Research and Reports
Food Allergy Anaphylaxis in Infants and Toddlers
The Asthma and Allergy Foundation of America (AAFA) conducted a study on anaphylaxis in infants and toddlers: the AAFA Infant Toddler Anaphylaxis (ITA) Study. Anaphylaxis is a severe allergic reaction that can be life-threatening if not treated quickly and properly.
The most common causes of anaphylaxis are food, latex, insect stings and bites, and medicines. Food is the most common cause of anaphylaxis in young children. If someone has a severe allergic reaction, the first line of treatment is epinephrine. Epinephrine is safe and works quickly to stop serious symptoms of an allergic reaction.
Anaphylaxis can be hard to recognize in infants and toddlers. It’s important for parents and caregivers to know the signs and symptoms in young children and when to give epinephrine.
About the Study
AAFA worked with leading food allergy researchers to better understand how parents and caregivers recognize and treat severe allergic reactions (anaphylaxis) in infants and toddlers. Results from this study are published in the Journal of Allergy and Clinical Immunology: In Practice.
Key Findings
AAFA surveyed 374 caregivers of children who had an allergic reaction to food when younger than 3 years old. AAFA defined anaphylaxis as a reaction with symptoms affecting two of five organ systems, with at least one of them being impacting the airways or heart and blood vessels. These important key findings came from AAFA’s ITA study:
1. Signs and Symptoms of Anaphylaxis in Infants and Toddlers May Differ from Older Children and Adults
The ITA study identified signs and symptoms of anaphylaxis that are specific to infants and toddlers and recognized by parents/caregivers. The most common symptoms of anaphylaxis in infants and toddlers were skin reactions, swelling, vomiting, and diarrhea. Signs related to the heart and blood vessels – like blue-grey-white appearance and poor head control – were not as common as skin or stomach/gut issues.
Compared to older children and adults, infants and toddlers are more likely to have:
- Itching
- Rash
- Hives
- Vomiting
- Diarrhea
- Hoarse voice/cry
- Sudden behavioral change
Compared to older children and adults, infants and toddlers are less likely to have:
- Increased breathing rate
- Trouble breathing
- Itchy throat
The ITA study also found that parents/caregivers recognized signs that they later realized were due to an allergic reaction. More education is needed on allergic reaction symptoms in babies.
The language this research uses can help improve education by identifying the signs and symptoms that are recognized by caregivers. More research is being done to understand what doctors see in health care settings, such as in emergency rooms or during oral food challenges. This research is important to create age-specific diagnostic criteria and guidelines, which can improve anaphylaxis recognition and response for health care providers. If doctors and caregivers use similar words, it can improve communications and decision-making.
For more information, read the original article in The Journal of Allergy and Clinical Immunology: In Practice titled, “Caregiver-Reported Presentation of Severe Food-Induced Allergic Reactions in Infants and Toddlers.”
2. Young Children with a Diagnosis of Food Allergy and an Anaphylaxis Action Plan Are More Likely to Be Treated with Epinephrine
Epinephrine is the first-line treatment for anaphylaxis. But it is still not used early enough or often enough. Only around 16 to 32% of people properly use epinephrine for severe allergic reactions.1
AAFA’s ITA study looked at the differences in treatment of probable anaphylaxis in infants and toddlers. Researchers evaluated the differences between:
- Young children who had a food allergy diagnosis before their most severe allergic reaction
- Young children who had not yet been diagnosed with food allergy at the time of their most severe allergic reaction
- If the primary caregivers of infants and toddlers with a food allergy diagnosis were provided with anaphylaxis action plans
- If the young children were treated with epinephrine by a primary caregiver (such as a parent or guardian) or in a health care setting (treatment by a doctor, nurse, or other health care professional)
The results show that epinephrine is more likely to be used in infants and toddlers with a previously diagnosed food allergy, compared to children without a diagnosis at the time of their most severe allergic reaction.
In children diagnosed with food allergy, the study found that 89% of children with anaphylaxis action plans were given epinephrine during their allergic reaction. Only 50% of children without a plan were given epinephrine. This included epinephrine use in both community (given by parents or caregivers) and health care settings.
