While it may seem unusual to start thinking about allergy treatments during winter time, it’s actually the perfect time to get a head start on preventing your or your child’s allergy symptoms. Allergen avoidance and allergy medications are the first steps in managing allergies. If these are not completely relieving your symptoms or you prefer minimizing long-term medication use, it is time to consider allergy immunotherapy (IT). This treatment, commonly referred to as “allergy shots,” involves getting personalized injections of specific allergens over the course of 3 – 5 years. Injections are traditionally given under skin.
The goal of allergy IT is to change the immune system, so the body tolerates the allergens and no longer sees them as “foreign” invaders. Treatment schedules vary, but in general, injections are initially given 1 – 2 times per week, and then spaced out to every 4 weeks for the remainder of the treatment course. The first injections are considered the “build-up” phase. During build-up, injection doses are very low and progressively increase with each visit until reaching a top dose, or maintenance dose. Maintenance dose is the term used for the patient’s optimal treatment dose, the dose they’ll continue to receive with each future injection.
Most people start to notice benefits within a year of starting the shots, including decreased symptoms and need for fewer medications. Allergy shots can also prevent new allergies from forming and can prevent allergic rhinitis (nose symptoms from allergies) from progressing to asthma.
While most people tolerate the injections well, risks of the injections include:
Common: Local injection site reactions (ex. pain, swelling, bleeding)
Rare: Severe allergic reaction (ex. difficulty breathing, swelling) that if left untreated could progress to a more life-threatening condition called anaphylaxis. These reactions often occur within 30 minutes of receiving the injection.
Because of risks associated with allergens injected under the skin, allergy shots should be given in a medical setting with proper medical equipment to treat reactions. Patients should wait in the doctor’s office 20 – 30 minutes after each injection to ensure accessibility to medical treatment if needed. Allergy shots are currently the only FDA approved-method for administering allergy immunotherapy. It can be used for treating symptoms caused by environmental allergies (ex. pollen, pet hair/dander, dust mites), allergic asthma, eczema, or venom from flying insects or fire ants. Talk with your doctor and watch our video to help decide if allergy shots are right for you or your child.
Upcoming immunotherapy posts will discuss other methods of immunotherapy (including allergy drops and tablets), new methods under research, and immunotherapy research for food allergies.
Amber M. Patterson, MD, works in the Section of Allergy and Immunology at Nationwide Children’s Hospital. As a wife and mother of three, she is passionate about harnessing efficiency to create time. Dr. Patterson wants to teach her patients how to feel better quicker and stay healthy longer.
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