Immunotherapy (allergy shots)
If you have allergies, you may be
wondering if allergy shots are the best
treatment for you. After all, getting
regular shots isn't anyone's idea of
fun, but the possibility of being free
from your allergy symptoms may be worth
Allergies are the result of a
chain reaction that starts in the immune
system. Your immune system controls how
your body defends itself. For instance,
if you have an allergy to pollen, your
immune system identifies pollen as an
invader or allergen. Your
immune system overreacts by producing
antibodies called Immunoglobulin E (IgE).
These antibodies travel to cells that
release chemicals, causing an allergic
Allergy shots (or immunotherapy) are
aimed at increasing your tolerance to
allergens that trigger your symptoms
every time you are exposed to them. An allergist/immunologist, often referred
to as an allergist, is the most
qualified physician to test which
allergy you have and tell you if allergy
shots are right for you
Who can be Treated with
Allergy shots are recommended for
patients with allergic asthma, allergic
rhinitis/conjunctivitis and stinging
insect allergy. They are not recommended
for food allergies. Before a decision is
made to begin allergy shots, the
following issues must be considered:
- Length of allergy season and the
severity of your symptoms
- Whether medications and/or
changes to your environment can
control your allergy symptoms
- Your desire to avoid long-term
- Time: immunotherapy requires a
major time commitment
- Cost: may vary depending on your
region and insurance coverage
Immunotherapy for children is
effective and often well tolerated. It
might prevent the onset of new allergen
sensitivities or the progression to
In some patients that suffer from
other medical conditions or who take
certain common medications, allergy
shots may be more risky. It is important
to mention other medications you take to
Who Should be Giving Allergy
Because adverse reactions to allergy
shots may occur, your allergist has the
right staff and equipment to identify
and treat these reactions. If possible,
allergy shots should be given in your
allergist's office. If not, your
allergist should provide the supervising
physician with complete instructions
about your treatment.
How do Allergy Shots Work?
Allergy shots work like a vaccine. Your
body responds to the injected amounts of
a particular allergen (given in
gradually increasing doses) little by
little, developing a resistance and
tolerance to it. Allergy shots can lead
to decreased, minimal or no allergy
symptoms when you are again exposed to
the allergen(s) in the shot.
There generally are two phases to
immunotherapy: build-up and maintenance.
The build-up phase, generally
ranging from three to six months,
involves receiving injections with
increasing amounts of the allergens. The
frequency of injections is once or twice
a week, though more rapid build-up
schedules are sometimes used.
The maintenance phase begins
when the most effective dose is reached.
This dose is different for each person,
depending on how allergic you are and
your response to the build-up phase.
Once the maintenance dose is reached,
there are longer periods between
injections, typically two to four weeks.
When Will I Feel Better?
For some people, a decrease in symptoms
is seen during the build-up phase; for
others, it may take as long as 12 months
on the maintenance dose.
If you don't respond, it may be
- Not enough dose of the allergen
in your vaccine
- Missing allergens not identified
during your allergy testing
- High levels of the allergen in
- Major exposure to non-allergic
triggers (i.e. tobacco smoke)
If there is no improvement after a
year of maintenance allergy shots, your
allergist will discuss other treatment
options with you.
When Should Allergy Shots be
Once the maintenance dose is reached,
effective immunotherapy is generally
continued for three to five years. The
decision to stop should be discussed
with your allergist at that time. Some
individuals may experience a permanent
reduction of their allergy symptoms but
others may relapse and a longer course
of allergy shots can be considered.
What are the Possible
There are two types of adverse reactions
that occur with allergy shots. Local
reactions are fairly common and
occur as redness and swelling at the
injection site. This can happen
immediately, or several hours after the
treatment. Systemic reactions are
much less common, are usually mild and
typically respond quickly to
medications. Signs include increased
allergy symptoms such as sneezing, a
stuffy nose or hives. Rarely, a serious
systemic reaction called anaphylaxis
(pronounced an-a-fi-LAK-sis) can
develop, with swelling in the throat,
wheezing, a feeling of tightness in the
chest, nausea or dizziness.
Most serious systemic reactions
develop within 30 minutes of allergy
injections. This is why it is strongly
recommended you wait in the office for
30 minutes after your injections.
Your allergist is trained to watch
for such reactions and his or her staff
is trained and equipped with the proper
medications to identify and treat them.
- Allergy shots are a treatment
aimed at building up your tolerance
to the substances that trigger your
- Allergy shots work like a
vaccine. Your body begins to respond
to the injected amounts of an
allergen by developing resistance
and tolerance to it.
- While most people may experience
a permanent reduction of their
allergy symptoms, others may not
respond to allergy shots.
- An allergist can test you for
allergies and tell you if allergy
shots are right for you.
- Reactions are possible, but your
allergist is trained to watch for
them and his or her staff is trained
to identify and treat them.
Feel Better. Live Better.
An allergist/immunologist, often
referred to as an allergist, is a
pediatrician or internist with at least
two additional years of specialized
training in the diagnosis and treatment
of problems such as allergies, asthma,
autoimmune diseases and the evaluation
and treatment of patients with recurrent
infections, such as immunodeficiency
The right care can make the
difference between suffering with an
allergic disease and feeling better. By
visiting the office of an allergist, you
can expect an accurate diagnosis, a
treatment plan that works and
educational information to help you
manage your disease.