Immunotherapy (Allergy Shots)

Though not a cure, allergy shots can significantly reduce allergy symptoms in some people who are unable to avoid allergens, and who do not respond well to other medications.

What is immunotherapy?
When is immunotherapy recommended?
How long are allergy shots given?
What is "rush immunotherapy"?
Are there other therapies?

What is immunotherapy?

Immunotherapy (commonly called allergy shots) is a form of treatment to reduce your allergic reaction to allergens. Allergens are substances to which you are allergic. Research has shown that allergy shots can reduce symptoms of allergic rhinitis (hay fever) and allergic asthma. Remember, not all asthma is due to allergies. Allergy shots can be effective against grass, weed and tree pollens, house dust mites, cat and dog dander and insect stings. Allergy shots are less effective against molds and are not a useful method for the treatment of food allergy .

Immunotherapy consists of a series of injections (shots) with a solution containing the allergens that cause your symptoms. Treatment usually begins with a weak solution given once or twice a week. The strength of the solution is gradually increased with each dose. Once the strongest dosage is reached, the injections are often given once a month to control your symptoms. At this point, you have decreased your sensitivity to the allergens. You have reached your maintenance level. Allergy shots should always be given at your healthcare provider's office.

When are allergy shots for adults given at the National Jewish Health Allergy Clinic?

When is immunotherapy recommended?

If you are thinking of allergy shots, ask your healthcare provider about a referral to a board certified allergist. A board certified allergist will follow a number of steps to evaluate if allergy shots are right for you.

First, the allergist will ask you questions about your environment and symptoms. This will help determine if skin testing is needed. Prick skin testing may be done. This will help identify the specific allergens that are causing your symptoms. Skin testing should only be done under the supervision of a board certified allergist.

Once an allergy has been identified, the next step is to decrease or eliminate exposure to the allergen . This is called environmental control. Evidence shows that allergy and asthma symptoms may improve over time, if the recommended environmental control changes are made. For example, removing furry or feathered pets or following control measures for house dust mites and cockroaches may decrease symptoms. Preventing your contact with grasses, weeds and tree pollen may be more difficult. Closing outside doors and windows and using air conditioning decreases exposure in the home.

Next, your healthcare provider may recommend medication. Antihistamines and nasal medications may be recommended. Allergy shots may be recommended for people with severe allergic rhinitis . They may also be recommended for people with allergic asthma when the allergen cannot be avoided. Allergy shots should be prescribed only by a board certified allergist.

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How long are allergy shots given?

Six months to a year of allergy shots may be required before you notice any improvement in symptoms. If your symptoms do not improve after this time, ask you allergist to review your overall treatment program. If the treatment is effective, the shots often continue three to five years, until the person is symptom-free or until symptoms can be controlled with mild medications for one year. In general, allergy shots should be stopped if they are not effective within two to three years.

What is "rush immunotherapy"?

"Rush immunotherapy" is a series of allergy shots. They are given over 2 to 3 days in a row. This "rushes" the initial phase of the treatment. Increasing doses of allergen extract are given every 30 minutes to hourly instead of every few days or weeks. There is an increased risk of a reaction with this procedure. Therefore, rush immunotherapy should only be done in a hospital or high risk procedure area under very close supervision.

Are there other therapies?

There are a number of alternative treatments that claim to "cure" allergies. These methods are not supported by scientific studies. They are not approved by the American Academy of Allergy and Immunology . Unapproved alternative treatments include:

• high-dose vitamin and mineral therapy
• urine injections
• bacterial vaccines
• exotic diets

It is easy to feel overwhelmed or confused by the many different methods of allergy testing and treatment. We encourage you to work with a board certified allergist to evaluate and determine what is appropriate for you.

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This information has been approved by Hal Nelson, MD (January 2005).