Virtually supported home peanut introduction during COVID-19 for at-risk infants

Abstract

No funding was received for this work. Conflicts of interest: D. P. Mack has provided consultation and speaker services for Pfizer, Aimmune, Kaleo, Merck, Covis, and Pediapharm, and has been part of an advisory board for Pfizer and Bausch Health. He sits on the editorial board for the Journal of Food Allergy. M. A. Hanna has provided speaker services for Pfizer and Pediapharm. E. M. Abrams is a member of the health care advisory board for Food Allergy Canada; and is on the National Advisory Committee for Food Allergy Canada. T. Wong has provided speaking engagements for Pfizer and Stallergenes-Greer, and has been part of an advisory board for Leo Pharma. L. Soller participates in research with DBV Technologies. S. C. Erdle declares no relevant conflicts of interest. S. Jeimy has been on speaker's bureaus for Aralez, Astra Zeneca, Sanofi, and Novartis. J. L. P. Protudjer sits on the steering committee of the National Food Allergy Action Plan. E. S. Chan has received research support from DBV Technologies; has been a member of advisory boards for Pfizer, Pediapharm, Leo Pharma, Kaleo, and DBV; is a member of the health care advisory board for Food Allergy Canada; was co-lead of the CSACI oral immunotherapy guidelines; and was an expert panel and coordinating committee member of the National Institute of Allergy and Infectious Diseases (NIAID)sponsored Guidelines for Peanut Allergy Prevention.

Novel Approaches to Food Allergy Management During COVID-19 Inspire Long-Term Change

“… 2 Indeed, some clinicians have already begun to incorporate virtually supported home introduction for at-risk infants. 21 This approach may represent a reasonable, timely option for families or clinicians who have hesitancy about food introduction, despite their infants being at lower risk.…”

“… 13 Others will prefer a virtually supported home peanut introduction. 21 Still, for some, screening may be preferred after engaging in a shared decision-making paradigm. Physicians must keep an open mind when educating patients and gain a clear understanding about what matters most to them.…”

Increasing Awareness of the Low Risk of Severe Reaction at Infant Peanut Introduction: Implications During COVID-19 and Beyond

“… 13 One novel approach for hesitancy that completely circumvents screening and has recently been shown during COVID-19 to be feasible is virtual physician-supervised home peanut introduction, especially among higher risk infants. 14 …”

Web-based Infant Food Introduction (WIFI): Feasibility and satisfaction of virtual allergist-supervised food introduction

“… 4 , 5 , 6 The feasibility of virtually supported home peanut introduction was recently demonstrated through a case series. 7 Families interacted with the clinician at the beginning of the encounter and throughout the procedure, which was not burdensome to the physician and was appreciated by caregivers. However, the virtually supported encounters were limited to peanut introduction, and little is known regarding feasibility and satisfaction of allergists and caregivers during this process.…”

“…The target dose of allergenic food protein was 2 g or an age-appropriate serving size. 7 During this process, the allergist was available at all times to assist caregivers virtually in the event of a reaction. Surveys were given to caregivers before and after the virtual encounter to evaluate their satisfaction with virtually supported food introduction measured on a numerical scale from 1 to 100 as well as to assess potential reasons for food introduction hesitancy.…”