The life-changing impact of preventable diseases in the anti-vaccination era
Over the next century, vaccines virtually wiped out long-feared scourges like polio and measles and drastically reduced the toll of many others. Today, however, some preventable, contagious diseases are making a comeback as vaccine hesitancy pushes immunization rates down. And well-established vaccines are facing suspicion even from public officials, with Robert F. Kennedy Jr., a longtime anti-vaccine activist, running the federal health department.
'This concern, this hesitancy, these questions about vaccines are a consequence of the great success of the vaccines — because they eliminated the diseases,' said Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center. 'If you're not familiar with the disease, you don't respect or even fear it. And therefore you don't value the vaccine.'
Anti-vaccine activists even portray the shots as a threat, focusing on the rare risk of side effects while ignoring the far larger risks posed by the diseases themselves — and years of real-world data that experts say proves the vaccines are safe.
Some Americans know the reality of vaccine-preventable diseases all too well. Here are takeaways from interviews with a few of them by The Associated Press.
Getting a disease while pregnant can change two lives
Janith Farnham has helped shepherd her daughter Jacque through life for decades. Jacque, 60, was born with congenital rubella syndrome, which resulted in hearing, eye and heart problems at birth. There was no vaccine against rubella back then, and Janith contracted it in early pregnancy.
Though Janith, 80, did all she could to help Jacque thrive, the condition took its toll. Jacque eventually developed diabetes, glaucoma, autistic behaviors and arthritis.
Today, Jacque lives in an adult residential home and gets together with Janith four or five days a week. Janith marvels at Jacque's sense of humor and affectionate nature despite all she's endured. Jacque is generous with kisses and often signs 'double I love yous,' even to new people she meets.
Given what her family has been through, Janith finds it 'more than frustrating' when people choose not to get children the MMR shot against measles, mumps and rubella.
'I know what can happen,' she said. 'I just don't want anybody else to go through this.'
Delaying a vaccine can be deadly
More than half a century has passed, but Patricia Tobin still vividly recalls seeing her little sister Karen unconscious on the bathroom floor.
It was 1970, Karen was 6, and she had measles. The vaccine against it wasn't required for school in Miami where they lived. Though Karen's doctor discussed immunizing the first grader, their mother didn't share his sense of urgency.
'It's not that she was against it,' Tobin said. 'She just thought there was time.'
Then came a measles outbreak. After she collapsed in the bathroom, Karen never regained consciousness. She died of encephalitis.
'We never did get to speak to her again,' Tobin said.
Today, all states require that children get certain vaccines to attend school. But a growing number of people are making use of exemptions. Vanderbilt's Schaffner said fading memories of measles outbreaks were exacerbated by a fraudulent, retracted study claiming a link between the MMR shot and autism.
The result? Most states are below the 95% vaccination threshold for kindergartners — the level needed to protect communities against measles outbreaks.
Preventable diseases can have long-term effects
One of Lora Duguay's earliest memories is lying in a hospital isolation ward with her feverish, paralyzed body packed in ice. She was three years old.
It was 1959 and Duguay, of Clearwater, Florida, had polio. It was one of the most feared diseases in the U.S., experts say, causing some terrified parents to keep children inside and avoid crowds during epidemics.
Given polio's visibility, the vaccine against it was widely and enthusiastically welcomed. Given polio's visibility, the vaccine against it was widely and enthusiastically welcomed. But the early vaccine that Duguay got was only about 80% to 90% effective. Not enough people were vaccinated or protected yet to stop the virus from spreading.
Though treatment helped her walk again, she eventually developed post-polio syndrome, a neuromuscular disorder that worsens over time. She now gets around in a wheelchair.
The disease that changed her life twice is no longer a problem in the U.S. So many children get the vaccine — which is far more effective than earlier versions — that it doesn't just protect individuals but it prevents occasional cases that arrive in the U.S. from spreading further and protects the vulnerable.
When people aren't vaccinated, the vulnerable remain at risk
Every night, Katie Van Tornhout rubs a plaster cast of a tiny foot, a vestige of the daughter she lost to whooping cough at just 37 days old.
