General Information
- Immunotherapy (IT), also known as allergy shots, is a form of long term treatment that decreases symptoms for people with:
- Allergic rhinitis and allergic conjunctivitis (runny nose, congestion, sneezing and itchy watery eyes when exposed to things such as pollens and animals)
- Allergic asthma (asthma symptoms becoming worse when exposed to things such as pollens and animals)
- Eczema with allergy to things such as pollens and animals - Stinging insect allergy
- Allergens are proteins that the body recognizes and cause allergy symptoms
- IT decreases sensitivity to allergens and often leads to lasting relief of allergy symptoms even after treatment is stopped
- Both children and adults can receive IT
- Factors to consider when deciding if IT is right for you are:
- Severity of your symptoms (keeping you up at night, impairing your regular activities) - How well medications and / or environmental controls are helping with your allergy symptoms
- Your desire to avoid long term medication use
- Time available for treatment (IT requires a significant time commitment)
- Cost which varies depending on region and insurance coverage
- Certain people are not candidates for IT such as those with
- Severe or uncontrolled asthma
- Serious medical conditions involving the heart or lungs
- Patients on beta blocker and ACE inhibitor medications
- IT can not be started if someone is pregnant
- Patients who are unable to stay in the clinic for 30 minutes after each injection
How Is Immunotherapy Performed?
- IT is given as an injection with a small needle in the upper arm starting with a weak concentration of the allergen and gradually increasing
- There are two phases for IT:
- Build up phase involves receiving injections with increasing amounts of the allergens about one to two times per week. The length of this phase varies from 1 - 6 months
- Maintenance phase begins once the effective dose is reached. During the maintenance phase, there will be longer periods of time between treatments, ranging from 2 - 4 weeks in most cases
- Most patients are treated for 3 - 5 years
- Your body responds to injected amounts of a particular allergen, given in gradually increasing doses, by developing immunity or tolerance to the allergen
How Effective is Immunotherapy?
- Many studies have shown that about 75% of patients have improvement in their symptoms
- You may notice a decrease in symptoms during the build-up phase, but it may take as long as 12 months on the maintenance dose to notice an improvement
- IT can prevent the development of new allergies, and in children it can prevent the progression of allergic disease from allergic rhinitis to asthma
- Some people experience lasting relief from allergy symptoms, while others may relapse after discontinuing allergy shots
- Some people still need medications such as nose sprays but the amount is usually less
- If you have not seen improvement after a year of maintenance therapy, discuss your treatment options with your allergist
- IT for stinging insects can be life saving and protects from serious reactions if stung
- Failure to respond to IT may be due to several factors including:
- Low dose of allergen in the shot
- Missing allergens not identified during the allergy evaluation - High levels of allergens in the environment
- Exposures to non allergic triggers such as tobacco smoke
Immunotherapy Safety
- IT should always be given by a physician who is trained to recognize and treat reactions
- Local reactions causing swelling and redness at the injection site are common and can occur immediately or several hours after the injection
- A large local reaction does not mean that a more serious reaction will occur with future injections
- Some people experience mild symptoms such as sneezing, nasal congestion or hives
- Serious and even life threatening reactions are rare but can occur and require immediate medical attention
- Symptoms of a serious reaction include swelling in the throat, wheezing or tightness in the chest, nausea, vomiting and dizziness
- Most serious reactions occur within 30 minutes which is why you have to wait at the doctors office for 30 minutes after every injection
- Situations where your doctor will not give you a shot because of safety concerns include:
- You can not wait in the clinic for 30 minutes after the shot
- Vigorous exercise 2 - 3 hours before the shot
- You are unwell
- Asthma is not controlled