About 1 in 17 children in the U.S. has food allergies.¹ That turns out to be at least 1 in every classroom. With numbers like these, serious allergic reactions – called anaphylaxis – are likely to happen.

Many children also have their first food allergy reaction in school. Because their food allergies are unknown, they aren’t carrying epinephrine, the first-line treatment for anaphylaxis.

This is why it’s so important for states to have epinephrine stocking laws. They allow schools to have an emergency supply of easy-to-use epinephrine options to treat life-threatening allergic reactions.

AAFA’s Support of Epinephrine in Schools and Public Places

The Asthma and Allergy Foundation of America (AAFA) released our 2025 State Honor Roll™ of Asthma and Allergy Policies for Schools. It identifies the states with the best public policies for people with asthma, food allergies, anaphylaxis, and related allergic diseases in U.S. elementary, middle, and high schools. Kids with Food Allergies (KFA) is a division of AAFA.

In this report, AAFA evaluated emergency medicine stocking for schools across all 50 states, Washington, D.C., and the U.S. Territories. We found that gaps remain. While most states have passed laws allowing schools to stock epinephrine, only 10 states require epinephrine stocking in schools and only 5 states allow schools to stock other forms of epinephrine, such as nasal epinephrine.

The report highlights the urgent need for stronger policies to ensure all schools are equipped with life-saving epinephrine in any form approved by the Food and Drug Administration (FDA).

A strong epinephrine stocking policy requires schools to stock any form of FDA-approved epinephrine, requires appropriate training for school personnel, addresses liability protections for people who give the medicine in good faith, and provides resources for schools to acquire the epinephrine.

How Can My School Get Epinephrine Devices?

Some makers of epinephrine devices have programs for schools:

EPIPEN4SCHOOLS®

Through this program, schools can get 4 free EPIPEN® or EPIPEN JR® auto-injectors or the authorized generic versions. If your school uses the free auto-injectors, you can get replacements at no cost. Learn more EPIPEN4SCHOOLS® Program.

neffyinSchools

neffy® is an epinephrine nasal spray. All public and private K-12 schools in the U.S. can get 2 cartons (4 single-use doses) of neffy.

At this time, many states do not have clear laws that allow schools to stock nasal epinephrine. Their laws address epinephrine auto-injectors but not nasal epinephrine. Because of this, only 4 states can currently participate in this program: Maine, Massachusetts, New York, and Wisconsin.

As states change their laws to include more epinephrine options, neffy will become available for more schools. Contact your lawmakers to ask them to change your state’s laws to include other epinephrine options.

Learn more about the neffyinSchools Program.

AUVI-Q

Schools and child care centers can buy undesignated epinephrine auto-injectors through kaleo. Learn more and download additional resources.

How Can I Advocate for Epinephrine Stocking in My State?

AAFA has an advocacy toolkit to help you advocate for epinephrine stocking in your state. The “Modernizing Epinephrine Stocking Laws: An Advocacy Toolkit” includes:

• A guide on how to find and contact your state legislators
• Tips for communicating with lawmakers and their staff
• Sample letters to help you share your concerns and policy recommendations

The sample letters are customized depending on your state’s current laws.

Download, print, and share

AAFA stands ready to help you advocate in your state. Contact advocacy@aafa.org for more information or help.

References
1. Zablotsky, B., Black, L.I., & Akinbami, L.J.(2023). NCHS Data Brief, no 459: Diagnosed allergic conditions in children aged 0-17 years: United States, 2021.National Center for Health Statistics. https://dx.doi.org/10.15620/cdc:123250