Callie Grace was born on Christmas Eve 2009. When she turned a month old, she began having symptoms of pertussis, or whooping cough. She was too young for the Tdap vaccine against it and was exposed to someone who hadn't gotten their booster shot.
At the hospital, Van Tornhout recalled, the medical staff frantically tried to save her, but 'within minutes, she was gone.'
Today, Callie remains part of her family's life, and Van Tornhout shares the story with others as she advocates for vaccination.
'It's up to us as adults to protect our children — like, that's what a parent's job is,' Van Tornhout said. 'I watched my daughter die from something that was preventable … You don't want to walk in my shoes.'
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
BBC News
an hour ago
- BBC News
Why are ethnic minority groups falling behind on vaccines?
Last year data on childhood vaccines was broken down by ethnicity for the first showed a wide variation in uptake across ethnic minority groups and Public Health Scotland called for more work to understand what is going on. In some areas there is concerns that ethnic minority groups are falling behind the rest of the population when it comes to instance, the figures showed that almost a quarter of children of African descent in Scotland had not had their second dose of MMR by the age of was also low for children of Caribbean or Black cases have been increasing across Scotland and experts fear children are missing out on full protection against the potentially deadly disease by not getting their second uptake of vaccines in minority ethnic groups isn't just seen in childhood say Covid-19, flu and Human Papillomavirus (HPV) show similar why are ethnic minority groups often more hesitant when it comes to vaccination? What do the stats show? The BBC has analysed uptake rates across a range of vaccinations and across ethnic MMR (Measles, Mumps and Rubella) across Scotland as a whole, the number of children getting the first dose by the age of two is just below the World Health Organisation (WHO) target of 95% to ensure "herd immunity".The stats show that not as many children from ethnic minority groups, such as African and Caribbean or Black, are getting the first dose by the age of two but they catch up by the time they are five or uptake of the second dose, which provides full coverage against the diseases is concerning health 75% of children in the African ethnic group received the second dose by the age of five last year. The figure was 83.8% for Caribbean or Black people in Scotland and 87.3% in Asian death of a child in Liverpool earlier this month has sparked calls to increase efforts on part of the strategy, Public Health Scotland has introduced a "status check" and an opportunity to catch up on missed MMR doses in secondary to MMR, the HPV, Covid-19 and flu vaccine uptake show trends of lower uptake in minority ethnic Health Scotland data for the last flu vaccine programme shows that uptake varies from 55.2% in the White Scottish group, down to 36.2% in the Arab groups, 34.4% in the Pakistani groups and only 22.6% in the Caribbean groups of eligible adults. Vaccine hesitancy not anti-vax In June, a health inequalities report from Public Health Scotland studied the factors which had affected the uptake of the Covid and Flu vaccines in some ethnic pointed to a lack of trust in organisations promoting the vaccine, not enough information that is culturally and linguistically appropriate, a lack of flexibility in vaccine appointments and perceived harms from vaccines promoted via social Antonia Ho, a professor of infectious diseases at the University of Glasgow, tells the BBC it is important to understand that there were many reasons why people don't take up vaccinations - it is not simply a case of them being against vaccination."Vaccine hesitancy shouldn't be conflated with being anti-vax," she Ho says often people who don't take up vaccines have legitimate could include questions such as whether their ethnic group was represented in clinical trials, she research from the Royal College of Paediatrics and Child Health (RCPCH) also points to other barriers such as the timing and location of vaccine said: "Research and public health resources are sometimes misdirected by focusing too heavily on vaccine hesitancy, when in fact there are many parents who want to vaccinate but simply can't access services that work for them."The report also acknowledges a "growing disparity in vaccine uptake among some ethnic minority groups, socioeconomically disadvantaged families and migrant communities". Ethnic minorities treated differently Dr Sahira Dar, a GP in Glasgow and president of the British Islamic Medical Association, says it is important not to assign blame to minority ethnic communities. "We know that lower vaccine uptake and challenges to access appropriate health services are interlinked," she Dar says patient experience of healthcare can be more difficult depending on how someone is perceived by healthcare staff."If you are black, brown, or from an ethnic minority or if you are a refugee or a woman wearing a hijab, unfortunately patients from these groups are treated differently," Dr Dar says there is a correlation between these difficulties in healthcare settings and a general mistrust in the an issue that was highlighted in September last year by Scotland's Health Secretary Neil Gray. He acknowledged racism as a "significant public health challenge" and said combatting it was "fundamental" to reducing health inequalities in Scotland. Cultural barriers to healthcare According to Dr Dar, a lack of cultural understanding can be a barrier cites the example of the HPV