question: Background Oral immunotherapy (OIT) is effective in desensitizing food allergic patients but adverse reactions limit its use. Objective To study the effect of the COVID-19 lockdown in Israel, between March-15 to April-30 2020, on the incidence of home epinephrine-treated reactions. Methods All patients who were in the up-dosing phase of OIT for &#8805;1 month during the lockdown, or a respective period in years 2015-2019, were studied. The incidence of homeepinephrine treated reactions during the 2020 lockdown was compared to the respective period in 2015-2019, and to periods before and after the lockdown. Results A total of 1163 OIT treatments were analyzed. Two epinephrine injections occurred during 2020 (0.7%) compared to 29 injections (3.28%) during 2015-2019 (p=0.034). Patients treated in 2020 were older (8.1 vs. 7 years, p Conclusion The lower rate of home epinephrine-treated reactions during the COVID-19 lockdown in Israel suggests that potentially avoidable triggers contribute significantly to the rate of adverse reactions during OIT.