What is Immunotherapy (IT) or an Allergy Shot?
Immunotherapy (IT) is a series of injections (shots). In each injection you are given a small amount of a mixture containing extracts to which you are allergic. You start out at a very low concentration and gradually build up to the highest concentration or what we call the “maintenance” strength. Depending on the series your doctor orders, you will go through 5 or 6 concentrations until you reach the maintenance strength.
How Does Immunotherapy (IT) Work?
IT causes changes in the immune system so when your body is exposed to the allergen (what you are allergic to) you have less of a reaction (fewer symptoms). The mechanism by which IT works is believed to be related to a desensitization process where your immune system is made more familiar to allergens you come in contact with and prevents this overreaction. After going through the course of IT prescribed by your physician, your symptoms should lessen and you should require less medicine (essentially turning this immune switch off).
How Often Will I Take Allergy Shots (IT)?
When you first start IT you should receive a shot at least once a week. When you are receiving the lower concentrations you may receive an injection as often as three times a week allowing 48 hours between injections so you can get through these lower concentrations faster. Once you reach the highest concentration or maintenance strength, the interval can be extended up to once a month depending on how well your symptoms are controlled. Our nursing staff will give you information on spreading the time interval of your shots when you reach your maintenance dose.
What if I Miss My Shots?
It is not a problem if you miss a short period of time (one to two weeks) however, it may lengthen the time necessary to reach your maintenance dose. If wait more than 2 weeks between injections, your dose may stay the same or decrease. Our providers will determine the appropriate dosage based on your previous reactions to the IT and the number of doses missed.
How Long Before I Will Start Seeing Improvement in my Symptoms?
This will vary from patient to patient. As a general rule, you will not begin to notice significant improvement until you have been on your highest concentration or maintenance strength for several months. Most patients will reach maximum benefit after they have been on their maintenance for a year to a year and a half. You should continue the allergy medications your doctor has prescribed until advised to reduce or discontinue them. You should also continue the environmental control measures recommended to you. This combination of treatments will provide the best results and a decrease in your symptoms.
How Long Will I Take IT?
This again will vary from patient to patient. However, the usual minimum course is 3 to 5 years. Some patients will remain on IT longer.
How are My Extracts Prepared?
Your extract is individually prescribed and contains protein extracts of what was positive on your skin tests. Pollen and environmental extracts are diluted in saline. Venom extracts for stinging insects are mixed with small amounts of human albumin. If you have any religious objections to receiving a very small amount of human albumin in your extract, please discuss your concerns with your physician.
What Are the Side Effects of IT?
We are not aware of any long-term side effects. However, there may be some immediate effects. The immediate side effects can range from local swelling, redness and itching at the injection site to typical allergy symptoms of itchy, watery eyes and running nose. More severe reactions may include shortness of breath, difficulty swallowing or skin rash. Rarely patients can have a severe reaction with lowered blood pressure. Studies have shown patients who are going to have the most severe reactions begin to experience symptoms within 20 to 30 minutes after receiving an injection. That is why we require you have your injection in the presence of a physician and you wait for 20 minutes after an injection. Some high-risk patients and those on the higher dosages will be asked to wait 30 minutes. These reactions can occur regardless of how long you have been on IT. If you should have any symptoms other than irritation at the site of the injection, you should let the nurse know immediately.
What Should I Do if I Develop a Reaction to My Shot After I Leave the Office?
If the reaction is at the injection site only with increased swelling or redness, you may apply ice and take an antihistamine if the reaction is bothersome to you. This should be reported to the nurses prior to your next injection as your dose may need to be adjusted. If the reaction involves an increase in allergy symptoms, hives or shortness of breath, call the office immediately. If you are experiencing severe shortness of breath, go immediately to the nearest Emergency Department or call 911. Do not attempt to drive yourself or child to the Emergency Department if you are in severe distress, instead call 911.
When Should I Not Get an Allergy Shot?
If you are acutely ill, have a fever or increased asthma symptoms you should not receive an allergy shot. If you are experiencing severe allergy symptoms, please notify the nurse prior to your injection. If you are taking beta-blocker medications (usually for high blood pressure, heart conditions, glaucoma or migraine headaches) prescribed by another doctor you should not receive an allergy shot. Notify our staff immediately if these medications are prescribed for you.
Can I Take IT if I am Pregnant?
Yes. You cannot start IT if you are pregnant. If you are already on IT and tolerating shots well then you may continue. If you become pregnant while you are still building up on your concentration then you will be maintained at your current strength without further increase until after your pregnancy. Please notify our office as soon as you know you are pregnant.
I Know Someone Who Only Takes Allergy Shots Once or Twice a Year, Why do I Need to Take Them so Frequently?
That person is not getting “allergy shots” with allergen extract but rather probably some sort of steroid. These are not the same things. The steroid shot only improves allergy symptoms temporarily while IT with allergen extract has long-term benefits.
When Can I Begin my IT?
Your allergen extract is individually prepared for you in our antigen preparation lab. It usually takes approximately two weeks to prepare. We will contact you when your extract is ready at the office. If you have not heard from us in two weeks, please call our office. Your extract expires one year from the time it is prepared so it is best to start your shots as soon as they are ready. Check with our office for walk-in shot clinic hours.