vaccine, which prevents an infection which is sexually transmitted and is responsible for almost all cases of cervical of the HPV vaccine was reported by ethnicity for the first time in the 2023/2024 school year and it showed the rate was much lower in some ethnic minority first opportunity to get the vaccine is in the first year of secondary school when the White Scottish ethnic group had an uptake of 73.7%.In the same age group, uptake was lower (57.4%) in the Black ethnic group and (53.3%) in the Pakistani ethnic continues to be administered in school until S4, offering opportunities to catch up on coverage. It can also be available further on the some communities there can be stigma attached to conversations about sexual relationships and sexual Dar says some may view getting the HPV vaccine as encouraging Sigi Joseph, a GP in Glasgow, echoes this."Some cultures might think 'well my child isn't going to be having sex', so they might choose not to get the vaccine," she Joseph says understanding of different cultural barriers - such as Muslim women who prefer to be treated by another women for modesty - is vital otherwise it could result in people being turned away from accessing healthcare."If someone's had a stressful or difficult experience, they probably would talk to their friends and family," she says. "How far that filtrates is difficult to know." An overall distrust in 'the system' Dr Josephine Adekola, a senior lecturer specialising in disaster risk management at the University of Glasgow, began investigating the reasons for lower vaccine uptake in Scottish African communities in 2021 during the Covid pandemic - and heard a variety of concerns."A lot of the hesitancy was linked to discriminatory practices and racism," Dr Adekola her study, participants told her about long-running problems, with the immigration sector, schooling, housing, and even insufficient action being taken against workplace discrimination. "The different experiences of policies interrelate with misinformation and disinformation to create so much distrust in this community to make them hesitant," she Adekola says that lack of support and bad experiences with one sector can lead to people grouping separate parts of the government and public bodies together, resulting in an overall distrust in "the system". Misinformation spreads around the world Misinformation about vaccines is a widespread problem Dr Adekola says ethnic minority groups have the extra factor of receiving messages from trusted family members in different countries which contain misinformation or pressure not to get says that during the Covid pandemic she heard misinformation such as the suggestion that Black people were immune to the was also a conspiracy theory that linked getting the vaccine to the "Mark of the Beast" - a Biblical prophecy which says those that aren't "marked" will suffer economically, and those that are will be in allegiance with the is an issue which was also highlighted by Tory leader Kemi Badenoch who grew up in evidence at the UK Covid Inquiry in November 2023, she said there were "lots of conspiracy theories" shared in her own family's WhatsApp group chat and a lack of trust in the government in some communities. The 'ethnicity data gap' Dr Mark Wong, a senior lecturer at the University of Glasgow and expert in ethnicity data, also believes that racism is the key reason for poorer health outcomes for minority ethnic people and why there is a lower vaccine says people from minority ethnic backgrounds are not taken seriously when in healthcare Wong says they are often dismissed or what they say they are experiencing is not trusted as real."That has led to delays in diagnosis, delays in treatment and sometimes, ultimately, early, unnecessary deaths and health problems," Dr Wong adds that the mistrust minority ethnic people have towards public authorities and the "heightened alertness" in potentially being discriminated against is not fully understood, which results in public health messaging not effectively reaching or convincing minority ethnic communities. Dr Wong says proving the link between lower vaccine uptake and higher deaths in ethnic minority communities during the Covid-19 pandemic had been difficult initially because of a long-standing ethnicity data gap in says there was a "missed opportunity" at the very start of the pandemic to record ethnicity led to experts in Scotland relying on reporting from the rest of the UK which highlighted the disproportionately negative impact on minority ethnic Wong says he had highlighted this in a working group to the Scottish government at the end of 2020, around the same time as the Covid-19 vaccination rollout the recording of ethnicity data only began in November describes having this information documented now as a "turning point" for the quality of ethnicity data for vaccination programmes since response to the BBC's questions on vaccine uptake in ethnic minority groups, a Scottish government spokesperson said: "The Scottish Vaccination and Immunisation Programme will continue to focus on increasing uptake of the MMR vaccine, building confidence in communities and reducing health inequalities. "NHS Boards know their communities best and are responsible for local delivery plans which support accessible and timely vaccination for people who may face barriers to uptake."A Public Health Scotland statement said: "Scotland has a very successful vaccination and immunisation programme with high uptake/coverage rates. "However, as seen in other nations, there have been in declines in uptake over time and persistent health inequalities that leave some communities more vulnerable than others."
