Prevalence and characteristics of peanut allergy in US adults

Christopher Warren, Dawn Lei, Scott Sicherer, Robert Schleimer, Ruchi Gupta

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Background: Peanut allergy (PA) is the leading pediatric food allergy and a common cause of anaphylaxis. Little is known, however, on the prevalence and characteristics of PA in the adult population and whether phenotypic differences exist between adult-onset and childhood-onset PA. Objectives: This study describes the current US population-level burden of adult PA. Methods: A cross-sectional food allergy survey was administered via phone and web in 2015 and 2016, resulting in nationally representative complex-survey weighted data for 40,443 adults. Reported food allergies were considered “convincing” if symptoms to specific allergens were consistent with an IgE-mediated reaction. Results: The prevalence of current self-reported PA was 2.9% among US adults, with 1.8% having convincing PA. Over 17% of adults with peanut allergy reported onset of their PA in adulthood. In adults with childhood-onset PA, 75.4% reported physician-diagnosed PA, compared with only 58.9% of adult-onset PA. Despite a similar frequency of food allergy–related emergency department visits within the past year (approximately 1 in 5 adults with PA allergy), adults with childhood-onset PA were significantly more likely to have a current epinephrine prescription compared with those with adult-onset PA (56% vs 44% respectively; P =.02) and were more likely to use an epinephrine autoinjector (48% vs 35%, P =.01). Conclusions: Approximately 4.6 million US adults have PA—over 800,000 of whom appear to have developed their PA after age 18 years. Further examination of phenotypic differences between childhood-onset and adult-onset PA may improve understanding and management of adult PA.

Original languageEnglish
Pages (from-to)2263-2270.e5
JournalJournal of Allergy and Clinical Immunology
Issue number6
StatePublished - Jun 2021


  • Food allergy
  • adult-onset food allergy
  • atopy
  • peanut allergy
  • prevalence


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