Impact statement
This study focused on accidental allergic reactions (AAR) in Japanese children with immediate-type food allergies. Although the annualized rate of AAR was relatively low, our findings reveal that half of the affected children experienced moderate to severe reactions. Furthermore, identifying low-dose reactivity as a risk factor for AAR could have practical implications for pediatricians and allergists, emphasizing the importance of careful risk management. This research contributes to a better understanding of AAR in children, potentially improving the safety and care of young patients with food allergies.