HONG KONG — Hong Kong welcomed a new pair of giant pandas gifted by Beijing on Thursday with a lavish ceremony, raising hopes for a boost to the city’s tourism.

An An and Ke Ke are the third pair of giant pandas to be sent to the city from mainland China since the former British colony returned to Chinese rule in 1997. Their arrival came after their new neighbor, Ying Ying, gave birth to twins last month and became the world’s oldest first-time panda mother on record.

With the addition of the new bears, the twins, and their father, Le Le, Hong Kong now houses six pandas.

Chief Executive John Lee on Tuesday said An An is a 5-year-old male panda who is agile, intelligent and active, while Ke Ke, a 5-year-old female, is good at climbing, cute and has a gentle temperament.

The new arrivals will undergo two months of quarantine and adapt to their new home at Ocean Park, a zoo and aquarium that has long been a favorite of residents and tourists. Lee expressed hope that the public could meet the new bears in mid-December.

In October, the government will invite residents to propose new names that showcase the pandas’ characteristics.

Tourism industry representatives are optimistic about the potential impact of housing six pandas, hoping it will boost visitor numbers in Hong Kong. Officials have encouraged businesses to capitalize on the popularity of the new bears and newborn cubs to seize opportunities in what some lawmakers have dubbed the “panda economy.”

Pandas are widely considered China’s unofficial national mascot. The country’s giant panda loan program with overseas zoos has long been seen as a tool of Beijing’s soft-power diplomacy. Giant pandas are only found in China’s southwest and their population is under threat from development.

But caring for pandas in captivity is expensive. A zoo in Finland agreed with Chinese authorities to return two loaned giant pandas to China more than eight years ahead of schedule because they were too costly for the facility to maintain amid declining visitors.

Hong Kong’s Ocean Park has been hosting pandas since 1999, when the first pair, An An and Jia Jia, arrived in the financial hub shortly after it was handed back to China.

Jia Jia, who died at 38 in 2016, is the world’s oldest-ever panda to have lived in captivity. The average lifespan for a panda in the wild is 18 to 20 years, while in captivity it’s 30 years, according to the Guinness World Records.
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GENEVA — Police in northern Switzerland said Tuesday that several people have been detained and a criminal case opened in connection with the suspected death of a person in a “suicide capsule.”

The “Sarco” capsule is presumably designed to allow a person sitting in a reclining seat inside to push a button that injects nitrogen gas into the sealed chamber. The person is then supposed to fall asleep and die by suffocation in a few minutes.

Exit International, an assisted suicide group based in the Netherlands, said it is behind the 3D-printed device that cost over $1 million to develop.

Swiss law allows assisted suicide so long as the person takes his or her life with no “external assistance” and those who help the person die do not do so for “any self-serving motive,” according to a government website.

A law firm informed prosecutors in Schaffhausen canton that an assisted suicide involving the Sarco had taken place Monday near a forest cabin in Merishausen, regional police said in a statement. They said that “several people” were taken into custody and that prosecutors opened an investigation on suspicion of incitement and accessory to suicide.

Dutch newspaper Volkskrant reported Tuesday that police had detained one of its photographers who wanted to take pictures of the use of the Sarco. It said Schaffhausen police had indicated the photographer was being held at a police station but declined to give a further explanation.

The newspaper declined to comment further when contacted by the Associated Press. 

In an email, the Dutch Foreign Ministry told the AP that it was in contact with the newspaper and Swiss officials. 

“As always, we cannot interfere in the legal process of another country. At the same time, the Netherlands stands firmly for press freedom. It is very important that journalists worldwide can do their work freely,” it said. 

Exit International, the group behind the Sarco, said in a statement a 64-year-old woman from the U.S. Midwest — it did not specify further — who had suffered from “severe immune compromise” had died Monday afternoon near the German border using the Sarco device.

It said Florian Willet, co-president of The Last Resort, a Swiss affiliate of Exit International, was the only person present and described her death as “peaceful, fast and dignified.”