Example #1: An infant had local hives around their mouth after eating scrambled eggs. The baby’s family took them to the doctor who diagnosed egg allergy, prescribed epinephrine, and gave them an anaphylaxis action plan. As a toddler, the child accidentally ate food with eggs and had symptoms of anaphylaxis (widespread hives, vomiting, hoarse voice). The family treated the toddler with epinephrine for this reaction.
Example #2: An infant regularly vomited after drinking milk. The baby’s family was not aware vomiting can be a sign of a food allergy. The child later had a severe allergic reaction but had not been to an allergist yet for an evaluation. This means the child did not have epinephrine on hand nor an anaphylaxis action plan at the time of their most severe allergic reaction.
After adjusting for age and previous diagnosis, the odds of a child being treated with epinephrine at any time when they likely had anaphylaxis was five times greater when they had an action plan prescribed than when not.
Anaphylaxis action plans and prompt diagnosis of food allergy are important so infants and toddlers with food allergy can be treated with epinephrine if they have a severe allergic reaction.
For more information, read the original article in The Journal of Allergy and Clinical Immunology: In Practice titled, “Factors Associated with Epinephrine Use in the Treatment of Anaphylaxis in Infants and Toddlers.”
Acknowledgements
This study was authored in partnership with the following experts:
- Michael Pistiner, MD, MMSc, MassGeneral Hospital for Children, Harvard Medical School
- Jose Mendez-Reyes, MD, MassGeneral Hospital for Children, Harvard Medical School
- Sanaz Eftekhari, Chief Business Development Officer and Vice President of Research, Asthma and Allergy Foundation of America
- Melanie Carver, Chief Mission Officer, Asthma and Allergy Foundation of America
- Jay Lieberman, MD, LeBonheur Children’s Hospital, University of Tennessee
- Julie Wang, MD, Icahn School of Medicine at Mount Sinai
- Carlos Camargo, Jr., MD, DrPH, Massachusetts General Hospital, Harvard Medical School
The authors thank Wayne Shreffler, MD, PhD, and Lacey Robinson, MD, for review and comments on the survey, and Hannah Jaffee of AAFA for editorial support on study publications.
This AAFA-led collaborative research was funded by kaléo, Inc.
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Drug Company Assistance Programs
The medicines covered by the programs below may change at any time. The following medicines are covered as of Jan. 24, 2025.
Company:
- AstraZeneca
Medicines offered:
- AIRSUPRA®
If you have commercial insurance: If you have employer-provided or individual private (commercial) insurance, you may be able to get AIRSUPRA for as low as $0 with the SUPRA Savings Card.
If you have government insurance: For people with Medicare Part D coverage, the average out-of-pocket cost is $89 per month. For people with Medicaid, the out-of-pocket costs range from $.99-$13 per month. Some states offer even lower copays or eliminate the copay altogether. If you have Medicare Part D and cannot afford AIRSUPRA, you may be eligible for the patient assistance program, AZ&Me.
If you have no insurance: If you do not have health insurance or your insurance does not cover AIRSUPRA, you will pay the amount determined by your pharmacy. You may also be eligible for the patient assistance program, AZ&Me.
Learn more on the Cost Assistance with AIRSUPRA website or call 866-480-0030.
Company:
- AstraZeneca
Medicines offered:
- BEVESPI AEROSPHERE®
- BREZTRI AEROSPHERE®
- SYMBICORT®
- FASENRA®
- TEZSPIRE®
If you have commercial insurance, government insurance, or no insurance:
AstraZeneca US Patient Support offers various savings for several of their medicines. They offer copay savings cards and patient assistance programs depending on what type of insurance you have.
For more information, visit AZPatientSupport or call 800-236-9933.
AstraZeneca has capped the cost of their inhalers to $35 if you have commercial or private insurance. Learn more about the price cap.
Company:
- AstraZeneca
Medicines offered:
- TEZSPIRE®
If you have commercial insurance: The TEZSPIRE Together Co-Pay Program can help may help you save regardless of income if you qualify. Get doses for as little as $0 and up to $100 off your in-office administration costs (pre-filled syringe only). Learn more on the TEZSPIRE Together Co-Pay Program website or call 888-987-7473.
