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    What To Expect With Allergy Shots

    Majed Koleilat, MD, and Shannon Vickers, NP Deaconess Clinic Allergy 05/03/2022
    If your allergy symptoms aren’t always managed through medications and avoidance, a next step may be allergy immunotherapy (allergy injections).  Allergy injections, commonly called allergy shots, are a way to make you less allergic to certain allergens. They are custom-made to a particular patient based on their skin testing results.

    Allergy Injection Overview
    Allergy immunotherapy is a form of long-term treatment that, for many people, decreases symptoms of allergic rhinitis, allergic asthma, conjunctivitis (eye allergy) or stinging insect allergy.
    Allergy shots decrease sensitivity to allergens, and often lead to lasting relief of allergy symptoms even after treatment is stopped. This makes it a cost-effective, beneficial treatment approach for many people.
    We start off with an extremely low dose of what the patient is allergic to, and give the injection into the back side of the upper arm. It is not an intramuscular shot, so it doesn’t hurt like many shots do. Each week, the patient receives an increasing dose of their allergy vaccine, thus making them tolerant to these allergens.
    The shots start out weekly, or occasionally twice a week, and after about 6-8 months, are gradually spread out to monthly shots. Patients receive monthly injections for 3-5 years.
    Who Can Benefit From Allergy Shots?
    Both children and adults can receive allergy shots, although it is not typically recommended for children under age five. This is because of the difficulties younger children may have in cooperating with the program, and in explaining any symptoms or reactions they may be experiencing.
    When considering allergy shots for an older adult, medical conditions such as heart disease should be taken into consideration and discussed with your allergist/immunologist first.
    You and your allergist/immunologist should base your decision regarding allergy shots on:
    •    Length of allergy season and severity of your symptoms
    •    How well medications and/or environmental controls are helping your allergy symptoms
    •    Your desire to avoid long-term medication use
    •    Time available for treatment (allergy shots require a significant commitment, especially at first)
    •    Cost, which may vary depending on insurance coverage and physician practice.
    How Do Allergy Shots Work?
    Allergy shots work like a vaccine. Your body responds to injected amounts of a particular allergen, given in gradually increasing doses, by developing immunity or tolerance to the allergen.
    There are two phases:
    •    Build-up phase. This involves receiving injections with increasing amounts of the allergens about once per week. The length of this phase depends upon how often the injections are received, but generally ranges from four to eight months.
    •    Maintenance phase. This begins once the effective dose is reached. The effective maintenance dose depends on your level of allergen sensitivity and your response to the build-up phase.
    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. If allergy shots are successful, maintenance treatment is generally continued for three to five years. Any decision to stop allergy shots should be discussed with your allergist/immunologist.
    How Effective Are Allergy Shots?
    Allergy shots have shown to decrease symptoms of many allergies. It can prevent the development of new allergies, and in children it can prevent the progression of allergic disease that can lead up to asthma. The effectiveness of allergy shots appears to be related to the length of the treatment program as well as the dose of the allergen. Some people experience lasting relief from allergy symptoms, while others may relapse after discontinuing allergy shots.
    Where Are Allergy Shots Given?
    Allergy shots should be supervised by a physician in a facility equipped with proper staff and equipment to identify and treat adverse reactions to allergy injections.
    What Are The Risks?
    A typical reaction is redness and swelling at the injection site. This can happen immediately or several hours after the treatment. In some instances, symptoms can include increased allergy symptoms such as sneezing, nasal congestion or hives.
    Serious reactions to allergy shots are rare. When they do occur, they require immediate medical attention. Symptoms of an anaphylactic reaction can include swelling in the throat, wheezing or tightness in the chest, nausea and dizziness. Most serious reactions develop within 30 minutes of the allergy injections. This is why it is recommended you wait in your doctor's office for at least 30 minutes after you receive allergy shots.
    Next Steps
    So, how do you get started?

    Talk to an allergy doctor. An allergist/immunologist has specialized training and experience to diagnose specific allergens that trigger your symptoms. An in-person evaluation and skin testing are usually enough to identify what’s bothering you. At Deaconess Clinic Allergy, patients can schedule new patient appointments online. My partners and I can consult with patients about their next step, which is often allergy testing.  From there, we will work with you to determine the best plan for treating your allergies—which may include immunotherapy—to help you be healthier and enjoy a better quality of life with fewer allergy symptoms.
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