Governor Josh Shapiro has signed Elijah’s Law (House Bill 928) into law, making Pennsylvania the eighth state to adopt legislation designed to protect young children from life-threatening allergic reactions in childcare settings. Signed on October 22, 2026, the bipartisan measure establishes new requirements for allergy awareness, emergency preparedness, and access to life-saving epinephrine in childcare facilities across the Commonwealth.
The legislation, championed by state Representatives Bridget Kosierowski and Kristen Marcell, addresses dangerous gaps in how childcare providers recognize and respond to anaphylaxis, a severe allergic reaction that can become fatal without prompt treatment. The bill passed with overwhelming bipartisan support, receiving a 197–6 vote in the House and a 49–1 vote in the Senate.
Under the new law, childcare facilities will be able to obtain prescriptions for FDA-approved emergency epinephrine delivery systems, including traditional auto-injectors and nasal sprays. The legislation also establishes a requirement for facilities to acquire and stock emergency epinephrine, although that requirement depends on funding specifically designated by the state. This distinction is important: while the law creates a framework for making emergency medication available, funding will play a critical role in ensuring facilities can maintain their supplies.
Importantly, the law allows trained childcare personnel to administer epinephrine when they reasonably believe someone is experiencing anaphylaxis, even if that person has never been diagnosed with an allergy or prescribed the medication. This provision is especially significant for young children, whose first recognized allergic reaction may occur while attending daycare or preschool.
The legislation also addresses staff training, medication storage, emergency response procedures, and educational materials for parents. By helping childcare workers recognize the warning signs of anaphylaxis and respond quickly, the law aims to reduce dangerous delays in treatment. The new requirements are scheduled to take effect on April 20, 2027, giving facilities time to prepare.
At the heart of Elijah’s Law is the memory of Elijah Silvera, a three-year-old boy who died on November 3, 2017, after being served a grilled cheese sandwich at his New York City preschool despite staff having been informed of his severe dairy allergy. When Elijah began experiencing a life-threatening allergic reaction, staff failed to respond appropriately or promptly summon emergency medical assistance. His mother rushed him to a nearby hospital, but he died from anaphylaxis.
Following their son’s death, Elijah’s parents, Thomas Silvera and Dina Hawthorne, founded the Elijah-Alavi Foundation to prevent similar tragedies. Through education, advocacy, and partnerships with lawmakers, the foundation has worked to establish stronger allergy safety standards in early childhood settings nationwide.
Thomas Silvera has become a leading advocate for legislation requiring childcare personnel to recognize anaphylaxis, receive appropriate emergency training, and have access to epinephrine. His family’s efforts have helped transform Elijah’s story into a growing movement to protect children who may be too young to recognize or communicate the symptoms of a severe allergic reaction.
Representative Kosierowski emphasized the importance of immediate action when a child experiences anaphylaxis.
“In an emergency situation, specifically an allergic reaction in a child, you need to recognize it fast and treat it quickly,” she said. “This bill gives Pennsylvania childcare workers the training and the medication needed to save lives.”
Representative Marcell also stressed the importance of equipping childcare providers to respond during an emergency.
“When a child is experiencing a severe allergic reaction, every second counts,” she said. “Childcare providers need the training and tools to recognize what is happening and respond immediately. This legislation gives them greater ability to act during an emergency and gives parents additional peace of mind when they leave their children in someone else’s care.”
Pennsylvania’s enactment continues the growing momentum behind Elijah’s Law nationwide. As we reported in July, Missouri became the seventh state to adopt the legislation, advancing the Elijah-Alavi Foundation’s mission to improve allergy safety in early childhood education. Pennsylvania now becomes the eighth state to take action, adding to the expanding number of jurisdictions establishing protections inspired by Elijah’s death.
Although the specific requirements vary by state, the underlying goal remains the same: ensuring that childcare providers are better prepared to prevent avoidable tragedies by recognizing anaphylaxis and responding immediately with appropriate treatment.
Governor Shapiro’s signature represents another milestone in a movement born from one family’s devastating loss. As Pennsylvania prepares to implement its new requirements, Elijah’s legacy continues to influence how childcare facilities approach food allergy safety and emergency preparedness.
For Thomas Silvera, Dina Hawthorne, and the families who have supported their efforts, each new state adopting Elijah’s Law brings the country closer to a future in which every child facing anaphylaxis has access to trained caregivers and lifesaving treatment when it matters most.
