To the Editor Dr Anagnostou and colleagues comprehensively addressed peanut allergy via ingestion, yet one plausible route remains absent from current guidance: parenteral delivery through blood transfusion products. Peanut allergens, like pathogens, reach sensitized individuals through pathways that differ markedly in risk. Airborne and skin-contact exposures carry minimal clinical significance; current evidence explicitly discourages nut bans in schools and on aircraft as ineffective. Although the dominant route remains oral ingestion, as detailed by the authors, the intravenous route has been overlooked.