of the vaccine, which are rare, he said.
“If we can prevent this disease safely in children, we should prevent it. For children 12 to 17, we can,” Offit said. “It is frustrating to have the golden ticket out of this pandemic, and to have parents of teenagers choosing not to give it.”
With the start of school just weeks away, Kristal Wilson, 36, a parent from Boston, said she knows a lot of other parents who are “still up in the air.”
Still, Wilson decided to vaccinate her 13-year-old daughter to protect her from the virus when she returns to school in the fall, where classrooms are full and the ventilation is poor.
“Just to be better safe than sorry” she said.
Camille Caldera was a Globe intern in 2022.Follow her on Twitter @camille_caldera.