Scottish Sun
9 hours ago
- Scottish Sun
Urgent warning as thousands of Scots children at risk of brain damage over shortage of vital vaccine
Click to share on X/Twitter (Opens in new window) Click to share on Facebook (Opens in new window) CHILDREN are at risk of brain damage because of a shortage of measles vaccinations in rural areas, medical experts have warned. Remote GPs are suffering from 'empty fridge syndrome' with a lack of vaccines to prevent a deadly measles outbreak in their communities. Sign up for Scottish Sun newsletter Sign up 3 Thousands of Scots children at risk of brain damage over shortage of vital vaccine Credit: Alamy 3 There is a lack of vaccines to prevent a deadly measles outbreak Credit: Getty 3 Having the MMR vaccine is the best way to prevent it, according to the NHS Credit: Getty The lack of vaccines was described as 'deeply concerning', and one GP leader said he is 'very worried' about the risk of an outbreak. A child died in Liverpool in recent weeks after contracting measles, believed to be the second child to die from the disease in the UK in the last five years. Seventeen other children have been treated at Alder Hay Hospital for measles. Dr Chris Provan, chair of the Royal College of General Practitioners, confirmed parents are more hesitant to vaccinate children due to online misinformation. But he said the potentially deadly consequences of measles outweigh the very low risk of an adverse reaction to the vaccine. He told the BBC society has forgotten how bad measles can be, with complications ranging from brain damage and convulsions to ear infections. I am very worried about the risk to Scotland. We need to act now Dr Chris Provan He said: 'The immunisation rate for measles has gone down to the lowest rate it has been in the last 10 years. 'The antivax movement is a significant part of it, but part of it is really down to barriers to getting the immunisation sometimes. 'Sometimes in remote and rural areas there is less ability to give the vaccine when patients are in the practice for something else. 'There is something called empty fridge syndrome, where GPs in rural areas don't have the vaccine, so they can't give it out to the patients who have travelled for other reasons.' Mum's warning to all parents after her 'fit and healthy' daughter, 10, died a DECADE after 'mild bout of measles' He confirmed there have been two deaths in the USA and one in Canada recently. Some parents remain concerned about discredited claims that the vaccine is linked to autism. Dr Provan added: 'Science has now shown there is no link to autism or bowel disease, so the risks of the vaccine are very small compared to the risk of measles. 'I am very worried about the risk to Scotland. We need to act now.' It's deeply concerning that children could be at risk of serious harm because of falling vaccination rates under the SNP Brian Whittle He called for a major public health campaign to promote vaccination, particularly in remote areas and deprived communities where vaccine uptake is 10 per cent below the general population. Peter Barlow, professor of immunology and infection at Edinburgh Napier University, said: 'Measles is so contagious that even a small drop in rates of immunisation can result in outbreaks. 'Entire communities and populations can become infected quite quickly. "If enough of a community is protected by a vaccine, then it makes it more difficult for the disease to spread. Symptoms of measles MEASLES usually starts with cold-like symptoms, followed by a rash a few days later. Some people may also get small spots in their mouth. The first symptoms of measles include: A high temperature A runny or blocked nose Sneezing A cough Red, sore, watery eyes Small white spots may appear inside the cheeks and on the back of the lips A rash that starts on the face and behind the ears before spreading to the rest of the body. The spots of the measles rash are sometimes raised and join together to form blotchy patches. They're not usually itchy. The rash looks brown or red on white skin. It may be harder to see on brown and black skin. Complications of measles Measles can lead to serious problems if it spreads to other parts of the body, such as the lungs or brain. Problems that can be caused by measles include: pneumonia meningitis blindness seizures (fits) These problems are rare, but some people are more at risk. This includes babies and people with weakened immune systems. Credit: NHS 'Herd immunity is very important for protecting people who might be at greater risk "Such as those too young to receive a vaccine and individuals who are immunocompromised or undergoing medical treatment for diseases such as cancer. 