Current CDC Guidance recommends the use of spacers/valved-holding chambers and an MDI instead of nebulizer delivered asthma medication when feasible, to reduce the chance or aerosolization and transmission of COVID. Schools cannot prohibit nebulizer use if the private healthcare provider determines nebulization is required. Schools should maintain student and staff safety following current CDC guidance.

NYS Laws: Asthma and Asthma Medications 

§ 916 - Pupils with asthma or another respiratory disease requiring rescue inhaler treatment
§ 919 - On-site nebulizers

NYSED Guide and Memos On Asthma and Asthma Inhaler Comparison

NYS Guide for Asthma Management in Schools
Adapted from the National Institutes of Health, Managing Asthma: A Guide for Schools (2014) and tailored specifically for NYS through a collaboration of the NYSDOH and the NYS Education Department. It provides information to assist school personnel to help students with asthma remain healthy and participate fully in school. (NYSED 9/2018)

Albuterol Metered Dose Inhalers-Stocking Policy Memo
Pertains to stocking albuterol metered-dose inhalers and/or liquid albuterol for use in a nebulizer for students diagnosed with asthma whose personal albuterol prescription is empty (NYSED 8/23/

NYSCSH HFA Inhaler Comparison
Provides a brand by brand comparison of HFA inhalers, the priming needed, and visual of the NHLBI Step-Wise approach for Managing Asthma. (NYSCSH 8/2018)

NYSCSH Resource Toolkit for Asthma Management during COVID-19
NYSCSH has created a resource toolkit for asthma management during COVID-19 which includes information about the use of MDI with a spacer over the nebulizers, sample parent letters about MDI use and a sample permission form for use of a school-provided spacer or valved holding chamber, sample charts for COVID vs flu vs cold vs allergies,  and links to evidence-based care
. (8/10/20)

Action Plans, Sample Spacer/Valved Holding Chamber Permission Forms

NYSDOH and NYC Action Plans and generic asthma emergency plan for staff use when no nurse is present, as well as a sample order/permission form for a school-supplied spacer/valved holding chamber, are located in the Forms and a Notifications>Emergency Care Plans|Flow Sheets section of this website. 

Advocacy Organizations

Allergy & Asthma Network provides education, advocacy, and resources for schools and families. They have added resources specific to COVID and managing asthma, which includes webinars and downloadable posters.

The American Academy of Allergy, Asthma & Immunology (AAAAI) is made up of allergist/immunologists, other medical specialists, allied health, and related healthcare professionals dedicated to the practice of allergy, asthma, and immunology. They have specific resources related to COVID-19.

American Association for Respiratory Care Guide to Aerosol Delivery Devices 4th Edition This guide contains information on different aerosol delivery technologies and hazards of aerosol therapy that can impact the patient receiving therapy as well as care providers and bystanders. (2017)

American Lung Association provides resources for students, families, and schools including Asthma Basics, Asthma-Friendly Schools Initiative, Asthma Medication in Schools, Back to School with Asthma Toolkit, Kickin' Asthma and Open Airways For Schools.

Asthma and Allergy Foundation of America Provides an Asthma Toolkit with information on required and/or suggested face masks or coverings, physical distancing, schedule changes, and new cleaning practices.

Asthma Care At School During COVID Poster

CDC Asthma Publications and Resources Page

Provides information on developing, implementing, and evaluating school-based asthma programs, and a toolkit for districts and schools to create asthma-friendly schools. Includes information for School Leaders.

National, Lung, Blood and Heart Institute (NHLBI) Asthma Resources

Searching the term "Asthma" will provide a list of useful resources  with tips for parents, and guidelines for asthma management

New York City Department of Health and Mental Hygiene Asthma Resources Page

Includes asthma management and medication fact sheets, Open Airways School-based Asthma Program, and other resources in multiple languages.

New York State Department of Health Asthma Resources Page

Provides Asthma Clinical Guideline Tool, Asthma Action Plans in English/Spanish with an area for provider attestation and parent permission, NYS Asthma Data, and Statistics, Steps to follow for an Asthma Attack in the School Setting brochures and posters and resources order form

NYSDOH Asthma Data on Asthma ED Visits and Hospitalizations By County

Page Reviewed 2/16/21