Fayetteville doctors highlight spray option for severe allergy emergencies

Children with life-threatening allergies may have a simpler emergency option to carry into Fayetteville classrooms, summer camps and ballfields: a spray of epinephrine up the nose instead of an injection.

Dr. Haidy Adly Marzouk of St. Joseph’s Health Hospital in Fayetteville said neffy, the intranasal epinephrine spray, is sprayed up the nose and could be a game changer for children with severe allergies. The appeal is practical. A needle-free dose may be easier for parents, teachers, coaches and babysitters to use quickly in a moment when fear and hesitation can cost time.

The Food and Drug Administration first approved neffy on August 9, 2024, for emergency treatment of Type I allergic reactions, including anaphylaxis, in adult and pediatric patients who weigh at least 30 kilograms, about 66 pounds. On March 7, 2025, the agency expanded that use to include children 4 years of age and older who weigh 15 to less than 30 kilograms. In 2026, FDA approval letters removed the age limit for patients who weigh 15 kilograms or more and clarified storage and administration instructions, widening the conversation beyond older children and adults.

That matters in Central New York because allergy season is ramping up, and the risk is not limited to one medical setting. The Centers for Disease Control and Prevention says schools, out-of-school-time programs and early care and education programs should have plans to prevent and respond to food allergy emergencies, including anaphylaxis. The New York State Education Department updated its school allergy and anaphylaxis guidance in April 2026, and state school health guidance now lists neffy alongside injectable epinephrine products such as EpiPen, Adrenaclick and AUVI-Q.

The numbers show why families are paying attention. The CDC said 5.3% of U.S. children younger than 18 had a food allergy in 2024. The American Academy of Pediatrics says food allergy affects up to 10% of children, and anaphylaxis is estimated to occur in 1 in 15 schools per year.

For parents in Onondaga County, the immediate step is to review the allergy action plan before summer camps, school trips and sports seasons begin. Families with a child who has a severe allergy, especially one who weighs 15 kilograms or more, can ask a pediatrician, allergist or school nurse whether the spray fits the child’s emergency plan or whether an injectable device remains the better choice. The bigger shift is that schools and caregivers now have another tool to build into training, stocking and emergency response when every second matters.