Dr. Philip Nitschke, an Australian-born trained doctor behind Exit International, has previously told the AP that his organization received advice from lawyers in Switzerland that the use of the Sarco would be legal in the country.

In the Exit International statement on Tuesday, Nitschke said he was “pleased that the Sarco had performed exactly as it had been designed … to provide an elective, non-drug, peaceful death at the time of the person’s choosing.”

The claims of Nitschke and Exit International could not be independently verified.

On Monday, Health Minister Elisabeth Baume-Schneider was asked in Swiss parliament about the legal conditions for the use of the Sarco capsule. She suggested its use would not be legal.

“On one hand, it does not fulfill the demands of the product safety law, and as such, must not be brought into circulation,” she said. “On the other hand, the corresponding use of nitrogen is not compatible with the article on purpose in the chemicals law.”

In July, Swiss newspaper Blick reported that Peter Sticher, a state prosecutor in Schaffhausen, wrote to Exit International’s lawyers saying any operator of the suicide capsule could face criminal proceedings if it was used there — and any conviction could bring up to five years in prison.

Prosecutors in other Swiss regions have also indicated that the use of the suicide capsule could lead to prosecution.

Over the summer, a 54-year-old U.S. woman with multiple health ailments had planned to be the first person to use the device, but those plans were abandoned.

Switzerland is among the only countries in the world where foreigners can travel to legally end their lives and has organizations that are dedicated to helping people kill themselves. But unlike others, including the Netherlands, Switzerland does not allow euthanasia, which involves health care practitioners killing patients with a lethal injection at their request and in specific circumstances.

Some lawmakers in Switzerland have argued that the law is unclear and have sought to close what they call legal loopholes.
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Egypt’s second-largest city, Alexandria, lies in the Eastern Mediterranean, a top climate change hotspot that has dealt with record global air and ocean temperatures this year. Egypt-based photojournalist Hamada Elrasam presents scenes of everyday life that have been impacted by the changing climate phenomenon in the low-lying metropolis that has survived over two millennia, only to find itself on this century’s climate frontlines. Written in collaboration with Elle Kurancid.
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wyoming, iowa — Taking a late-summer country drive in the Midwest means venturing into the corn zone, snaking between 12-foot-tall green, leafy walls that seem to block out nearly everything other than the sun and an occasional water tower.

The skyscraper-like corn is a part of rural America as much as cavernous red barns and placid cows.

But soon, that towering corn might become a miniature of its former self, replaced by stalks only half as tall as the green giants that have dominated fields for so long.

“As you drive across the Midwest, maybe in the next seven, eight, 10 years, you’re going to see a lot of this out there,” said Cameron Sorgenfrey, an eastern Iowa farmer who has been growing newly developed short corn for several years, sometimes prompting puzzled looks from neighboring farmers. “I think this is going to change agriculture in the Midwest.”

The short corn developed by Bayer Crop Science is being tested on about 30,000 acres (12,141 hectares) in the Midwest with the promise of offering farmers a variety that can withstand powerful windstorms that could become more frequent due to climate change. The corn’s smaller stature and sturdier base enable it to withstand winds of up to 50 mph — researchers hover over fields with a helicopter to see how the plants handle the wind.

The smaller plants also let farmers plant at greater density, so they can grow more corn on the same amount of land, increasing their profits. That is especially helpful as farmers have endured several years of low prices that are forecast to continue.

The smaller stalks could also lead to less water use at a time of growing drought concerns.

U.S. farmers grow corn on about 90 million acres (36 million hectares) each year, usually making it the nation’s largest crop, so it’s hard to overstate the importance of a potential large-scale shift to smaller-stature corn, said Dior Kelley, an assistant professor at Iowa State University who is researching different paths for growing shorter corn.

Last year, U.S. farmers grew more than 400 tons (363 metric tons) of corn, most of which was used for animal feed, the fuel additive ethanol or exported to other countries.

