Allergy Shots (Immunotherapy)
Allergy shots, otherwise known as allergy immunotherapy or desensitization, are a way of treating the root cause of allergies. It is effective for seasonal allergies (hay fever), year-round allergies, allergic asthma and insect allergy. Immunotherapy is not used for food allergies or drug allergies.
This type of therapy is usually meant for a patient that has persistent symptoms, has failed medical therapy or even for the patient who does respond to medications, but desires to take fewer medications. It is recommended for all patients that have insect (bee/wasp) allergy.
How Allergy Shots Work
Allergy serum, the liquid that is injected into patients, is a combination of all the allergens the patient is allergic to. Allergy testing helps determine what will be included in the serum.
The serum is then diluted down and the patient is injected in the arms with increasing amounts on a weekly basis. Some patients will get one shot each time and others will get two shots (one in each arm). This depends on how many things the person is allergic to. It takes about 10-12 months to reach a projected top concentration, the "Top Dose". Some patients may not tolerate very high concentrations and their "Top Dose" may be lower than others. Allergy shots do not work right away but usually take a few months before patients notice a decrease in symptoms.
Treatment Schedule
Once a top dose is determined, the injections can be spaced out to every other week for approximately 6 months, then every 3 weeks for about 9 months, and then once a month for 1-2 years more. Along the way, the patient does meet with the physician to evaluate their individual progress. We usually recommend a minimum of 3 years of allergy immunotherapy to have a longer effect of the shots.
What to Expect When Getting Allergy Shots
Patients are asked to wait in the office a full 30 minutes after every allergy shot to monitor for an allergic reaction to an injection. Reactions can range from mild local reactions with just some swelling at the injection site to more severe symptoms with hives, trouble breathing or wheezing. Anaphylaxis, a life threatening reaction, occurs rarely and would require treatment by the physician.
Preparing for Allergy Shots
Prior to getting an allergy shot, patients are always interviewed by our nurse about any reactions that may have occurred from the prior injection as well as their health status on the day of the injection. Adjustments if needed will be discussed with the doctor. Patients are not given their allergy shot if they have a fever over 100°, are coughing or wheezing or appear ill.
All patients or parents of patients under the age of 18 are required to read and sign our Allergy Shot Consent Form prior to starting allergy injections.
Frequently Asked Questions
People that get allergy shots receive injections of allergy serum specific against what they are allergic to. Examples of what may be contained in the serum include pollens (trees, grass, weeds and ragweed), dust mite, mold, cat and dog extract. Allergy shots are not given for food allergies. The serum is placed in bottles labeled for that person and is only used for that individual.
The allergy immunotherapy program takes from 3-5 years to complete. Initially, injections are given weekly for the first year (build up doses of serum). It takes this long to reach the highest doses of the serum (maintenance dose). Once this is achieved the allergy shots are changed to every other week for 12 injections (approximately 6 months), then every 3 weeks for 12 injections (9 months), then every 4 weeks to complete the 3-5 years total.
Patients receiving allergy shots are seen by the physician after the first 15 injections (approximately 4 months). Issues such as response to therapy, including changes in frequency and severity of symptoms and need for medications are reviewed then. Patients are then seen after every 12 injections to reevaluate progress with the program.
Prior to getting your allergy injection you will be asked how you feel that day. If you are not feeling well on the day of the injection including having a fever (greater than 100 degrees), shortness of breath, coughing, or wheezing you will not be able to get your injection. You can receive your injection if you are being treated for an infection and on antibiotics as long as you do not have a fever over 100 degrees.
You must stay 30 minutes after each allergy injection no matter how many injections you have had in the past. Allergic reactions to the injections can happen on any injection even if you have had them for years with no problems.
During the build up phase of your allergy injections you can come in once or twice per week. If you come in twice per week you will be able to build up to the maintenance dose in about 6 months. If you come weekly you will build up in about 12 months. It is best to try to have one day in between the injections to give your arms a chance to decrease any swelling that may occur.
It is normal to have some swelling after the allergy injections. Try to remember how large the swelling was in sizes of coins (dime, nickel, quarter) and how long it lasted. For reactions that are greater than a quarter and last more than 24 hours we will make some adjustments in your injections.
Allergy shots can be continued during pregnancy. For those patients who are still on the build up doses, we do not escalate the dose during pregnancy — we keep the same dose and wait until after delivery to escalate further. Please inform us as soon as possible if you are pregnant so we can make the necessary changes to your program.
We have a protocol to handle when you are late for your allergy injection. Depending on how long it has been since your last injection, certain reductions in your dose will be made.
The success of allergy immunotherapy revolves around slowly building up injections from very dilute concentrations of serum to more concentrated allergy serum. The effect of the allergy shots will be lost if there are long lapses in between injections. Studies have shown that the best effects of immunotherapy are in patients that received at least three consecutive years of therapy.
Yes. Patients that take either beta blockers or certain psychiatric drugs known as MAO-Inhibitors cannot receive allergy shots. Beta blockers are used to treat many different types of medical problems including high blood pressure, certain irregular heart rhythms, tremors and migraine headaches. If you are not sure if any of your medications fall into either of these two categories please let us know so we can check for you.
Warren Allergy is proud to offer a proven approach to food allergy desensitization.