'Outbreaks can escalate very quickly, especially in communities with clusters of unvaccinated individuals. Scottish Conservative public health spokesman Brian Whittle said: 'It's deeply concerning that children could be at risk of serious harm because of falling vaccination rates under the SNP. 'The MMR jab is vital because this highly contagious disease can lead to severe complications, but under the nationalists, uptake has dropped to a 10-year low. 'Medics are doing the best, but the SNP needs to ensure that parents are aware of the consequences of not getting their children vaccinated.'
NBC News
20 hours ago
- NBC News
A cross between a nicotine pouch and an energy drink: What to know about caffeine pouches
David Gomez, a school resource officer for the Boise County Sheriff's Office in Idaho, started noticing caffeine pouches last spring. Students were using the pillow-shaped pouches, which can contain more than 200 milligrams of caffeine, alongside nicotine pouches like Zyn. They'll use them either as a disguise for nicotine pouch usage — caffeine and nicotine pouches often look virtually identical — or a complement to it, Gomez said. 'They'll use the Zyn pouches that they put in their lip, and then they'll take a caffeine pouch,' he added. 'They don't care what it is they're putting in their lip.' The use of caffeine pouches among teens is still relatively rare. But some experts and educators have concerns that that could soon change. Teen-friendly marketing of these products is spreading on social media. And Richard Mumby, the marketing executive who helped launch the e-cigarette Juul, which was widely blamed for sparking a teen vaping epidemic, is back with a caffeine pouch startup called Wip. Wip joins a growing market drafting off the popularity of nicotine pouches and trying to sell Americans on a new alternative to caffeinated beverages. Caffeine is part of 'the fabric of many Americans' everyday lives,' Mumby told NBC News — but he argues there's room for improvement. Wip and its competitors are pitching caffeine pouches as a convenient, portable and affordable alternative to caffeinated drinks. A cross between nicotine pouches and energy drinks, they are placed between the lip and gums to quickly deliver a hands-free hit of caffeine. Pouches typically last anywhere from roughly 20 minutes to an hour, but their caffeine buzz can linger longer. Wip's pouches come in flavors like mint, strawberry kiwi and sour cherry, and each one contains either 100 or 200 milligrams of caffeine — the latter being roughly equivalent to two cups of coffee, or half the amount of caffeine most adults can safely consume in an entire day, according to the U.S. Food and Drug Administration. The health effects of caffeine pouches are not well-studied. But not all experts are sold on this new form of caffeine delivery. Rob van Dam, a professor of exercise and nutrition sciences at George Washington University's Milken Institute School of Public Health who studies caffeine, voiced concerns about the potency of some pouches on the market, particularly for consumers who are not used to them. 'It may be a bit different than coffee,' he said. 'It may hit faster, and you may overdose, in a way, more quickly.' The potential appeal to teens is another concern, given the existing popularity of nicotine pouches and energy drinks. (Philip Morris, which makes Zyn, has previously told NBC News that 'Zyn's marketing is directed toward legal age nicotine users who are 21+.') While there are no federal age restrictions on the sale or use of caffeine, the American Academy of Pediatrics recommends that teens consume no more than 100 mg of caffeine per day — or, even better, avoid using it at all, said Dr. Mark Corkins, chair of the AAP's Committee on Nutrition. Youth caffeine use came under increasing scrutiny following high-profile reports of death and serious injury among young people who consumed Panera Bread's heavily caffeinated Charged Lemonade, which the brand discontinued in 2024 as part of a 'menu transformation.' Separately, medical visits related to kids drinking other caffeinated beverages are also on the rise: From 2022 to 2023, America's Poison Centers charted a 24% increase in calls related to energy-drink consumption among people younger than 20. And the rate of pediatric emergency room visits related to caffeine usage roughly doubled between 2017 and 2023, although such visits remain rare, according to data from Epic Research. 