EURneffy: Is This The Answer To Your Allergy Anxiety?

EURneffy® (Neffy) has now been approved in the U.K and for many this has been a long-awaited advancement in the allergy world, having been available in the USA since late 2024. There’s been a lot posted about this in the allergy space but as ever, nothing from a psychological perspective, so here are some of my thoughts on this as an allergy psychologist, and whether it is actually the answer to allergy anxiety.

What is Neffy?

For those not familiar with Neffy it’s an adrenaline device to treat severe allergic reactions, but administered nasally rather than via injection/needle as has been needed previously. It is the same medicine but just delivered differently and studies suggest it is just as effective as auto adrenaline devices.

I’m proud to say that I was part of the advisory committee for Neffy, which I believe for a pharmaceutical product, heavily medical led, is a huge step. The fact that Neffy acknowledged there are psychological implications to launching this product is a big deal. When psychology hasn’t had a place at the table for many years, I was honoured to be part of discussions and I genuinely felt like my views were being considered, which in itself speak volumes.

Needle phobia and anticipatory anxiety

But back to the psychology; Neffy addresses an obvious gap in current treatment of severe allergic reactions and anaphylaxis. If you have a needle phobia then the thought of using adrenaline auto injectors can be incredibly distressing and the thought of needing to use a needle device, for some, only magnifies existing anxiety about allergies, when in fact we want the devices to give you reassurance rather than increase fear.

I get a lot of referrals and queries directed to me about how to manage this anticipatory anxiety or phobia of using auto adrenaline devices (EpiPen, Jext etc). Whilst needle phobia can be effectively treated with psychological therapy, this can take time, and not everyone has access to this type of support. Not only that, but it can be very hard to fully assess the effectiveness of the treatment for fear of adrenaline auto injectors. This is because although most people can feel more confident after therapy, thankfully adrenaline pens aren’t something that need to be used that often. So usually, the test of whether you would truly know you could use it, would only be in an emergency situation.

Furthermore, even for those who are not needle phobic, the uncertainty of what it would be like to use the device and the anticipated pain, can be a source of anxiety, which can put people off carrying or using adrenaline auto injectors.

A needle free device would therefore remove this anxiety, and not only stop the anticipated fear, but is also likely to make people more confident to do things that they may currently avoid because of the fear of needing to use it.

Most importantly it will hopefully stop the delay of adrenaline in those who would otherwise avoid giving themselves an injection and therefore help save lives; a huge selling point.

Barriers to carrying adrenaline

Many people I work with, especially teenagers already feel different because of their allergies and carrying around 2 auto injectors, this isn’t exactly discrete, especially on a night out!

Although you will still be advised to carry 2 doses of Neffy (as with auto injectors), the Neffy is considerably smaller and therefore much easier to carry. I believe this will be a huge advantage for many, not only making it more likely that people will carry these devices, but also make people less embarrassed by their allergies, which is only going to help with confidence to do more things.

So why might not everyone be filled with excitement about this?

Anxiety is not always to do with the needle, for many it’s much more about the fear relating to the consequences of a reaction. If your fear is that you could die, this drives a whole different set of thought processes.

Whilst the evidence is positive in suggesting Neffy is equivalent to using an adrenaline auto injector, our anxious brains often default to fear not logic. Therefore, in times of high stress, people default to what’s familiar and what feels safe, and for many that will likely mean grabbing for an auto injector, because it feels familiar and it feels safe.

It will take some time for confidence in a new device to be built up and lots of people will need to see more evidence and hear more stories from others who have successfully used it, before they are convinced. And this is completely fine. Auto injectors aren’t going anywhere and as a clinical psychologist I think that choice is so important for helping us feel in control and feel more confident in exactly what we need to do in emergency situations.

Parental anxiety

At the moment Neffy is licensed for individuals weighing 30kg or more (this is around age 8-9 years +), however a younger version will likely be available in the future.

I know that some parents will naturally be anxious about how they may administer this to a child. Administrating an auto injector on a screaming, fearful child can be hard enough, let alone trying to fire something up their nose. Parents may be anxious about whether it has been administered correctly. It is my opinion that for many parents, psychologically, they may feel more confident that an adrenaline pen has been administered correctly, rather than a nasal spray; until confidence is built up. I think this will happen, but it will take time for some.

Sensory sensitivities

A further point of consideration is that many children I work with, have sensory challenges and/or neurodivergence. So having anyone come close to their face, coupled with the sensation of the device, is going to be a challenge that we need to be honest about.

Lots of children don’t like spray in their face, or up their nose and using the Neffy also results in an after-sensation. Yes, some might argue that this is better than a needle prick, but I don’t believe we can make this judgement because every child is different and experiences sensory information differently, which is again why choice is going to be so important.

Just like demo auto injectors which don’t mirror the pain of the needle, the demo Neffy isn’t going to simulate the experience of using, however this is something the team are aware of and looking into.

Anxiety around going to hospital

In the U.K, it is advised that after administering any adrenaline that you go to hospital for monitoring and to manage cases of biphasic reactions, and Neffy won’t be any different in this respect. So, for those who delay using adrenaline because of the thought of going to hospital, this won’t change. It is for the role of health care professionals working with and prescribing devices to be clear on recommended guidance, explore these barriers and ensure this fear doesn’t delay administration of any adrenaline device.

To conclude

I’m really excited for the role out of Neffy. I know so many people for whom this will be a game changer.

However, if you’re a little more hesitant or unsure, that is completely okay. Choice is key and this is only adding choice, not taking it away.

If your child has recently experienced an allergic reaction, I have a free guide with my key prompts for how to support your child and prompts to ask as a parent, which will aim to reduce the likelihood of post reaction trauma. You can download it here.