Food Allergy and the Military

Why Severe Allergies May Disqualify You From Joining The United States Armed Forces

Did you know that having a life-threatening food allergy can disqualify you from joining the US Armed Forces?

To join the US Military, recruits must undergo a medical screening/examination to determine their eligibility and fitness for duty. According to the US Department of Defense Instruction, all recruits must meet the following criteria:

The person under consideration is free of contagious disease that will probably endanger the health of other personnel.
The person is free of medical conditions that required excessive time lost from duty for necessary treatment or hospitalization.
The person is medically capable of satisfactorily completing required training.
The person is medically adaptable to the military environment without the necessity of geographic limitations.
The person is medically capable of performing duties without aggravations of existing medication conditions.

Within the more specific medical standards, the US Department of Defense Instruction finds a “History of systemic allergic reaction to food or food additives” to be disqualifying medical condition from the US Armed Forces.

The rationale? Military service people are subject to be deployed to remote locations with limited food supplies and variable healthcare options. Further, cofactors known to decrease anaphylaxis thresholds are common to military life (e.g., fatigue, physical exertion) and may put the service person at increased risk for severe reaction.

In 2017, the Military Allergy and Immunology Assemble (MAIA) of the American Academy of Allergy, Asthma, and Immunology (AAAI) conducted a review of each military branch’s policies related to IgE-mediated food allergies. The US Army, Navy, Air Force and Marine Corps have different enlistment regulations and retention policies, summarized in this article from AAAAI.

Medical Waivers

Applicants with a disqualifying condition can request medical waivers/exemptions to clarify their eligibility. The following section highlights scenarios in which such waivers are likely to be granted or withheld for atopic conditions:

Unlikely to Receive Waivers

Applicants with a “history of systemic allergic reaction to food or food additives” are unlikely to be granted a medical waiver.
Applicants who are recommended by their military or civilian allergist to carry an epinephrine auto injector are unlikely to be granted a medical waiver.
Applicants who demonstrate IgE-sensitization and decline to conduct an oral food challenge are unlikely to be granted a medical waiver.
Applicants who demonstrate IgE-sensitization and fail an oral food challenge are unlikely to be granted a medical waiver.
Applicants diagnosed with eosinophilic esophagitis are unlikely to be granted a medical waiver.

Likely to Receive Waivers

Applicants who demonstrate IgE-sensitization, but successfully pass an oral food challenge without reaction, are likely to be granted a waiver.
Applicants with oral allergy syndrome are likely to be granted a waiver for this condition.

More Than Food

While All Things Allergies hopes to empower our community not to be held back by their chronic conditions, this is an admittedly disheartening reminder of the legitimate barriers imposed food allergy.

Food allergies have always been about more than food – Disqualification from the US Armed Forces is just another example of the systemic impact of allergic conditions on our educational, career, and lifestyle choices.

Resources

Adams, Karla E. (2024). Military Accession Guidelines. Annals of Allergy, Asthma & Immunology. Volume 132, Issue 5, 585 – 591. https://www.annallergy.org/article/S1081-1206(23)01499-0/fulltext

FARE. (2018). Is Food Allergy a Disqualification for Military Service? Food Allergy Research and Education. https://www.foodallergy.org/fare-blog/food-allergy-disqualification-military-service

Waibel, K., Lee, A., Coop, C., Mendoza, Y., White, K. (2018). Food allergy guidance in the United States military: A work group report from the American Academy of Allergy, Asthma & Immunology’s Military Allergy and Immunology Assembly. Journal of Allergy and Clinical Immunology, Volume 142, Issue 1, 54 – 59. https://www.jacionline.org/article/S0091-6749(18)30705-X/fulltext