How the EpiPen Evolved From Military Technology to Lifesaving Tool
An accidental throat obstruction at a Brooklyn brunch spot brings to mind the skinny plastic pen often tucked away in a tote bag, next to a phone charger and melting lip balm.
Most people rarely consider the origin of the device, but its creation dates back to 1973 when Sheldon Kaplan developed a spring-loaded injector to help the Pentagon administer an antidote to a nerve agent, according to the National Inventors Hall of Fame.
The National Inventors Hall of Fame notes that this initial blueprint paved the way for the Department of Defense to adopt the ComboPen as well as the creation of the modern EpiPen we recognize today.
Beyond the military application, Kaplan developed a medical kit for NASA’s Apollo missions and a pneumatic medical dressing for reconnaissance pilots, per the National Inventors Hall of Fame profile. He was inducted into the hall of fame in 2016, seven years after his death in 2009.
The device operates through a straightforward mechanism: it contains epinephrine for treating anaphylaxis, a severe allergic reaction, and is pressed against the outer thigh so the needle deploys directly into the muscle.
While allergies are frequently dismissed as a childhood issue, large-scale survey data reveals a different trend among adults.
A 2019 nationwide survey titled Prevalence and Severity of Food Allergies Among US Adults, published in JAMA Network Open, found that 10.8 percent of the 40,443 adults surveyed had a food allergy. That percentage translates to over 26 million adults in the United States.
Nearly half, or 48 percent, of the adults surveyed reported developing at least one food allergy after reaching adulthood. Researchers also said that 19 percent of participants stated they had a food allergy, a figure higher than the 10.8 percent who met clinical criteria, showing that not all perceived allergies are confirmed by testing.
More than half, specifically 51.1 percent, of adults with a food allergy experienced a severe reaction, yet only 24 percent maintained a current prescription for epinephrine, according to the same JAMA Network Open paper. That disparity between severe reactions and active prescriptions suggests many adults remain unprepared for emergencies.
Research indicates that early administration of epinephrine for food-induced anaphylaxis reduces hospital admission risks. Over a six-year period, an investigation involving 384 pediatric patients treated at a single emergency department was published in The Journal of Allergy and Clinical Immunology: In Practice under the title Early Treatment of Food-Induced Anaphylaxis with Epinephrine Is Associated with a Lower Risk of Hospitalization.
That study found only 17 percent of children who received epinephrine before arriving at the hospital were admitted, compared to 43 percent of those who did not receive it beforehand. Children who received early epinephrine were also more likely to own an auto-injector, at 80 percent versus 23 percent.
Even though the research focused on pediatric patients, the core takeaway—that prompt administration of epinephrine improves results—remains equally relevant to the grown-ups who store these devices in their glove compartments and carry bags. Because this research was observational and limited to a single medical facility’s pediatric patients, it merely highlights a correlation rather than establishing a direct cause-and-effect relationship.
Anyone who has experienced a food reaction or suspects they may have an allergy should speak to an allergist.