Document ID: ./input/supremecourt_opinions/opinions/10pdf/09-152.pdf
Page Number: 14

Cite as:  562 U. S. ____ (2011) 

11 

Opinion of the Court 

not  end  there.  The  phrase  “even  though”  in  the  clause
“even  though  the  vaccine  was  properly  prepared  and 
[labeled]”  is  meant  to  signal  the  unexpected:  unavoidable 
side  effects  persist  despite  best  manufacturing  and  label-
ing  practices.43    But  petitioners’  reading  eliminates  any
opposition  between  the  “even  though”  clause—called  a 
concessive  subordinate  clause  by  grammarians—and  the
word  “unavoidable.”44    Their  reading  makes  preemption 
turn  equally  on  unavoidability,  proper  preparation,  and 
proper  labeling.  Thus,  the  dissent  twice  refers  to  the 
requirements of proper preparation and proper labeling as
“two additional prerequisites” for preemption independent 
of  unavoidability.45    The  primary  textual  justification  for 
the  dissent’s  position  depends  on  that  independence.46 
But linking independent ideas is the job of a coordinating 
junction like “and,” not a subordinating junction like “even
though.”47 
—————— 

43 The  dissent’s  assertion  that  we  treat  “even  though”  as  a  synonym
for  “because”  misses  the  subtle  distinction  between  “because”  and 
“despite.”  See post, at 17, n. 14.  “Even though” is a close cousin of the
latter.   See  Webster’s  New  International  Dictionary  709,  2631  (2d  ed. 
1957).    The  statement  “the  car  accident  was  unavoidable  despite  his
quick  reflexes”  indicates  that  quick  reflexes  could  not  avoid  the  acci-
dent,  and  leaves  open  two  unstated  possibilities:  (1)  that  other,  un-
stated  means  of  avoiding  the  accident  besides  quick  reflexes  existed,
but  came  up  short  as  well;  or  (2)  that  quick  reflexes  were  the  only 
possible  way  to  avoid  the  accident.    Our  interpretation  of  §300aa– 
22(b)(1)  explains  why  we  think  Congress  meant  the  latter  in  this 
context.  (Incidentally, the statement “the car accident was unavoidable 
because of his quick reflexes” makes no sense.) 

44 See W. Follett, Modern American Usage: A Guide 61 (1966). 
45 Post, at 9, 17. 
46 Post, at 3–5. 
47 The dissent responds that these “additional prerequisites” act “in a 
concessive, subordinating fashion,” post, at 17, n. 14 (internal quotation 
marks and brackets omitted).  But that is no more true of the dissent’s 
conjunctive interpretation of the present text than it is of all provisions
that  set  forth  additional  requirements—meaning  that  we  could  elimi-
nate “even though” from our English lexicon, its function being entirely