'Caffeine, in general, is an area we are very concerned about,' Corkins said. 'Pouches are just another delivery form.' A growing market — and an ethical 'gray zone' Caffeine pouches aren't entirely new. The brand Grinds started selling coffee pouches about 15 years ago, initially targeting the niche market of baseball players who wanted an alternative to chewing tobacco. At first, business 'was like flying a plane into headwinds,' said co-founder Patrick Pezet. 'No one knew what pouches were. It was totally foreign.' Business has increased steadily over time, growing by 20% to 50% each year since the company launched, Pezet said. Especially in the last five years or so — in parallel with the rise of the popular nicotine pouch brand Zyn — there's been a dramatic shift in the public's awareness of and willingness to use mouth pouches, Pezet said. (Wip said in a press release that almost half of adults ages 18 to 40 are interested in using pouches for energy.) Caffeine pouches are still a small market, particularly compared to the multibillion-dollar U.S. coffee industry or even the nicotine pouch industry. Still, Pezet said, his company has a growing customer base, mostly made up of adults who want an alternative to nicotine products. Another sign of growth: an explosion of competitors. 'We keep close tabs on the entire market,' Pezet said. 'There's probably 50 to 60 total caffeine pouches or energy pouches out there. Two or three years ago, that number was a couple dozen.' As the market proliferates, it has given rise to a 'gray zone' of legal but ethically dubious promotion to young people, Pezet said. (A blog post on Grinds' website says 'there is absolutely no age restriction on purchasing or using Grinds Coffee Pouches,' but Pezet said the brand directs its marketing toward customers 18 and older.) In some social media posts, creators explicitly promote caffeine pouches to students. 'Can you pop a lower decky in school?' asked an influencer in one TikTok post about pouches from the brand LyvWel, using a slang term for mouth pouches. 'One-hundred percent, guys. You can use the lower deckies in school. You don't have to be 21 to buy them.' A representative for LyvWel said the post was not created, approved or sponsored by LyvWel. 'Although caffeine products are legally available to anyone who can purchase tea, coffee, or energy drinks, LyvWel was created specifically as an alternative for adult nicotine pouch users,' the representative wrote in an email. 'We do not market to teens.' Some TikTok creators who review and promote caffeine pouches appear to be teenagers themselves, although it is not clear whether their posts have been approved by the brands they mention. 'Viral, organic social-media marketing' Dr. Robert Jackler, a professor emeritus at Stanford Medicine who studies tobacco-industry advertising, sees echoes of Juul in Wip's marketing. Wip is active on TikTok and Instagram — two platforms used heavily by young people — and features athletes and fitness influencers in its posts, a combination that Jackler said is 'patently youth-oriented' and reminiscent of the lifestyle-focused, influencer-driven marketing campaigns that Juul ran under Mumby, now the Wip CEO. Such marketing prompted multiple lawsuits alleging Juul purposely targeted underage customers. Juul executives have repeatedly denied that allegation and have not admitted wrongdoing in legal settlements. But the company's product became nearly synonymous with youth vaping at a time when almost 30% of high school students used e-cigarettes. '[Mumby] is doing the same kind of viral, organic social-media marketing that he did with Juul,' Jackler said. 'We take responsible caffeine consumption and responsible marketing of our product seriously,' a Wip spokesperson said in a statement provided to NBC News. 'While there are no legal age restrictions on caffeine products, we have adopted marketing guidelines that exceed the age-related standards set by the American Beverage Association for most common energy drinks. Wip is not intended for use by anyone under the age of 18, and our guidelines ensure the product is marketed responsibly. We proactively train all external partners on our marketing guidelines so there is education and alignment at every layer of our business.' Despite their spread online, caffeine pouches do not seem to be nearly as ubiquitous in schools as Juul was at its prime, nor as either energy drinks or nicotine pouches are today. An estimated 64% and 5% of teenagers have tried energy drinks and nicotine pouches, respectively, while there is little data on youth caffeine pouch usage. Dylan Lippold, a middle school teacher in Wisconsin, said he remains more concerned about energy drink consumption among his students. 