If you have government insurance: The TEZSPIRE Together Program, you may be able receive TEZSPIRE at no cost if you qualify. This includes people who:
- Are uninsured
- Have Medicare Part B with no supplemental insurance
- Have a Medicare Advantage plan with an affordability gap
- Have insurance that does not cover TEZSPIRE
For more information, call 888-987-7473.
Company:
- Boehringer Ingelheim
Medicines offered:
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- Combivent® Respimat®
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If you have commercial insurance or don’t have insurance: If you qualify, your cost will automatically be discounted when you buy these inhalers at participating retail pharmacies. If your cost is more than $35, download and use a savings card. Learn more at: InhalerOffer.com
If you have government-funded insurance: If you use Medicare, Medicaid, CHIP, or TRICARE, visit the Boehinger Cares Patient Assistance Program webpage or call 800-556-8317 to apply for assistance.
Boehringer Ingelheim has capped the cost of their inhalers to $35 if you have commercial or private insurance. Learn more about the price cap.
Company:
- Sanofi and Regeneron Pharmaceuticals, Inc.
Medicines offered:
- DUPIXENT®
If you have commercial insurance: The Dupixent MyWay® Copay Card may help you lower the cost of your copay. Learn more on the Dupixent MyWay Copay Card website or call 844-DUPIXENT (844-387-4936), option 1.
If you don't have insurance or your insurance doesn’t cover Dupixent: You can apply for the DUPIXENT MyWay Patient Assistance Program. For more information or to sign up, call 844-DUPIXENT (844-387-4936), option 1.
If you have Medicare: At this time, there is not a savings program for Dupixent if you have Medicare. Call 844-DUPIXENT (844-387-4936), option 1 for more information.
If you have Medicaid: Your copay and coverage may vary depending on what state you live in. If you meet the criteria, you may also be able to get help from the DUPIXENT MyWay Patient Assistance Program. For more information or to sign up, call 844-DUPIXENT (844-387-4936), option 1.
Medicines covered:
- Epinephrine devices – all brands
Savings programs:
- See AAFA’s list of all available epinephrine devices and their patient assistance programs.
Company:
- Genentech
Medicines offered:
- Xolair®
If you have commercial insurance: Genentech offers a copay savings program for Xolair. You may also be able to get help from an independent copay assistance foundation. 
If you have government insurance or don’t have insurance: You may be able to get help from an independent copay assistance foundation. Find programs.
Company:
- GSK (GlaxoSmithKline)
Medicines offered:
- ARNUITY ELIPTA
- ANORO ELLIPTA
- BREO ELLIPTA
- INCRUSE ELLIPTA
- NUCALA®
- SEREVENT®
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If you have commercial insurance: You may be eligible for the GSK Copay Assistance Program.
If you have Medicare or no insurance: You may qualify for the GSK Patient Assistance Program. This program can help you receive certain GSK prescription medicines and vaccines at no cost.
For more information, visit GSK Patient Assistance Program & Savings Offers or call 888-825-5249.
GSK has capped the cost of their inhalers to $35 if you have commercial or private insurance. Learn more about the price cap.
Company:
- GSK (GlaxoSmithKline)
Medicines offered:
- NUCALA®
If you have commercial insurance: If you have a commercial medical or prescription insurance plan, you may be able to take part on the NUCALA Copay Program. If you are approved, the GSK Copay Program may help with your cost share for NUCALA and the your cost share for administration up to the total annual copay program maximums.
If you have government insurance or no insurance: You are not eligible for this program if you are covered by any federal or state prescription insurance program.
For more information, visit the NUCALA Copay Program website or call 800-691-1939.
Company:
- Organon
Medicines offered:
- ASMANEX® HFA
- ASMANEX® TWISTHALER®
- DULERA®
If you have commercial insurance: If you qualify, you may be able to save with an ASMANEX Multiuse Savings Coupon.
If you qualify, you may pay as little as $15 per Dulera prescription on each of up to 12 qualifying prescriptions. The maximum savings is $90 per prescription.
If you have government insurance or no insurance: At this time, there is no assistance program if you have Medicaid or Medicare.
Company:
- Teva
Medicines Covered:
- QVAR RediHaler®
- CINQAIR®
Teva Cares Patient Assistance Program provides certain Teva medicines at no cost if you live in the United States and meet specific insurance and income criteria. Learn more about program eligibility.
