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Immunotherapy

Take a Shot at Allergy Relief

Spring is here! And everyone should be able to enjoy the beautiful weather. Unfortunately, many people have some of their worst allergy symptoms in the spring. Runny nose, congestion, sneezing, itchy eyes, and wheezing – just to name a few – can also lead to other problems like recurrent sinusitis, ear infections, nosebleeds, and snoring.

If you or your child has allergies, your immune system mistakes harmless substances like pollen, dust, animal dander, and mold, for dangerous ones, and produces specific IgE antibodies. This, in turn, leads to the release of chemicals, such as histamine, which contribute to your allergic symptoms.

Allergy shots (also called immunotherapy) aim to increase your body’s tolerance to a given allergen over time. The decision to start the shots is based on several factors, including symptom severity, medication effectiveness, and ongoing exposure to allergens. Time and possible out-of-pocket costs are also important factors.

Allergy shots are typically offered to children over the age of five and adults. If a candidate is an asthmatic, the condition must be stable for immunotherapy to be considered.

Doctors who prescribe immunotherapy are typically allergists or otolaryngologists (ENTs). Patients must first undergo allergy testing to determine their sensitivities.Every physician has his or her own way of creating the customized formula or recipe that makes up the allergy extract; between one to four different injections may be administered at each visit. During the initial build-up phase, a very small amount of the allergy extract will be injected once or twice a week, usually into the fat of the upper arm. Typically this hurts a lot less than getting a viral or bacterial vaccine, which is often given into muscle. At each subsequent visit, increasing amounts will be injected, until a maintenance dose is achieved which Usually takes between three to six months.After that, the injections are continued every two to four weeks.

Local reactions, like minor swelling or itching, are fairly common. More serious reactions, including hives and difficulty breathing, are possible but very rare. Because these require prompt medical treatment, injections should always be supervised by a trained medical professional.

It may take a year before improvement is noted and patients can be weaned off traditional allergy medications. The shots are usually continued for three to five years. Some patients may choose to continue immunotherapy indefinitely if they feel that their symptoms worsen soon after stopping the treatment. Research has shown that the majority of patients will experience relief from their symptoms, although individual results can vary.

Allergy shots are an effective therapy for treating allergies to pollen, dust, cats, dogs, cockroaches, and mold that cause nasal and eye allergies, asthma, and possibly even eczema. Immunotherapy is also a valid option for people with allergies to stinging insects, such as honeybees, yellow jackets, wasps, and hornets. Unfortunately, allergy shots are not currently a mainstream option for treating food allergies, but clinical studies are ongoing.

While other medications are useful for control, immunotherapy is the only treatment option currently available that may provide a cure in the form of long lasting relief from your allergy symptoms.

Kimberly George, MD, has lived in the central Virginia area for over 30 years. A mother of three boys under eight, she is board certified in allergy, immunology, pediatric and internal medicine.
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