BackgroundAnaphylaxis is an acute, potentially life-threatening systemic hypersensitivity reaction that commonly occurs in the community setting and is best managed with epinephrine. ObjectiveThe purpose of this study was to examine the effects of the COVID-19 pandemic on trends in acute at home anaphylactic events including Emergency Room (ER) visits and treatment for anaphylaxis. MethodsWe used data from two sources: survey data from the Food Allergy Research & Education (FARE) Patient Registry; and electronic medical records of patients who presented to Tampa General Hospital ER with a diagnosis of anaphylaxis. We collected data from events during the Covid epidemic and before and after vaccine availability. Data was analyzed using descriptive statistics. Results190 FARE survey responses were completed. Sixty-three patients reported that the COVID-19 pandemic changed how they responded to the allergic reaction. Of these 63 patients, 71% avoided seeking medical care outside the home, 30% used self-medication more quickly than usual, and 14% delayed the use of medication. Only 87 events (46%) were treated with epinephrine. 4358 presented to TGH ER from April 1, 2018, to March 31, 2022, with an ICD-10 diagnosis code of anaphylaxis or allergic reaction. Only 718 received epinephrine in the ER. 867 patients presented 1 year prior to March 1, 2020 (before vaccine availability) and 1,833 patients presented 1 year after April 1, 2021 (after vaccine availability). ConclusionsOnly 16% of patients received epinephrine by survey and ER data capture. After COVID vaccine availability there were more ER visits for anaphylaxis among patients seen in a tertiary care teaching hospital.