Allergen Immunotherapy

The Goal

  • To reduce symptoms caused by allergies/asthma.
  • To reduce/eliminate the need for medications (especially steroids).
  • To prevent the progression of allergies/asthma.

Immunotherapy has been shown to prevent the development of new allergies and, in children, it can prevent the progression of the allergic disease from allergic rhinitis to asthma. Allergy shots can lead to long-lasting relief of allergy symptoms even after treatment is stopped.

Who will benefit: Immunotherapy is recommended for people with allergic asthma, rhinitis, conjunctivitis and certain food allergies. Children can receive immunotherapy as well. Five is the youngest recommended age to start allergy shots. There is no upper age limit for immunotherapy. In considering immunotherapy in adults, consideration must be given to medications such as Beta Blockers and Tricyclic Antidepressants, which could potentially make immunotherapy riskier.

Duration of treatment: There are two phases to immunotherapy. In the build-up phase injections are given 1-2 times per week with increasing amounts of allergens until the full (maintenance) dose is achieved. This phase typically lasts six months. In the maintenance phase, injections are given every 2-4 weeks. This phase continues for three years. You will then be reassessed to determine if further injections are needed. Some patients require a 4th and 5th year; rarely are shots needed beyond five years.

What to expect: You will receive a series of injections. The injections are given in the subcutaneous (fatty) tissue on the back of the arm. For your safety, you will be required to remain in the lobby for 20-30 minutes after getting the injections. Before you leave, a nurse must check for any reaction at the injection site. You may notice decreasing symptoms during the initial build-up phase before you reach maintenance, but it may take as long as 12 months on the maintenance dose to see improvement in some patients. New vial appointments require a provider visit and may last 60-90 minutes

Missing Shots: If you miss an allergy shot, call and make another appointment immediately and notify the nurse at your next appointment. Missing your regular shots makes it take longer for you to obtain your maintenance dose. It is critical to maintain your allergy shot schedule. Please refer to the Appointment Record for a detailed list of our hours and as a guide to schedule your appointments. If you miss a new vial appointment, you may be subject to a charge for the preparation of your vials.

If you feel sick the day of your allergy shot: If you feel ill the day of your shot, but are not experiencing any chest congestion, chest tightness, wheezing, or difficulty breathing, you may still be able to get your shot but make sure to tell the nurse before getting your shot. If you are unsure whether you should get your shot or not, please call our office to discuss your concerns with the nurses prior to coming in for your shot.

Side effects of allergy shots: Because the injections are made from extracts of substances to which you are allergic, allergic reactions are possible. It is imperative that injections be performed under the supervision of medical personnel so that if a reaction does occur it can be identified and treated quickly.

Local reactions to allergy shots are fairly common and consist of redness and swelling at the injection site. These reactions can occur immediately or several hours later. In some cases, there may be swelling of the arm.

Systemic reactions are much less common and result in allergy symptoms such as sneezing, nasal congestion or hives. It is rare, but possible, for a serious systemic reaction, called anaphylaxis, to occur. In addition to symptoms associated with a mild systemic reaction, symptoms of an anaphylactic whole-body reaction can include (but are not limited to): swelling of the throat, wheezing or a sensation of tightness in the chest, nausea, and dizziness. Anaphylaxis is a life-threatening allergic reaction and must be treated immediately. Most serious reactions, such as anaphylaxis, occur within 20 minutes after injection, which is why we require our patients to wait in the lobby this long after their injection and to be checked by one of our medical staff before they are permitted to leave.

Keep in mind, nearly all allergy shot patients go through their entire course of therapy without a serious reaction but Premier Allergy, Asthma & Sinus is working to reduce even this small risk of an adverse reaction. If you develop any symptoms following your injections, please notify the nurse immediately. Seek immediate medical care if you experience generalized symptoms such as shortness of breath, wheezing or lightheadedness.

We require patients to arrive and be inside the inner doors awaiting check-in a minimum
of 30 minutes prior to close. Patients that arrive but are not inside the inner doors by
the time previously stated will not be able to receive their allergy injections at that time
and will need to reschedule. Please note the first visit of each vial (in bold) will be with a provider. This may take 60-90 minutes. Please plan accordingly.

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