Allergy Shots

What is Allergen Immunotherapy?

Allergy shots or “allergen immunotherapy” is one of the best treatments we have to offer because they have the potential to modify allergy symptoms. This affects the eyes, the nose and the lower airways as in the case of asthma. Injections are given with therapeutic vaccines prepared by mixing protein “allergens” extracted from plant pollens (trees, grasses or weeds), house dust mites or animal hair (cats or dogs, for example). Allergy skin or blood tests are used to determine which natural substances or airborne “allergens” could be triggering allergy symptoms in patients. They will then guide selection of those appropriate to be included in the vaccines of individual patients. Over 85% of patients  receiving allergy shots with allergens to which they are allergic have favorable responses. This includes long-term reduction in the need for nasal allergy and asthma medications. Allergen immunotherapy is one of the few disease-modifying therapies that targets the underlying cause(s) of allergic respiratory conditions. In children, allergy shots may reduce the risk of developing asthma among allergic children as they grow older. Speaking with our pediatric allergist can help you determine if your child may be a good candidate.

Allergy Shots

Allergy shots offer:

  • Improved asthma control
  • Relief from seasonal or year-round allergy and sinus symptoms
  • Reduced need for allergy and asthma medications

Who should consider allergy shots?

Allergy shots are recommended for patients with severe allergy symptoms not controlled with medication or for those unable to tolerate medications. This treatment is best suited for patients with perennial (year-round) or prolonged seasonal symptoms. Shots are strongly recommended in patients who develop mild or moderate asthma symptoms after exposure to house dust mite, cats and pollens.

What is the procedure for administering allergy injections?

Sterile treatment vials are prepared with mixtures of allergens known to trigger symptoms in the individual patient. Serial injections are then administered under the supervision of one of our allergy specialists. The therapeutic vial consists of a mixture of protein extracts of the offending allergens previously identified by history and skin testing. From this starting vial, serial dilutions are made. Starting at very dilute concentrations, a series of injections are given underneath the skin 1-2 times per week during what is considered the initial “buildup” phase of treatment.

Over time, patients become “desensitized” and build up tolerance to allergens causing their symptoms. It usually takes 4 to 5 months for symptoms to improve. The interval between shots is gradually increased until a high maintenance dose can be given every 2 to 4 weeks. Maintenance dose injections are continued for 3 to 5 years in most patients. This is because it is known that it takes that long for the efficacy of shots to persist after injections are stopped.

Cluster or Accelerated Buildup of Injections

Patients diagnosed with nasal allergy deciding to receive allergen injections may choose to receive an accelerated schedule of injections. This is to shorten the initial build-up period. Our practice offers a new approach known as “cluster build up” whereby patients receive multiple allergen injections during four 3-hour visits. This greatly reduces the time needed to reach effective maintenance doses from 6 to 2 months. Cluster build-up would allow patients to see favorable responses much sooner than with traditional approaches.

Risks of allergy injections

A systemic allergic reaction can occur within the first 30 minutes after an injection. Most of these are mild with diffuse itching or skin rash, but very rarely can be more severe with bronchospasm and fall in blood pressure. Reactions occur once in every 10,000 injection visits but severe reactions occur only once in every 160,000 injection visits. For this reason, all patients receiving injections must receive these when one of our physicians is present and then be observed for 30 minutes in the office. Systemic reactions are treated promptly in the office by the physician and nursing staff.

Alternative to allergy shots.

Some patients might be candidates allergen immunotherapy delivered as sublingual tablets. Currently, safe and effective tablets are available for grass and ragweed pollen allergy as well as for house dust mite allergy. These can be self-administered by patients at home.