“It is huge. It’s a big, fundamental shift,” Kelley said.

Researchers have long focused on developing plants that could grow the most corn but recently there has been equal emphasis on other traits, such as making the plant more drought-tolerant or able to withstand high temperatures. Although there already were efforts to grow shorter corn, the demand for innovations by private companies such as Bayer and academic scientists soared after an intense windstorm — called a derecho — plowed through the Midwest in August 2020.

The storm killed four people and caused $11 billion in damage, with the greatest destruction in a wide strip of eastern Iowa, where winds exceeded 100 mph. In cities such as Cedar Rapids, the wind toppled thousands of trees but the damage to a corn crop only weeks from harvest was especially stunning.

“It looked like someone had come through with a machete and cut all of our corn down,” Kelley said.

Or as Sorgenfrey, the Iowa farmer who endured the derecho put it, “Most of my corn looked like it had been steamrolled.”

Although Kelley is excited about the potential of short corn, she said farmers need to be aware that cobs that grow closer to the soil could be more vulnerable to diseases or mold. Short plants also could be susceptible to a problem called lodging, when the corn tilts over after something like a heavy rain and then grows along the ground, Kelley said.

Brian Leake, a Bayer spokesman, said the company has been developing short corn for more than 20 years. Other companies such as Stine Seed and Corteva also have been working for a decade or longer to offer short-corn varieties.

While the big goal has been developing corn that can withstand high winds, researchers also note that a shorter stalk makes it easier for farmers to get into fields with equipment for tasks such as spreading fungicide or seeding the ground with a future cover crop.

Bayer expects to ramp up its production in 2027, and Leake said he hopes that by later in this decade, farmers will grow short corn everywhere.

“We see the opportunity of this being the new normal across both the U.S. and other parts of the world,” he said.
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NEW YORK — First lady Jill Biden is unveiling a new set of actions to address health inequities faced by women in the United States, plans that include spending at least $500 million annually on women’s health research. 

Biden was making the announcement Monday while closing out the first day of this year’s Clinton Global Initiative annual meeting in New York. 

The additional government spending will mainly come from the Department of Defense, which provides medical care to more than 230,000 active-duty military women and nearly 2 million military retirees, as well as their family members. The research will focus on why these women experience endocrine, hematological and other immunity-related disorders twice as often as men. 

“Our nation is home to the best health research in the world, yet women’s health is understudied and research is underfunded,” Biden said at a separate event on Friday. “And we still know too little about how to effectively prevent, diagnose, and treat a range of health conditions in women, from heart disease to cancers.” 

The commitment was among the largest of the more than 100 expected at the two-day meeting of political, business and philanthropic leaders gathering to address some of the world’s most pressing issues. Former President Bill Clinton, former Secretary of State Hillary Clinton, and Clinton Foundation Vice Chair Chelsea Clinton have set this year’s theme as “What’s Working,” a way to look for potential solutions and effective programs in tumultuous times. 

“You don’t look at a problem and say, ‘That’s impossible,’” Bill Clinton said in his opening remarks. “You don’t just throw up your hands. You roll up your sleeves.” 

An example of that strategy came from the announcement that a wide-ranging group of 15 nonprofits, humanitarian aid organizations and other funders will join forces to address the humanitarian crisis in Sudan following more than a year of conflict. 

The Coalition for Mutual Aid in Sudan — which includes The Bill & Melinda Gates Foundation, Global Giving, Global Fund for Women, and The Unitarian Universalist Service Committee — will donate at least $2 million to mutual aid groups in the country by the end of the year. It also pledged to raise another $4.5 million for those groups within the next two years. 

Patricia McIlreavy, president of the Center for Disaster Philanthropy, which has been representing the coalition, said that, while much more aid is needed, the collaboration and problem-solving of the group is an important step forward. 

“It gets us started,” McIlreavy told The Associated Press. “And it models the behavior you want to see from others. If you wait until it’s the perfect opportunity, you’ve missed many of the opportunities that were good enough.” 

