General Information

  • Immunotherapy (IT), also known as allergy shots, is a form of long term treatment that decreases symptoms for people with:
    • Allergic rhinitis and allergic conjunctivitis (runny nose, congestion, sneezing and itchy watery eyes when exposed to things such as pollens and animals)
    • Allergic asthma (asthma symptoms becoming worse when exposed to things such as pollens and animals)
    • Eczema with allergy to things such as pollens and animals - Stinging insect allergy
    • Allergens are proteins that the body recognizes and cause allergy symptoms
  • IT decreases sensitivity to allergens and often leads to lasting relief of allergy symptoms even after treatment is stopped
  • Both children and adults can receive IT
  • Factors to consider when deciding if IT is right for you are:
    • Severity of your symptoms (keeping you up at night, impairing your regular activities) - How well medications and / or environmental controls are helping with your allergy symptoms
    • Your desire to avoid long term medication use
    • Time available for treatment (IT requires a significant time commitment)
    • Cost which varies depending on region and insurance coverage
  • Certain people are not candidates for IT such as those with
    • Severe or uncontrolled asthma
    • Serious medical conditions involving the heart or lungs
    • Patients on beta blocker and ACE inhibitor medications
    • IT can not be started if someone is pregnant
    • Patients who are unable to stay in the clinic for 30 minutes after each injection

How Is Immunotherapy Performed?

  • IT is given as an injection with a small needle in the upper arm starting with a weak concentration of the allergen and gradually increasing
  • There are two phases for IT:
    • Build up phase involves receiving injections with increasing amounts of the allergens about one to two times per week. The length of this phase varies from 1 - 6 months
    • Maintenance phase begins once the effective dose is reached. During the maintenance phase, there will be longer periods of time between treatments, ranging from 2 - 4 weeks in most cases
  • Most patients are treated for 3 - 5 years
  • Your body responds to injected amounts of a particular allergen, given in gradually increasing doses, by developing immunity or tolerance to the allergen

How Effective is Immunotherapy?

  • Many studies have shown that about 75% of patients have improvement in their symptoms
  • 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
  • IT can prevent the development of new allergies, and in children it can prevent the progression of allergic disease from allergic rhinitis to asthma
  • Some people experience lasting relief from allergy symptoms, while others may relapse after discontinuing allergy shots
  • Some people still need medications such as nose sprays but the amount is usually less
  • If you have not seen improvement after a year of maintenance therapy, discuss your treatment options with your allergist
  • IT for stinging insects can be life saving and protects from serious reactions if stung
  • Failure to respond to IT may be due to several factors including:
    • Low dose of allergen in the shot
    • Missing allergens not identified during the allergy evaluation - High levels of allergens in the environment
    • Exposures to non allergic triggers such as tobacco smoke

Immunotherapy Safety

  • IT should always be given by a physician who is trained to recognize and treat reactions
  • Local reactions causing swelling and redness at the injection site are common and can occur immediately or several hours after the injection
  • A large local reaction does not mean that a more serious reaction will occur with future injections
  • Some people experience mild symptoms such as sneezing, nasal congestion or hives
  • Serious and even life threatening reactions are rare but can occur and require immediate medical attention
  • Symptoms of a serious reaction include swelling in the throat, wheezing or tightness in the chest, nausea, vomiting and dizziness
  • Most serious reactions occur within 30 minutes which is why you have to wait at the doctors office for 30 minutes after every injection
  • Situations where your doctor will not give you a shot because of safety concerns include:
    • You can not wait in the clinic for 30 minutes after the shot
    • Vigorous exercise 2 - 3 hours before the shot
    • You are unwell
    • Asthma is not controlled