Allergy Shots

Immunotherapy Treatment for Allergies

What is Immunotherapy?

Immunotherapy is one of the major breakthroughs in modern allergy treatment. It is call by different names, including desensitization, hypo-sensitization, and just plain “allergy shots”.

In the immunotherapy process, a series of injections is given of gradually increasing doses of allergen extracts. Only the specific substances to which a patient tested allergic to are included in the extract mix. These include, most commonly, weed, grass, tree pollens, dust mites, and mold spores. Each shot given has a bit higher dose than the preceding, until a “maintenance” level is reached. This higher maintenance dose is continued for a period of time – generally one to three additional years – as allergy symptoms continue to abate.

Partial to complete relief is experienced in about two-thirds of patients. The relief can last for a period of years after the allergy shots are ceased. In many cases the relief is very long term, especially in children.

A patient who embarks on this therapy should make the commitment to see it through. It is time consuming, and certainly not without cost. Starting immunotherapy, then stopping, then restarting again can be an expensive waste of time.

Before you wave immunotherapy off as being too expensive or time consuming, please do the math. Think about how much you spend in the course of a year on antihistamines, decongestants, analgesics and the like to obtain relief. Then consider the time missed from work or school due to allergy symptoms (or how much leisure time has been wasted).

Certainly, immunotherapy is not the answer for every patient. Some find relief from occasional symptoms through a treatment program of avoidance measures and prescription medications. But many others sing the praises of allergy shots, when, after taking the injections for a period of time, the desensitization begins to kick in and the allergic response is reduced or eliminated. After allergy testing our allergists will discuss the risks and benefits of immunotherapy if it is indeed indicated.

Reducing people’s sensitivity to certain allergens (e.g. pollens, animals, molds, venoms) has been possible for nearly 100 years in this country. Over the years, we have improved and refined the methods used. The “gold standard” method for the past 50 years has been subcutaneous (just under the skin) injections of purified allergens, also known as subcutaneous immunotherapy (SCIT). An alternative to injection therapy is now available. This method involves placing allergen liquids or dissolvable tablets under the tongue where the allergens are absorbed into the body through the oral mucous membranes. This method is referred to as sublingual immunotherapy (SLIT). SLIT offers two conveniences compared to SCIT that make this an exciting alternative to injection therapy: no needles and at-home therapy!

Both methods reduce your allergy symptoms by altering your immune system’s reaction to naturally occurring allergens. Over time, with continued use, you can live comfortably with animals or pollens that now cause you allergic eye, nose or lung symptoms. Fewer symptoms mean fewer medicines and a much better quality of life! Medications used in allergy therapy (antihistamines, nasal steroids, eye drops, etc.) are like a Band-aid on a toddler’s cut finger; when the Band-aid hides the cut from the child’s eyes, he feels better. If the Band-aid falls off later that day, the cut becomes visible again and the child panics. Another Band-aid keeps things calm until the cut eventually heals. Allergy medications do not “cure” allergies; they simply reduce the symptom severity. Allergy immunotherapy, whether SCIT or SLIT, can actually “heal the cut” reducing medication needs in the future, sometimes to zero!

How are these Therapies Administered to you?

Both methods rely upon frequent exposure to your allergens although the frequency and starting doses vary between the two methods. Both methods carry a slight risk of allergic reaction. The risk with SCIT is higher than with SLIT and requires in-clinic delivery with a 20 to 30-minute wait with each injection. We start SLIT in our clinic but quickly move to at-home use because of the reduced severe allergic reaction risk. The two methods are compared side-by-side below.

Method	SCIT	SLIT
Starting Dose	Usually 1/10,000th the “maintenance” dose	1/10th the “maintenance” dose
Dose frequency	1-2 times a week for first 3-6 months, once a week for next 6 months and ultimately once every 2-4 weeks (Average patient) Accelerated build-up schedules are available.	Once daily, always!
Treatment Location	Clinic	Home after first 3 doses in clinic
Duration of Treatment	3-5 years recommended	Same as SCIT
Symptom Reduction Possible	Up to 100% relief (without medicines!)	40-60% relief (Higher in some cases)
Time to Initial Symptom Improvement	4-9 months (average)	2-6 months (average)
Number of Treated Allergens Possible	Up to 30+ (pollens, molds, mites, animals, venoms)	1-3 (cat, dog, mold, select pollens)
Adverse Reactions: Most common to least common	Injection site swelling and itch. Hives, eye/nose allergy symptoms, breathing difficulty, full anaphylaxis are rare but possible.	Oral itch and slight oral swelling. Nausea, vomiting, hives and breathing difficulty are very rare.
Insurance Coverage	Yes, plan-dependent	Not yet
Eligible Patient Age Range	4-5 years and up	2-3 years and up

Which Method is Best For You?

Subcutaneous therapy offers the greatest benefit potential to the largest percentage of our allergy patients. Use this if you have multiple pollen, mold and/or animal allergies or if you are insect venom-allergic. At the moment, SCIT is the only option for venom-allergic patients. Use this method also if you are looking for “maximum” benefit.

If you are very afraid of needles, have only a few major allergens (dog, cat, grass or sagebrush pollens) or have a personal life schedule that prevents in-clinic treatment, SLIT may be the best choice for you! Children allergic to the family cat or dog can reverse their allergy symptoms using SLIT and avoid a “shot”! A hunter allergic to sagebrush pollen can finally find relief in the Fall hunting season with the convenience of in-home therapy! Please talk about this choice with your allergist.

How To Schedule Immunotherapy:

Before you begin your immunotherapy treatment, you will first need to contact your closest Asthma and Allergy location and schedule an initial appointment. Once you have been established an immunotherapy patient, we will work with you to schedule your immunotherapy treatment so you can receive your allergy shots.

Please visit our contact page if you have any questions about the procedures.