FAA Proposed Rule Could Weaken Safety on Flights
For people with life-threatening allergies, having epinephrine available during a medical emergency can mean the difference between life and death. At 35,000 feet, where reaching an emergency room may take hours, that access becomes even more critical.
A Proposed Change to Airline Emergency Medical Kits
A new proposal from the Federal Aviation Administration (FAA) could change what U.S. airlines are required to carry in their onboard emergency medical kits—and leave passengers less protected.
Currently, regulations detail specific medications and equipment that must be stocked on airplanes, including two doses of epinephrine in vial or ampoule form. This requires a medical professional to be on board to draw the medication into a syringe and administer it. (Typical epinephrine delivery devices such as auto-injectors and nasal sprays are not mandated.)
Many advocates had hoped Congress's direction to the FAA to reevaluate the contents of its first aid and emergency medical kits through the FAA Reauthorization Act of 2024 would lead to strengthened protections by requiring easy-to-administer forms of epinephrine.
However, that has not been the case.
The proposed rule eliminates the existing detailed list and replaces it with a broader instruction to stock medications and supplies able to treat nine major life-threatening conditions including anaphylaxis.
It does not specify epinephrine or any other medication or device by name nor does it mandate modern, ready-to-use options like auto-injectors or nasal sprays.
This leaves both the allergy community and the broader public who may have an as-yet-undiagnosed life-threatening allergy at risk.
The FAA proposal has not yet been finalized, and advocates can still make their voices heard by submitting a public comment.
If the proposed rule isn't modified, passengers with a life-threatening allergy are left with a concerning question: If anaphylaxis happens in the air, will the medication needed to stop it be available?
This is a question Maya Konoff and her mom Jill Mindlin understand well.
Preparing for an Allergic Emergency in the Air
Maya has multiple life-threatening food allergies and has been flying since she was very young. Rather than allowing her allergies to keep the family from traveling, Jill focused on preparing for the risks they could control.
When Maya was a child, that preparation was extensive. The family notified airlines about her allergies, pre-boarded to clean her seating area, covered surfaces, and brought all of Maya’s food from home.
Today, Maya is an adult who travels independently—including internationally—and many of those precautions remain part of her routine. She tends not to eat onboard, pre-boards and cleans the surfaces around her seat, informs flight attendants of her allergy, and tells the passengers seated beside her.
Epinephrine is always part of the plan as well.
She carries at least two epinephrine auto-injectors when she flies and often brings more. When Jill was responsible for Maya’s medications, she took that preparation even further on long trips.
For a flight to China that would spend hours traveling over the Arctic Circle, Jill knew an emergency landing might not be possible for a significant stretch of the trip. She brought as many epinephrine auto-injectors as she could—ideally one for every hour of the flight—in case Maya required multiple doses before the plane could reach medical care.
That experience illustrates why needing emergency medication aboard an aircraft is different from needing emergency medication almost anywhere else. A person experiencing anaphylaxis on the ground can call 911. A passenger experiencing anaphylaxis midway across an ocean cannot.
Not Everyone Knows They Are at Risk
There is another reason Maya believes epinephrine needs to be available on airplanes: not everyone who experiences anaphylaxis knows beforehand that they are at risk.
People can develop allergies at different points in their lives, which means a passenger could experience a first severe allergic reaction while flying. That person would have no reason to be carrying an epinephrine auto-injector.
“I think that people are missing the fact that we're not the only ones who could, God forbid, have an allergic reaction on a flight,” Maya said of people like herself with diagnosed food allergies.
That makes a well-equipped emergency medical kit an important safeguard not only for people with known allergies but potentially for everyone onboard.
Make Your Voice Heard
The FAA proposal has not yet been finalized, and public comments on the proposed rule are being accepted through October 5, 2026.
Comments become part of the official record that the agency considers before issuing a final rule. The proposal is listed under Docket No. FAA-2026-9178. (Use this link to comment.)
Allergy Advocates New York encourages members of the allergy community—and anyone who believes lifesaving medication should be readily available during an in-flight emergency—to submit a comment asking the FAA to strengthen the final rule.
Tell the FAA why access to epinephrine on commercial aircraft matters to you. Share your experience traveling with life-threatening allergies or caring for someone who does. And urge the agency to require that emergency medical kits contain epinephrine in a form that can be administered quickly and effectively when anaphylaxis occurs.
"Please please please give feedback to prevent what could be a very, very serious mistake," Jill pleaded. She and Maya hope people will speak up before the rule is finalized.
Comments must be submitted by October 5, 2026.
About the Author
Kristen Stewart is the Communications Manager for Allergy Advocates New York, where she writes about allergies, anaphylaxis, advocacy, and practical resources for individuals, families, and communities.