World Food Program director Cindy McCain said earlier this month that “Sudan’s nearly a forgotten crisis” and that 25 million people there already face acute hunger. Last week, the top United Nations humanitarian official said fighting is escalating in the conflict that began in April 2023 when long-simmering tensions between Sudan’s military and paramilitary leaders broke out in the capital Khartoum and spread to other regions. The U.N. says more than 14,000 people have been killed and 33,000 injured. 

“With ongoing impediments to a large-scale international aid response, Sudanese community groups have become the primary frontline responders and are currently the most effective means of reaching millions on the brink of starvation,” Patricia McIlreavy, president of the Center for Disaster Philanthropy, said in a prepared statement on behalf of the coalition. “With so many lives on the line, the imperative to support local aid efforts in Sudan has never been more urgent.” 

The Center for Disaster Philanthropy says more than 12 million people have been forced from their homes in Sudan, creating what is now the world’s largest displacement and hunger crisis. The danger from the conflict has prevented most international aid agencies from delivering supplies to those in need. 

Greg Milne, the Clinton Global Initiative CEO who convened a panel in April to raise awareness and support for the Sudanese people, said the new coalition is an example of what bringing organizations from varied sectors can do. 

“We know strong, diverse partnerships can help address often overlooked and even dire challenges, and develop unexpected and innovative solutions,” he said. 

Philanthropic leaders, including Bill Gates, World Central Kitchen founder Jose Andres, Open Society Foundations President Binaifer Nowrojee, and Rockefeller Foundation President Raj Shah will share information about their work during CGI, as will Prince Harry, who will discuss the launch of The Archewell Foundation Parents’ Network, which supports parents of children harmed online. In his Tuesday appearance, the Duke of Sussex will also address his work with the World Health Organization and others to reduce violence against children, an issue he and his wife Meghan outlined on a recent trip to Colombia. 

Brazilian President Luiz Inacio Lula da Silva, Barbados Prime Minister Mia Mottley, Kosovo President Vjosa Osmani Sadriu, and Latvian President Edgars Rinkevics are set to address the conference, as are CEOs from Pfizer, Mastercard, IKEA, Pinterest, Sanofi and Chobani. 
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NEW YORK — California and several environmental groups sued ExxonMobil on Monday and accused the oil giant of engaging in a decades-long campaign that helped fuel global plastic waste pollution. 

Speaking at an event during Climate Week in New York City, California Attorney General Rob Bonta said the state sued Exxon after concluding a nearly two-year investigation that he said showed Exxon was deliberately misleading the public about the limitations of recycling. 

“Today’s lawsuit shows the fullest picture to date of ExxonMobil’s decades-long deception, and we are asking the court to hold ExxonMobil fully accountable for its role in actively creating and exacerbating the plastics pollution crisis through its campaign of deception,” Bonta said in a statement. 

The investigation mirrors California’s previous probes into the oil industry’s alleged efforts to mislead the public about climate change, which the state is also suing over, and continues a long-standing adversarial relationship between the state and Big Oil. 

Once a major crude supplier, California’s oil production has been on a steady decline for almost four decades, with companies saying the regulatory environment there makes it a difficult place to invest. 

Exxon rival Chevron Corp., meanwhile, a strong critic of California’s policies, said this year it plans to move its headquarters from the state where it was born to oil-friendly Texas.  

A coalition of environmental groups including the Sierra Club appeared to join California’s legal battle, filing a related lawsuit in the same state court in San Francisco, raising similar allegations against Exxon. 

Bonta, a Democrat, said his office specifically had sought information on Exxon’s promotion of its “advanced recycling” technology, which uses a process called pyrolysis to turn hard-to-recycle plastic into fuel.  

He had said the technology’s slow progress was a sign of Exxon’s ongoing deception. He said he wants to secure an abatement fund and civil penalties for the harm inflicted by plastics pollution on California. 

Exxon pushed back at the attorney general, arguing that solutions like advanced recycling work. 

