About one in 13 children in the United States have a diagnosed food allergy, but according to the Asthma and Allergy Foundation, there are many who remain undiagnosed and unprotected against the risks of a sudden, severe reaction.
PA House Bill 803, which would allow schools to stock and administer epinephrine, is an attempt to protect children with undiagnosed allergies who have reactions at school. Epinephrine is the primary treatment for anaphylaxis, a serious and potentially fatal allergic reaction which can cause throat-swelling, a rash, and a drop in blood pressure.
The bill has passed in the House and was recently approved by the Senate Education Committee. Prime sponsor Rep. Dick Stevenson (R- Mercer) says he expects the Senate to vote on the bill within a week.
According to Stevenson, many schools are poorly equipped to care for children who have undiagnosed allergies. Children who are aware of their allergies usually carry prescription EpiPens, the most common form of epinephrine auto-injector, or have EpiPens stored for them by the school nurse. However, students who are unaware of their allergies and are exposed to a trigger at school can go into anaphylactic shock without any treatment available.
“Currently schools are unclear about what their responsibilities are and what they can and cannot do in this area,” said Stevenson.
In Massachusetts, where schools are required to stock epinephrine, a quarter of all epinephrine injections given in schools were given to children who had no prior allergy history.
In Pennsylvania, schools' policies on EpiPen stocking and administration vary from district to district.
Lynda Mitchell, vice president of the Asthma and Allergy Foundation of America, says nurses in districts without stock epinephrine policies in place take on huge liability risks if they administer the drug to a child without a prescription, even if the nurse recognizes the signs of anaphylaxis.
“That’s what this law is designed to do, to give them Good Samaritan protection for using stock epinephrine if a child does not have a prescribed epinephrine auto-injector,” explained Mitchell.
Stevenson’s bill requires schools that stock epinephrine to have trained faculty on hand who can recognize and treat anaphylaxsis and to obtain parental consent for each child at the beginning of the school year.
According to Stevenson, the time is not yet right to push for a mandate that would require schools to stock the drug and train employees.
“We’re very concerned about mandates at this time, because we don’t want to increase costs for schools unnecessarily,” said Stevenson. “It’s much more difficult to get the legislation passed through both the House and the Senate if it is a mandate at this current time. That’s why we drafted it the way we did.”
Two pharmaceutical companies that sell epinephrine auto-injectors, Mylan Inc. and Sanofi S.A, were involved in drafting the legislation and supporting its passage, according to Stevenson.
“Some manufacturers have indicated that they would be willing to supply [epinephrine pens] initially at no cost, just to have the service out there,” said Stevenson. “So I did not feel that they were doing this purely to serve their own agenda of making more money.”
According to Bloomberg Businessweek, Mylan lobbied strongly for federal legislation that passed in 2013 and gives states additional asthma and allergy-related grants for passing legislation like HB 803. According to the article, Mylan expects to increase its EpiPen customer base from 2.6 million to 28 million as more schools stock the drug.
Last year, a PA bill sponsored by Sen. Matt Smith to require EpiPen stocking in schools failed, but Stevenson says he has high hopes for HB 803.
“I’m optimistic,” said Stevenson. “It’s gotten farther this year than it has in the past. Often bills take several sessions to pass.”