'I would walk into a class and see five or so kids drinking [an energy drink] in the morning,' he said. 'That's a little concerning that a middle schooler needs that much caffeine to get going for the day.' Health concerns Caffeine is often seen as a harmless, or even beneficial, stimulant — and within reason, it can be. Although most experts agree it's possible to become dependent on caffeine, it's not considered as addictive as nicotine. And in addition to providing energy and mental clarity, caffeine consumption can come with significant health benefits, studies conducted among adults have shown. 'In population studies, people drinking three or four cups of coffee per day have a lower risk of cardiovascular diseases, like coronary heart disease and stroke,' van Dam said. 'But going beyond that, like more than five cups of coffee per day, we do not see the same benefits.' And, he noted, it's not clear whether the caffeine in energy drinks or pouches carries the same benefits as classic coffee. At high levels of consumption, caffeine can cause side effects that range from relatively benign (anxiety, jitters, GI distress, difficulty sleeping) to more worrisome (heart palpitations, high blood pressure, increased heart rate). In rare cases, heavy caffeine consumption can cause fatal complications, including cardiac arrest, studies show. For children and teenagers, who are typically smaller and weigh less than adults, the thresholds of safe caffeine consumption are lower. The AAP recommends against pediatric caffeine usage not only because of the potential for toxicity, but also because kids who need to use a lot of caffeine probably aren't getting enough sleep, Corkins said. 'Even if you get a stimulant, it's not a substitute for sleep,' he said. Research also suggests that children who consume more than 100 mg of caffeine during a school day are more likely than those who don't to struggle with self-control and behavioral issues. For users of all ages, caffeine pouches, like nicotine pouches, may pose a threat to oral health, added Jackler, who in addition to studying tobacco marketing is an ear, nose and throat doctor. Routinely placing a foreign substance between the lips and gums may lead to gum recession and dental problems, so 'it's not necessarily an optimal way of taking in your caffeine, especially if it's something you're doing all day,' Jackler said. Consumers should also be aware that caffeine pouches may not be tightly regulated, van Dam said. While the FDA has cracked down on the sale of 'pure and highly concentrated' caffeine products — like tubs of caffeine powder that contain thousands of servings that users must measure out themselves — caffeine pouches are regulated 'as either dietary supplements or conventional foods, depending on their composition and marketing,' an FDA spokesperson said. Supplements typically do not go through FDA review and approval before being sold to consumers. Labeling is another concern, Jackler said: Some energy pouches on the market do not clearly state how much caffeine they contain. Even with accurate labels, the potency of some caffeine pouches raises eyebrows. Two-hundred milligrams of caffeine is 'really the maximum amount that's being recommended in one sitting,' van Dam said, and some brands meet or exceed that amount in a single pouch. The pouch industry isn't alone in that; energy drinks and coffee drinks can also pack in huge amounts of caffeine per serving, often also without clear labeling. But these products are both more familiar to consumers and easier to pace, in that people can stop sipping if they start to notice side effects, van Dam said. A caffeine pouch, by contrast, delivers a concentrated dose of caffeine fairly quickly, and 'once it's absorbed, it's absorbed,' he said. Research also suggests that consuming nicotine and caffeine at the same time can compound their negative effects on the heart — a concern, given that some users alternate between nicotine and caffeine pouches. Given these dangers, Jackler fears what could happen if caffeine pouches go the way of nicotine pouches, 'where kids put in four pouches in the upper lip and three pouches in the bottom lip,' he said. 'Young people, particularly, think that if a little bit helps, they're going to take even more.
