Author: Elizabeth McHugh

America suffered a tremendous loss in 2020: nearly 400,000 people died from Covid-19. In the years following, thousands more would die from the raging pandemic. That is until a vaccine with an efficacy against mortality rates of more than 90% brought the spread to a searing halt. Even still, millions of Americans reject vaccines for themselves and their children each year for contagious diseases like Covid-19, measles, and the seasonal flu.

Vaccine hesitancy and distrust originated in the early 1800s, as smallpox erupted across Europe. The technologically advanced smallpox vaccine concerned the first group of “anti-vaccinators.” Some of those who opposed vaccines believed them “unchristian” because they came from an animal and others’ opposition was rooted in their fundamental distrust of medicine in general.  

In the late ‘90s, Andrew Wakefield published a paper claiming that there was a causal link between the MMR (measles, mumps, rubella) vaccine and autism in children. Experts later discovered that Wakefield falsified his data, intentionally misleading readers so that he could sell a competing vaccine. Not only was his data falsified, but his study only included 12 children—a sample size far too small to achieve statistical significance. Wakefield’s license to practice medicine in the U.K. was revoked and the journal that published the paper quickly withdrew it. While Wakefield faced consequences in his personal and professional endeavors, the distrust in vaccines that he bred still lives on in many Americans today. According to a 2024 study by the University of Pennsylvania’s Annenberg Public Policy Center, more than a quarter of American adults still believe that the MMR vaccine causes autism (despite Wakefield’s admittedly falsified data). With measles cases on the rise and vaccination rates decreasing, the lower threshold for measles herd immunity is near; the United States is close to losing its “elimination status” for the extremely contagious disease.

In a post-Covid world, where vaccines have proven their efficacy time and again, distrust continues to grow. The need for calm, informed, sensible leadership is exigent in the United States. Instead, the Trump administration called on Robert F. Kennedy Jr. to lead the charge. A known anti-vaccine activist, Kennedy has promulgated misinformation, claiming that, among other things, vaccines cause autism. On a podcast in July 2023, Kennedy said, “There’s no vaccine that is safe and effective.”

Where do we go from here? In this critical moment, the onus is on state and local governments to educate their communities, provide emergency response support, and implement state-based vaccine programs. Healthcare providers can ally with local groups to communicate with the public and continue to push back against billions in childhood vaccination funding cuts. In a time where the truth is a hard sell, providers and local governments must put it on the shelves anyway.

In 2022, JUUL, an e-cigarette company originally founded to help cigarette smokers quit, settled a lawsuit that alleged that Plaintiffs paid more for JUUL products than they would have if accurate information regarding the product’s addictiveness and safety had been provided. The lawsuit further alleged that JUUL products were unlawfully marketed to minors. The complaint, filed in the Northern District of California, noted that JUUL’s advertising techniques were specifically employed to garner interest from a younger consumer population and used long-banned cigarette advertising techniques. The $300 million settlement was paid out to consumers in the middle of October 2024, with some purchasers receiving thousands of dollars in return. 

In avoiding the risk of going to trial, JUUL’s settlement sets the stage for future claims against substance producers potentially marketing to children or concealing the risks associated with consuming their product. As research emerges regarding alcohol consumption’s link to increased cancer risk, companies that produce sweet liquors with fun colors could be at risk for marketing to children. Per the National Institute of Health, nearly 5.8% of cancer deaths worldwide are attributable to alcohol consumption. As of October 22, 2024, the United States does not require that alcohol bottles bolster a warning of cancer risk. Ireland recently became the first country to require cancer warning labels on alcohol bottles. Many liquors also appear to be marketed towards children in many of the same ways that JUUL products were; they are colorful, with sleek designs, and often fruity or exotic flavors. At what point do the same legal principles apply to alcohol litigation?

Arguably, JUUL’s massive settlement set the stage for future substance complaints and litigation, particularly as it concerns public health and concern for minors. The alcohol industry finds itself at a crossroads: how can it continue to innovate its product and increase its revenue while treading carefully to avoid bankruptcy-inducing settlement payouts? The question might actually be one of abandoning some long-held, capitalistic business practices, pivoting from seemingly marketing to a younger audience, and bolstering the existing market. Instead of creating fun designs with exotic flavors, perhaps leaning into a “sophisticated” type of marketing that emphasizes the exclusivity of being of age to consume alcohol. By moving away from the youth-targeted marketing, companies can instead generate excitement for a new consumer base by advertising anticipation of reaching the drinking age. Perhaps they can also shift marketing to reflect a slower, less volume-induced type of consumption. By elevating the experience and shifting marketing strategy to reflect a sophisticated, adult activity, alcohol companies can avoid potential marketing litigation as it pertains to childish advertising. In looking towards the future, alcohol companies should be prepared to comply with all warning regulations and potentially shift marketing materials to target an older audience.