Category: Allergy Shots  

All About Allergy Shots, Immunotherapy

Allergy Shots-are they right for you?

To make the correct decision about allergy shots we have to determine the nature and cause of your symptoms. For instance, while nasal congestion may be due to allergies it could also be due to nasal polyps or a deviated nasal septum. A detailed history with allergy testing and sinus evaluation will help you determine whether your primary problem is allergic, anatomic or infectious. Properly selected patients usually have an excellent response to allergy immunotherapy.

Immunotherapy, also known as allergy shots, has been an effective means of controlling allergy symptoms for almost one century. In 1911, Dr. Leonard Noon described the first successful treatment of hayfever (Noon L: Prophylactic inoculation against hayfever, Lancet 1572-2, 1911). Since then, millions of allergy sufferers have experienced significant improvement in their symptoms as a result of this therapy.

Allergy shots are injections of purified allergens (such as pollens, molds and pet dander). With injections of gradually increasing amounts of allergen the body becomes hyposensitized (much less allergic). Most people (approximately 85%) experience significant symptomatic relief.  Allergy shots reduce sensitivity to allegens helping the patient become much less allergic to the allergens.  They can significantly improve quality of life and studies have shown that the benefit of allergy shots may continue for years after shots are discontinued.

The ideal patient for starting shots is:

  • Under 50 years of age
  • Otherwise healthy (no serious ailments)

Contraindications to allergy shots

  • Beta blocker medications
  • Unstable asthma
  • Any serious medical condition (such as severe heart disease or kidney failure)

Risks

Because you are receiving injections of the very things to which you are allergic, there is a chance that you may have an allergic reaction (rarely this may be severe) to a shot. For this reason all patients must wait 20-30 minutes after each injection and have their injection sites (upper arms) checked before leaving. You may also experience local swelling at the site of the shot. Please inform the staff if you have had any delayed reaction to the previous shot.

Alternatives

The best treatment for any allergy is avoidance of the trigger. Depending upon the nature of your allergy symptoms, medication and allergen avoidance (where possible) are practical options. Newer allergy treatments (Xolair, an injection for allergic asthma patients) may be an excellent choice for more severe asthmatics and can be combined with allergy shots as well. Sublingual immunotherapy (allergy drops, under the tongue) are a promising therapy but is not standard of care in the US.  While some allergists may offer this therapy, they are using allergy serum which is not FDA-approved  for this purpose.  Single pollen allergy tablets will reach the market soon and will probably be an effective means of treating patients with allergy symptoms restricted to a particular time of year (e.g. — tree or grass pollen season).  You may have heard about a single allergy shot before the pollen season which some doctors administer.  This is a high dose long-acting steroid injection, must be given at least annually and has potentially serious side effects especially if repeated year after year.

Schedule of shots

Allergy shots are given weekly (or more often if you wish) to start and after about 40 visits the schedule advances towards monthly injections.  The schedule can advance more rapidly if you come more often (up to 3 times/week).

Cost

There are 2 charges for the allergy shots: allergy serum preparation and a per visit charge for the shots.  Depending on your insurance plan you may have a copay for the shot visit but as long as your deductible is met the serum charge is usually covered by your plan.