LisaG, it's hard to say if your son's reaction would be considered "severe". I think they all are severe, because you just don't know what could happen. My son's allergist was not very concerned by my son's reaction (hives and swelling) or his high test result, and I don't think he even mentioned the epi-pen. I'd already gotten it from our pediatrician, though. Our pediatrician insists that it is very important that the Epi be administered at the first sign of a reaction because waiting for breathing trouble might be waiting too long. I know this doesn't answer your question very well, but my point is that different doctors will look at the allergy differently. Sure makes our job tougher, but I think we need to come to our own decisions about how to treat and react to this new way of life. Unfortunately, there are some unsupportive doctors out there. Good luck and let us know how the appointment goes.