If you do not meet the eligibility requirements for the Teva Cares Foundation Patient Assistance Programs, you may be eligible for help from other programs they offer.
For more information, visit the Teva Cares Foundation website or call 888-838-2872.
Pharmacy Drug Savings Programs
Program Name:
Contact Information:
- 844-265-6444
- moc.htlaehknilb@ofni
About the Program:
- Blink Health finds the lowest price for the medicines you need. Find discounted prescription prices on more than 15,000 medicines.
Program Name:
Contact Information:
- 844-926-2480
- moc.xrknilb@troppus
About the Program:
- BlinkRx is a digital pharmacy service that carries certain medicines. They can provide the lowest prescription price while providing free home delivery.
Program Name:
Contact Information:
- 855-268-2822
About the Program:
- GoodRx is a free resource that lets you compare medicine prices and find discounts.
Looking for savings on asthma inhalers? See the GoodRx Savings Guide for ways you may be able to save money on 25 asthma inhalers.
Program Name:
Contact Information:
- 833-317-2937
About the Program:
- The Kroger Health Savings Club is an annual membership program that entitles members to reduced prices on prescription drugs.
Program Name:
Contact Information:
About the Program:
- Mark Cuban CostPlus Drug Company offers access to affordable medicines at the lowest possible price. Learn about program eligibility.
Program Name:
Contact Information:
- 888-331-1002
About the Program:
- The SCBN Prescription Assistance program is for uninsured or underinsured people who cannot afford their prescribed medicines.
- The program requires a membership fee to participate.
Program Name:
Contact Information:
- Contact your local Walmart pharmacy
About the Program:
- The Walmart low-cost Prescription Program includes up to a 30-day supply for $4 and a 90-day supply for $10 of some covered generic drugs at commonly prescribed dosages. Prices for some drugs covered by the program may vary by state.
Program Name:
Contact Information:
- 877-296-4673
About the Program:
- Prescription Hope provides access to brand-name medicines for only $60 a month per medication through their medication access service. Learn about program eligibility.
Nonprofit Copay and Premium Assistance Programs
Organization:
Contact Information:
- 800-511-5144 (TTY 711)
- moc.htlaehairaca@eracremotsuc
About the Program:
- AcariaHealth provides specialty pharmacy services for people living with complex and chronic health conditions. Their Copay Assistance Support Team will research and apply to qualifying patient assistance programs on behalf of the patient. Learn about the program.
Organization:
Contact Information:
- 800-366-7741
About the Program:
- Accessia Health provides financial help to pay for copays, health insurance premiums, travel costs, and other medical expenses. Learn about program eligibility.
Organization:
Contact Information:
- 877-968-7233
About the Program:
- Good Days provides financial support for people who cannot afford the treatment they urgently need.
- Copay, travel, premium, and diagnostic testing assistance may be available.
- Learn about eligibility criteria.
Organization:
Contact Information:
- 980-859-3483
- gro.htaprobrah@ofni
About the Program:
- Harbor Path delivers lifesaving medicine for free to people who are uninsured. They currently serve 24 states. Use the eligibility calculator to see if you qualify.
Organization:
Contact Information:
- 800-675-8416
- gro.noitadnuofllewhtlaeh@stnarg
About the Program:
- HealthWell Foundation provide financial assistance to help with prescription copays, travel costs, behavioral health services, health insurance premiums, deductibles, and copays. Please note that diseases covered may change from time to time.
Organization:
Contact Information:
- 866-316-7263
About the Program:
- The PAN Foundation offers financial help for out-of-pocket medicine costs including copays, health insurance premiums, and transportation costs related to medical care. Learn about program eligibility. Please note that diseases covered may change from time to time.
Organization:
Contact Information:
- 866-512-3861
About the Program:
- PAF’s Co-Pay Relief (CPR) program provides direct financial help to qualified people with co-payments, co-insurance or cost-sharing associated with prescription drugs through funds for specific disease states. Learn about program eligibility. Please note that diseases covered may change from time to time.
Organization:
Contact Information:
- 800-769-3880
About the Program:
- Rx Outreach provides discounted medicines for eligible people. Learn about the program.
