Immunotherapy (Allergy Shots) Frequently Asked Questions
What Is Immunotherapy?
Immunotherapy, IT for short, is the process by which your body is trained to not react to things to which it should not be reacting. IT is more commonly known as “allergy shots” and taking allergy shots for a long-enough period of time can “desensitize” you to the things to which you are allergic. Using traditional allergy shot buildup regimens, it will take a few months to reach maximum benefit from the allergy shots so don’t become discouraged if results are not immediate. Each patient is different and some people experience improvement more rapidly than others. RUSH allergy shots provide quicker relief and are explained below.
Why Would I Want Allergy Shots?
Allergy shots are the closest thing we have to a cure for allergies. Allergy shots work for pollens, molds and environmental allergens but not yet for food (although research is being done in this area). IT markedly improves allergy symptoms in excess of 85% of patients treated with recommended doses of allergens by trained allergists. Treatment with IT can help reduce your reliance on allergy medications and new evidence suggests that treatment with IT can inhibit the development of new allergies. Many patients view allergy shots as a more natural alternative than daily medications (and in many cases less expensive and less hassle).
Are Allergy Shots Good For People With Asthma?
Allergy shots are perfect for patients with asthma and allergies. Research shows that allergy shots can reduce the amount of medication it takes to control asthma and even reduce the number of asthma exacerbations. Shots are particularly helpful for patients who have seasonal asthma symptoms also. The logic behind shots in asthma is that if it is an allergen that is one of the primary triggers for your asthma (as it is in 70% of people with asthma), if you are desensitized to the offending allergen, it will not be as likely to trigger an asthma attack in the future.
What Is Involved In Getting Allergy Shots?
If you desire IT, your skin test results are reviewed so that an allergy extract can be tailor made for you to counter your specific allergies. Shots are then given (usually in the arm) in escalating doses (very, very small doses at first) until you have built up to a full dose. After reaching your full target (or ‘maintenance’) dose, shots may often be spaced out to every other week but some patients find that they feel better if they continue to take shots weekly. A newer process called ‘RUSH’ immunotherapy shortens the time it takes to get to maintenance doses of allergy extract and provides somewhat quicker relief of symptoms. You will need to see the doctor regularly while you are on allergy shots to assess your response and make sure you are getting the maximum benefit from the shots.
Do I Have to Make an Appointment for the Shots?
No. Just come in to the office (if it is your first shot, please call ahead to make sure your serum is ready) and sign in at the mirrored window. A nurse will call your name and you will then be given your shot. You should then wait 15- 20 minutes – watch the tube, read, work on your laptop – just relax. The nurse will check your shot site to make sure there is no reaction, then you can hit the road. The whole process should take less than 30 minutes.
What are the Intervals Between Shots?
In the beginning we recommend getting a shot twice a week because this will help you get up to that all-important effective maintenance dose. After the first 9 weeks (this will be different if you do RUSH), you can go to once weekly or continue at twice weekly until you reach maintenance doses. Once you are on maintenance doses and you are doing well (and happy with your results), we can talk about spacing out your shots to every other.
What if I Miss a Shot?
It is not the end of the world. Most people miss a shot here or there at some point. It just means that it will take you a little longer to reach the effective maintenance dose. If you miss too many shots in a row, your dose will have to be decreased some to reduce the chance of a shot reaction.
What About the Cost?
Most insurance companies cover allergy shots. Our front desk is happy to discuss the cost with you based on your particular insurance. As your shots kick in, you’ll probably need less allergy medication – saving you co-pays!
What is RUSH Immunotherapy?
RUSH is a quicker buildup to an effective dose of allergy shots. This is accomplished by giving several allergy shots in one day during an all-day visit at the office. Most patients who undergo RUSH report that their symptoms begin to improve in about 6-8 weeks (some even sooner) as opposed to the 3-5 months it typically takes patients to significantly improve on a traditional allergy shot buildup schedule. While very effective and generally well tolerated, the reaction rate is higher for RUSH immunotherapy, at least in the beginning of treatment. You will be given premedication to take on the day prior to, the day of the all-day RUSH and for the first shot after RUSH. This premedication greatly reduces the chances that you will have any significant reactions. The only other downside to RUSH is that it requires you to take one full day off of work. RUSH is covered by most insurance companies but please check with us to ensure that you will be covered. RUSH is not more effective than traditional allergy shots, but it does improve symptoms more quickly.
How Long Will I Be on Allergy Shots?
Research shows that in order to permanently change your immune system from being allergic to the things to which you were positive on your skin test to not as allergic to those things takes a minimum of 3-5 years on maintenance doses of shots. If you take them for shorter periods of time, they will still help your symptoms while you take them, but the benefits will probably not be permanent. After 3-5 years, we can discuss if you would like to stop shots. Some people prefer to stay on shots for longer than the recommended minimum. Most people do very well for extended periods of time after stopping shots if taken for the recommended time. It is possible to develop new allergies years down the road but being on shots for 3-5 years seems to reduce that likelihood. No matter how you choose to do shots, whether using the traditional buildup phase or RUSH, you should stay on maintenance doses for 3-5 years if you can.
Are Allergy Shots Safe?
In general, allergy shots are very safe. Because you are being given an extract to which you are allergic, there is always the chance of a reaction. Usually these are mild but occasionally they can be severe (although they are always treatable). Because of this, you must wait in the office a minimum of 15 minutes (20 minutes is better) after your shots so that if you have a reaction, you are where we can immediately help you. If you live far away you may want to get allergy shots at a local doctor, but you will still need to wait in their office for 20 minutes after the shot to be safe. If you are given an EpiPen (adrenaline syringe) please be sure to have it with you when you get your shots.
What Can I Do To Make the Experience Better?
It is normal and common to get small lumps at the site of the allergy shot. To help this, be sure to take an antihistamine pill on the day of your shot. Also, rotate which arm the shots are given in. If lumps still appear, you can take an extra dose of antihistamine that night after your shot and many people find that icing the area for about 10 minutes helps also.
What Type of Reactions Are Possible From Allergy Shots?
The most common reaction is the redness, lump or itching at the site of the shot as mentioned above. Rarely, people may experience generalized itching, hives, wheezing, shortness of breath or swelling after a shot (usually within the first 15-20 minutes which is why we ask that you wait in the office after your shot). If you were to experience any of these symptoms it is important to let the person who gave you the shot know immediately so that treatment can be initiated. Life-threatening reactions including severe swelling, wheezing or low blood pressure (fainting, lightheadedness) rarely may occur and require the immediate attention of a physician. The risk of death from allergy shots is thought to be about one in one or two million shots. A real risk, but still less risky than driving a car or flying in a plane. You are literally much more likely to be struck by lightning than die from an allergy shot.
Can I Give (or Get) My Shots at Home?
Unfortunately, no. Many years ago, doctors used sub-optimal doses of allergy shots that never caused reactions but also seldom worked correctly or helped much. The governing bodies that oversee the administration of allergy shots have all agreed that shots must be given only in a doctor’s office with access to emergency equipment and medications with an adequate waiting and observation period after each shot. This is to protect you and your family. There are no exceptions.