About Allergy and Anaphylaxis Management in Schools

This page outlines the key components of effective school-based allergy and anaphylaxis management and provides practical tips and resources to help schools and primary care providers improve care for students with severe and life-threatening allergies.  

• Food allergy affects approximately 1 in 13 school-aged children.
• Reactions at school are fairly common. One study found that 18% of children having had at least 1 school reaction within the past 2 years.
• Up to one quarter of anaphylactic reactions at school are among students with previously undiagnosed allergy.
• Food is the most frequent trigger, accounting for approximately 60% of reactions in schools.
• One large study found that symptoms of anaphylaxis are most likely to develop in the classroom (47%), cafeteria (20%) and playground (10%).
• Almost a quarter of food allergic students report food allergy-related bullying, including from teachers and staff.
• Several studies have found important gaps in school nurse knowledge about allergy/anaphylaxis management, including lack of awareness that hand sanitizer does not remove residues that can trigger allergic reaction, lack of knowledge about when to use an additional epinephrine autoinjector, and use of antihistamine instead of epinephrine as first-line treatment.