“Suing people makes headlines but doesn’t solve the plastic waste problem. Advanced recycling is a real solution,” said a spokesperson for ExxonMobil, adding that California has done “nothing to ‘advance’ recycling.” 

Notre Dame Law School Professor Bruce Huber, who specializes in environmental law, said California may face an “uphill battle” with its lawsuit. 

“The state’s primary claim relies on public nuisance, a notoriously murky area of law. It could be difficult for a court to grant California relief here without opening a Pandora’s box of other, similar claims,” he said. 

Exxon is the world’s largest producer of resins used for single-use plastics, according to a report published last year by the Minderoo Foundation, with consultancies Wood Mackenzie and the Carbon Trust. 

Reuters has reported on the enormous obstacles facing advanced recycling that the plastics industry touts as an environmental savior. 

California’s lawsuit comes ahead of a final round of global plastic treaty negotiations set to take place in Busan, South Korea, at the end of the year. 

In those talks, countries are split over whether the treaty should call for caps on plastic production, a position opposed by Exxon and the global petrochemical industry. 

The United States last month said it supports a treaty designed around global plastic production cuts. 

Environmental groups praised the lawsuit.  

Christy Leavitt, Oceana’s plastics campaign director, said California’s lawsuit will “hold industry accountable and debunk the plastics recycling narrative that holds us back from real solutions.”
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Moscow — A Soyuz capsule carrying two Russians and one American from the International Space Station landed Monday in Kazakhstan, ending a record-breaking stay for the Russian pair.

The capsule landed on the Kazakh steppe about 3 1/2 hours after undocking from the ISS in an apparently trouble-free descent. In the last stage of the landing, it descended under a red-and-white parachute at about 7.2 meters per second (16 mph), with small rockets fired in the final seconds to cushion the touchdown.

The astronauts were extracted from the capsule and placed in nearby chairs to help them adjust to gravity, then given medical examinations in a nearby tent.

Oleg Kononenko and Nikolai Chub returned after 374 days aboard the space station; on Friday they broke the record for the longest continuous stay there. Also in the capsule was American Tracy Dyson, who was in the space station for six months.

Eight astronauts remain in the space station, including Americans Butch Wilmore and Suni Williams, who have remained long past their scheduled return to Earth.

They arrived in June as the first crew of Boeing’s new Starliner capsule. But their trip was marred by thruster troubles and helium leaks, and the U.S. space agency NASA decided it was too risky to return them on Starliner.

The two astronauts are to ride home with SpaceX next year.
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Cairo — Cholera is spreading in war-torn Sudan, killing at least 388 people and sickening about 13,000 others over the past two months, health authorities said, as more than 17 months of fighting between the military and a notorious paramilitary group shows no sign of abating.  

The disease is spreading in areas devastated by recent heavy rainfall and floods especially in eastern Sudan where millions of war displaced people sheltered.  

The casualties from cholera included six dead and about 400 sickened over the weekend, according to Sunday’s report by the Health Ministry. The disease was detected in 10 of the country’s 18 provinces with the eastern Kassala and al-Qadarif provinces the most hit, the ministry said.  

Cholera is a fast-developing, highly contagious infection that causes diarrhea, leading to severe dehydration and possible death within hours when not treated, according to the World Health Organization. It is transmitted through the ingestion of contaminated food or water.   

The disease is not uncommon in Sudan. A previous major outbreak left at least 700 dead and sickened about 22,000 in less than two months in 2017.  

Sudan was plunged into chaos in April last year when simmering tensions between the military and a powerful paramilitary group, the Rapid Support Forces, exploded into open warfare across the country.  

The fighting, which wrecked the capital, Khartoum, and other urban areas has been marked by atrocities including mass rape and ethnically motivated killings that amount to war crimes and crimes against humanity, especially in the western region of Darfur, according to the United Nations and international rights groups.  

It has killed at least 20,000 people and wounded tens of thousands others, according to the U.N. However, rights groups and activists say the toll was much higher.  

