Friends or family may suggest a special treatment called allergen immunotherapy, or allergy shots. For over 100 years, allergy shots have been used with very good efficacy in decreasing symptom severity, reducing the need for medications, and lessening asthma symptoms. Allergy shots can be even more effective than regular medications in some cases. They usually involve regular injections of allergen extracts (the things that we are allergic to) in order to modify the way that our immune system responds to the presence of these allergens. Dr. David Swender, D.O., from Oaklawn Medical Group sheds some light on the topic.
Typically, weekly injections given under the skin of the upper arm are administered for several months to “build-up” the dose. Subsequently, a final dose, called the “maintenance dose,” is usually given every 2-4 weeks for 3-5 years. While some patients choose to continue doses for a longer period of time, your doctor will let you know if this is necessary. Patients may continue to have good symptom control after discontinuing allergy shots, sometimes for years at a time.
Certain conditions call for allergy shots more than others. According to Swender, allergen immunotherapy is indicated for treating allergic rhinitis/conjunctivitis, allergic asthma, and even some forms of eczema. Bee sting allergies can also be treated with allergy shots very effectively. Poison ivy, food, drug, and latex allergies are not effectively treated with allergen immunotherapy.
The risks of allergy shots include local swelling and itching at the site of injections. There is a small risk of anaphylaxis, a potentially life-threatening allergic reaction. Therefore, shots must be given under the care of a physician who can recognize and treat such reactions.
There are many forms of immunotherapy that are being researched, often by administering the therapy by a different route. Sublingual immunotherapy is one variation of this treatment, where the allergen extract is concentrated and given under the tongue. Currently, there are two forms of sublingual immunotherapy that are approved by the FDA—grass and ragweed sublingual tablets. In order for these to be effective, they must be dosed daily for 12-16 weeks before the start of the allergy season, as well as during the allergy season. Doses are given at home, but due to the risk of an allergic/anaphylactic reaction to the tablets, the patient must have an epinephrine autoinjector available to use if symptoms develop.