Desensitization Immunotherapy Allergy Shots
Allergy injections make you less allergic or tolerant of particular allergens such as animal dander, dust mites, mold and pollen. Allergy injections do not always entirely eradicate the allergy, but they do result in marked improvement in symptoms, decreased medication use and can prevent the progression of allergies to asthma and reduce pre-existing asthma. Allergy immunotherapy is most effective when administered along with appropriate environmental control measures and medication, if necessary.
How do Allergy Shots Work? Allergy injections work by causing changes (Induce “tolerance”) in the immune system. These changes occur gradually over a period of many months. Patients receive injections initially 1-3 times weekly until a maintenance dose is reached. The schedule then progress to bi-weekly every 3 weeks until a monthly injection interval is reached. Weekly injections typically are necessary for the first 6-12 months. Injections begin with extremely dilute doses and then progress in a stepwise fashion until a concentrated therapeutic dose is achieved. Low-doses are initially necessary to safely “build tolerance.” Allergy serum contains the things you are allergic (animal danders –cat, dog, horse, goat, cockroach allergen, dust mites, grass, molds, tress and weeds). Desensitization for food is being researched. One or more formulas may be necessary and this is individually determined.
How long do I Have to Take Allergy Shots? Immunotherapy is a long-term approach to your problem. The typical duration of an allergy desensitization treatment plan is 3 to 5 years. During the bulk of this period, injections will be administered on a 1 to 4 week schedule. Improvement should be noted within the first year. Additional years of treatment are necessary for further improvement, and to maximize prolonged improvement after injections are discontinued.
Are the Allergy Shots working? The best way to assess progress with allergy injections is by evaluation of improvement of your symptoms and decreased need for medication. Regular follow-up appointments with our AAIR providers is necessary to help gauge your progress. Nasal symptoms should improve by 50-80% while receiving allergy injections. Improvement in asthma is more difficult to quantify, since many factors besides allergy are known to aggravate wheezing (such as infection and exercise), but a large percentage of asthma sufferers are able to decrease medications or even stop daily asthma medications. Children at risk for asthma may be able to “dodge the bullet” if allergy shots are received before wheezing occurs. Patients who fail immunotherapy usually are unable to reach the full strength does due to severe allergy or missing scheduled shots.
Are there any Side Effects of Allergy Shots?
The risk of allergy injections is an allergic reaction to the injection itself, since allergy serum is made up of the allergens to which you are sensitive.
Immunotherapy has been administered for over 100 years. Pregnant women who are on their maintenance dosage can receive shots. The site of injection should be examined before you leave our office.
It is possible to develop local swelling to the injection, which typically subsides over a period of a few hours. Occasionally, “systemic” reactions with nasal symptoms, wheezing, hives or potentially even more severe anaphylactic reactions may occur. Drop in blood pressure and severe throat closing are very rare complications of allergy shots. Deaths from allergy shots are extraordinarily rare. You may be asked to carry an epinephrine auto-injector. Most severe allergic reactions to allergy shots begin within 20-30 minutes of injections. It is, therefore, essential that the patient remain in the doctor’s office for at least that 20-minute period. This waiting period will allow us to successfully treat any reaction. All AAIR staff members are BLS/CPR certified.
Please immediately report any symptoms such as:
General: Dizziness, wooziness, feeling of impending doom
Throat: Swallowing difficulty, swelling
Nasal: Sneezing, congestion, severe dripping
Lungs: Chest tightness, Cough, Wheezing
Skin: Hives, delayed large swelling
GI: Abdominal cramps, diarrhea
*****Patients on beta blocker medication (such as propranolol) used to treat high blood pressure, arrhythmia, heart palpitations, tremors, glaucoma and migraine headache, should typically not be receiving allergy injections unless fully aware of risks. Beta blockers may increase the risk of systemic reactions to allergy shots as they can cause one to be resistant to the treatment of systemic reactions, epinephrine.
****Avoid exercise one hour before and one hour after receiving an allergy injection.
Note: Each time a new full strength vial is made, you will drop two doses from the previous shot as long as you are on schedule. You will return every 2-7 days for until you are back on your maintenance schedule. Allergy shot reactions are possible are more likely to occur during the initial build-up phase or with a newly prepared full strength serum.
Allergy injections are an effective way to decrease sensitivity to allergy provoking substances in the environment. If you have further questions regarding allergy injections, please discuss them with the AAIR staff.
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