The war also has created the world’s largest displacement crisis. More than 13 million people have been forced to flee their homes since the fighting began, according to the International Organization for Migration. They include over 2.3 million who fled to neighboring countries.  

Devastating seasonal floods and cholera have compounded the Sudanese misery. At least 225 people have been killed and about 900 others were injured in the floods, the Health Ministry said. Critical infrastructure has been washed away, and more than 76,000 houses have been destroyed or damaged, it said.  

Famine was also confirmed in July in the Zamzam camp for displaced people, which is located about 15 kilometers (10 miles) from North Darfur’s embattled capital of al-Fasher, according to global experts from the Famine Review Committee. About 25.6 million people — more than half of Sudan’s population — will face acute hunger this year, they warned.  

Fighting, meanwhile, rages in al-Fasher, the last major city in Darfur that is still held by the military. The RSF has been attempting to retake it since the start of the year.  

Last week, the paramilitary force and its allied Arab militias launched a new attack on the city. The military said its forces, aided by rebel groups, managed to repel the attack and kill hundreds of RSF fighters, including two senior commanders. 
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United Nations, United States — The United Nations on Sunday adopted a “Pact for the Future” aimed at addressing sprawling 21st-century challenges ranging from conflict to climate change and human rights, despite last-minute objections from a group of countries led by Russia.

Secretary-General Antonio Guterres, who organized the “Summit of the Future,” had billed it as a “once-in-a-generation opportunity” to reshape human history by rekindling international cooperation.

As an opening act for the annual high-level week of the U.N. General Assembly, which begins Tuesday, dozens of heads of state and government gathered for the signing of the text.

In the adopted version, leaders pledged to bolster the multilateral system to “keep pace with a changing world” and to “protect the needs and interests of current and future generations” facing “persistent crisis.”

“We believe there is a path to a brighter future for all of humanity,” the document says.

The pact outlines 56 “actions,” including commitments to multilateralism, upholding the U.N. Charter and peacekeeping.

It also calls for reforms to international financial institutions and the U.N. Security Council, along with renewed efforts to combat climate change, promote disarmament, and guide the development of artificial intelligence.

The adoption of the text faced a brief delay when Russia’s deputy minister of foreign affairs, Sergey Vershinin, introduced an amendment emphasizing the “principle of non-interference in the internal affairs of states” and urging the U.N. to avoid duplicating efforts.

Russia’s objections were backed by allies Belarus, North Korea, Iran, Nicaragua and Syria, but its amendment was overwhelmingly dismissed in a motion to take no action.

During the negotiations phase, Guterres had urged nations to show “vision” and “courage,” calling for “maximum ambition” to strengthen international institutions that struggle to respond effectively to today’s threats.

But while there are some “good ideas,” the text “is not the sort of revolutionary document reforming the whole of multilateralism that Antonio Guterres had originally called for,” Richard Gowan of the International Crisis Group told AFP.

That sentiment was widely shared among diplomats, many of whom expressed frustration when discussing the ambition and impact of the text, describing it as “lukewarm,” “the lowest common denominator,” and “disappointing.”

“Ideally, you would hope for new ideas, fresh ideas,” said one diplomat.

The fight against global warming was one of the sticking points in the negotiations, with references to the “transition” away from fossil fuels having disappeared from the draft text weeks ago, before being re-inserted.

Despite the criticism, it is still “an opportunity to affirm our collective commitment to multilateralism, even in the difficult current geopolitical context,” one Western diplomat said, emphasizing the need to rebuild trust between the Global North and South.

Developing countries have been particularly vocal in demanding concrete commitments on the reform of international financial institutions, aiming to secure easier access to preferential financing, especially considering the impacts of climate change.

The text does indeed include “important commitments on economic justice and reforming the international financial architecture,” Human Rights Watch (HRW) commented, while also praising “the centrality of human rights.”

However, world leaders “still need to demonstrate that they are willing to act to uphold human rights,” said Louis Charbonneau, HRW’s U.N. director.