Organization:
Contact Information:
- 855-845-3663
About the Program:
- TAF helps people and families by providing them with financial help for their copays, coinsurance, premiums, deductibles, and other health-related expenses.
Patient Assistance Tools and Databases
Tool:
- BenefitsCheckUp® – National Council on Aging
Contact Information:
- 800-794-6559
More Information:
- BenefitsCheckUp® is a free service of the National Council on Aging (NCOA). It is an online tool to connect older adults and people with disabilities to benefit programs such as health care, medicine, food, utilities, and more.
Tool:
Contact Information:
- 615-736-5075
- gro.epohfoyrasnepsid@ofni
About the Program:
- Dispensary of Hope provides medicine to communities, free of cost. They are a charitable medication distributor dedicated to providing pharmacies and clinics with reliable access to medication that was generously donated by pharmaceutical manufacturers. Find a dispensing site near you, here.
Tool:
Contact Information:
- 800-503-6897
- gro.sdemydeen@ofni
More Information:
- A national nonprofit that connects people to programs that may help them afford their medicines and other health care costs.
Tool:
- PhRMA’s Medicine Assistance Tool (MAT) – Partnership for Prescription Assistance
Contact Information:
- 571-350-8643
More Information:
- PhRMA’s Medicine Assistance Tool (MAT) is a search engine for many patient assistance resources offered by drug makers.
Tool:
Contact Information:
More Information:
- RxAssist offers a comprehensive database of patient assistance programs. Learn about the eligibility requirements.
Tool:
Contact Information:
- 844-234-3057
- moc.eracelgnis@troppus
More Information:
- SingleCare works with pharmacies on discounts on prescriptions. Look up prescriptions to find the lowest prices in your area.
Tool:
Contact Information:
- 800-719-5147
- moc.esnesxr@rednifsgnivasxr
About the Program:
- Walgreens Rx Savings Finder can help you find prescription discount cards that can help you find the lowest price on a medicine at Walgreens.
State Drug Assistance Programs
Organization:
- Extra Help – Social Security Administration
Contact Information:
- 800-772-1213
- (TTY 800-325-0778)
More Information:
- The Extra Help program helps people with limited income and resources lower or cut Medicare Part D costs.
Organization:
- State Health Insurance Assistance Programs (SHIPs) – National Technical Assistance Center
Contact Information:
- 877-839-2675
- gro.htlaehpihs@ofni
More Information:
- Free insurance counseling and help to Medicare-eligible people, their families, and caregivers.
Organization:
Contact Information:
- Contact your local county office.
More Information:
- CalAIM offers people on Medi-Cal access to services that address physical, behavioral, developmental, dental, and long-term care needs.
Organization:
- State Pharmaceutical Assistance Program – Medicare.gov
More Information:
- Find out if your state has a state pharmaceutical assistance program.
Organization:
- Pharmaceutical Assistance Program – Medicare.gov
More Information:
- Learn more about pharmaceutical companies that offer programs to help pay for prescriptions for people with a Medicare Drug Plan (Part D).
Community Resources
American Sleep Apnea Association: Assists people with sleep apnea who cannot afford their CPAP mask supplies through the CPAP Assistance Program.
Friends of Man: Receives applications for mobility equipment, prosthetics, home modifications, medical equipment, hearing aids, basic needs and much more. The referral must be made by a professional. This includes caseworkers, case managers, health care workers, social workers, school counselors, teachers, and clergy.
FoodFinder: A map of food pantries across the United States. Search your ZIP code to learn about free food assistance programs near you.
FundFinder: Helps you find financial assistance from charitable foundations.
Inspira Financial: Funds in a health savings account (HSA) or a health care flexible spending account (FSA) can be used for eligible medical expenses.
Society of St. Vincent de Paul: A national non-profit that provides local assistance and services.
United Way 211: The most comprehensive source of information about local resources and services in the country.
AAFA Regional Chapters
The AAFA New England Chapter has more information on drug assistance for Massachusetts residents.
The AAFA Michigan Chapter has more information on drug assistance for Michigan residents, including the Jared Williams Medication Fund (JWMF).
KFA is dedicated to saving lives and reducing the burden of food allergies through support, advocacy, education and research.