Regardless of its content, the pact and its annexes — a Global Digital Compact and a Declaration on Future Generations — are non-binding, raising concerns about implementation, especially as some principles — such as the protection of civilians in conflict — are violated daily.

“Our next task is to breathe life into them, to turn words into action,” Guterres urged on Saturday.
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TEFE, Brazil — The carcass of a baby dolphin lay on the sand bank left exposed by the receding waters in an Amazon lake that has been drying up during the worst drought on record. 

Researchers recovered the dead animal on Wednesday and measured water temperatures that have been rising as the lake’s level drops. In last year’s drought, more than 200 of the endangered freshwater dolphins died in Lake Tefe from excessive water temperatures. 

“We’ve found several dead animals. Last week, we found one a day on average,” said Miriam Marmontel, head of the dolphin project at the Mamiraua Institute for Sustainable Development.  

“We’re not yet associating the deaths with changes in water temperatures, but with the exacerbation of the proximity between human populations, mainly fishermen, and the animals,” she said. 

With branches of major rivers in the Amazon basin drying up in this year’s critical drought, the lake connected to the Solimoes River has shrunk, leaving less room for the dolphins in their favorite habitat. 

The lake’s main channel is 2 meters deep and roughly 100 meters wide, and it is used by all the boat traffic, from canoes to heavy ferries, Marmontel said. Two dolphins were killed recently when boats ran into them in the shallow water. 

“Nobody thought this drought would come so quickly or imagine that it would surpass last year’s drought,” fisherman Clodomar Lima said. 

While the dolphin deaths are nowhere close to last year’s toll, the dry season has more than a month to go and water levels will continue to decline, the researcher said. 

And it is not just the rare dolphin species that are suffering. Riverine communities across the Amazon are stranded by the lack of transport on waters too shallow for boats, and their floating houses are now on solid ground. 

Even houses built on stilts over water are now high and dry a distance from the river shore. 

Lake Tefe resident Francisco Alvaro Santos said it was the first time ever that his floating house was out of the water. 

“Water is everything to us. It is part of our daily lives, the means of transportation for everyone who live here,” said Santos. “Without water we are nobody!”
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LOUISVILLE, Kentucky — On his first day of school at Newcomer Academy, Maikel Tejeda was whisked to the school library. The 7th grader didn’t know why.

He soon got the point: He was being given make-up vaccinations. Five of them.

“I don’t have a problem with that,” said the 12-year-old, who moved from Cuba early this year.

Across the library, a group of city, state and federal officials gathered to celebrate the school clinic, and the city. With U.S. childhood vaccination rates below their goals, Louisville and the state were being praised as success stories: Kentucky’s vaccination rate for kindergarteners rose 2 percentage points in the 2022-23 school year compared with the year before. The rate for Jefferson County — which is Louisville — was up 4 percentage points.

“Progress is success,” said Dr. Mandy Cohen, director of the Centers for Disease Control and Prevention.

But that progress didn’t last. Kentucky’s school entry vaccination rate slipped last year. Jefferson County’s rate slid, too. And the rates for both the county and state remain well below the target thresholds.

It raises the question: If this is what success looks like, what does it say about the nation’s ability to stop imported infections from turning into community outbreaks?

Local officials believe they can get to herd immunity thresholds, but they acknowledge challenges that includes tight funding, misinformation and well-intended bureaucratic rules that can discourage doctors from giving kids shots.

“We’re closing the gap,” said Eva Stone, who has managed the county school system’s health services since 2018. “We’re not closing the gap very quickly.”

Falling vaccination rates

Public health experts focus on vaccination rates for kindergartners because schools can be cauldrons for germs and the launching pad for community outbreaks.

For years, those rates were high, thanks largely to mandates that required key vaccinations as a condition of school attendance.

But they have slid in recent years. When COVID-19 started hitting the U.S. hard in 2020, schools were closed, visits to pediatricians declined and vaccination record-keeping fell off. Meanwhile, more parents questioned routine childhood vaccinations that they used to automatically accept, an effect that experts attribute to misinformation and the political schism that emerged around COVID-19 vaccines.

A Gallup survey released last month found that 40% of Americans said it is extremely important for parents to have their children vaccinated, down from 58% in 2019. Meanwhile, a recent University of Pennsylvania survey of 1,500 people found that about 1 in 4 U.S. adults think the measles, mumps and rubella vaccine causes autism — despite no medical evidence for it.

All that has led more parents to seek exemptions to school entry vaccinations. The CDC has not yet reported national data for the 2023-24 school year, but the proportion of U.S. kindergartners exempted from school vaccination requirements the year before hit a record 3%.

Overall, 93% of kindergartners got their required shots for the 2022-23 school year. The rate was 95% in the years before the COVID-19 pandemic.

Officials worry slipping vaccination rates will lead to disease outbreaks.

The roughly 250 U.S. measles cases reported so far this year are the most since 2019, and Oregon is seeing its largest outbreak in more than 30 years.

Kentucky has been experiencing its worst outbreak of whooping cough — another vaccine-preventable disease — since 2017. Nationally, nearly 14,000 cases have been reported this year, the most since 2019.

Persuading parents

The whooping cough surge is a warning sign but also an opportunity, said Kim Tolley, a California-based historian who wrote a book last year on the vaccination of American schoolchildren. She called for a public relations campaign to “get everybody behind” improving immunizations.

Much of the discussion about raising vaccination rates centers on campaigns designed to educate parents about the importance of vaccinating children — especially those on the fence about getting shots for their kids.

But experts are still hashing out what kind of messaging work best: Is it better, for example, to say “vaccinate” or “immunize”?

A lot of the messaging is influenced by feedback from small focus groups. One takeaway is some people have less trust in health officials and even their own doctors than they once did. Another is that they strongly trust their own feelings about vaccines and what they’ve seen in Internet searches or heard from other sources.

“Their overconfidence is hard to shake. It’s hard to poke holes in it,” said Mike Perry, who ran focus groups on behalf of a group called the Public Health Communications Collaborative.

But many people seem more trusting of older vaccines. And they do seem to be at least curious about information they didn’t know, including the history of research behind vaccines and the dangers of the diseases they were created to fight, he said.

Improving access

Dolores Albarracin has studied vaccination improvement strategies in 17 countries, and repeatedly found that the most effective strategy is to make it easier for kids to get vaccinated.

“In practice, most people are not vaccinating simply because they don’t have money to take the bus” or have other troubles getting to appointments, said Albarracin, director of the communication science division within Penn’s Annenberg Public Policy Center.

That’s a problem in Louisville, where officials say few doctors were providing vaccinations to children enrolled in Medicaid and fewer still were providing shots to kids without any health insurance. An analysis a few years ago indicated 1 in 5 children — about 20,000 kids — were not current on their vaccinations, and most of them were poor, said Stone, the county school health manager.

A 30-year-old federal program called Vaccines for Children pays for vaccinations for children who Medicaid-eligible or lack the insurance to cover it.

But in a meeting with the CDC director last month, Louisville health officials lamented that most local doctors don’t participate in the program because of paperwork and other administrative headaches. And it can be tough for patients to get the time and transportation to get to those few dozen Louisville providers who do take part.

The school system has tried to fill the gap. In 2019, it applied to become a VFC provider, and gradually established vaccine clinics.

Last year, it held clinics at nearly all 160 schools, and it’s doing the same thing this year. The first was at Newcomer Academy, where many immigrant students behind on their vaccinations are started in the school system.

It’s been challenging, Stone said. Funding is very limited. There are bureaucratic obstacles, and a growing influx of children from other countries who need shots. It takes multiple trips to a doctor or clinic to complete some vaccine series. And then there’s the opposition — vaccination clinic announcements tend to draw hateful social media comments. 
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