Allergy shots, also known as allergen immunotherapy, or AIT, are one of the tools we have to treat allergies. They are offered to patients with a history of allergy and positive skin tests that match their symptoms.

Good question. Allergy shots were first used in 1910, so they’ve been around for more than 100 years, but their exact mechanism of action is still not clearly understood. The idea is to develop a tolerance to the allergic substance within the body. To do this, we administer small amounts of those substances in allergy shots. The amounts are gradually increased over time, until a standard maintenance dose is reached. That maintenance dose is then continued on a monthly basis throughout the course of therapy.

Well, really…the things you’re allergic to. Tiny, sterilized particles of pollen, dander, and other allergy-causing substances. Plus some saline and glycerin, to reduce the risk of bacterial growth.

Currently, sensitivity to airborne allergens, such as pollen, dander, dust, and mold. In addition, patients with life-threatening reactions to bee, wasp, and hornet stings are excellent candidates. FDA-approved and standardized allergy shots for food allergies aren’t yet available.

At first, weekly, but the schedule isn’t rigid. The sooner you reach maintenance dosing, the sooner you’ll begin to feel relief. We allow patients to come in as often as every other day, if their schedule allows it, while building their dose and progressing to maintenance. You should plan on coming in at least weekly, though, during that build-up period, which usually lasts 2 to 3 months. Once maintenance dosing is reached, shots can be reduced to monthly. Some patients find they need to come in slightly more often, to keep their symptoms controlled, so we generally let patients on maintenance dosing set their own schedule, from one to four week intervals.

Presently, only CSHP’s Medical Center Point clinic has staff trained to give allergy shots. Immunotherapy is not administered at other CSHP locations, including the primary care clinics.

It takes at least several months for them to become fully effective. It’s often best to start them before pollen season, if possible, and not wait until symptoms begin.

Allergy shots are a commitment. The current standard is a 3 to 5 year course of maintenance dosing. After that, we discuss your progress, and whether to stop or continue. Some patients have continued relief after stopping, some relapse after a couple years. Scientific studies haven’t really been able to identify which patients are likely to have that lasting benefit, but my observation (Dr. Menich) has been that it occurs more frequently in children and teens.

We hope so. Many patients can stop their allergy medication when they reach maintenance dosing, while some still need it during peak pollen season, but get better results. Reducing medication use is one of the principal advantages of allergy shots. We do ask, though, that you continue to take an antihistamine on the morning of a shot, to reduce reactions.

The principle risk of allergy shots is a severe reaction to the shot itself. These usually occur within minutes of the shot, and can involve wheezing, hives, a drop in blood pressure, and other signs of a condition called anaphylaxis. This is why we have a non-negotiable waiting and observation period of 30 minutes after you receive your shot. Such reactions need to be recognized an treated promptly. They are relatively rare, and occur mostly in patients who are highly allergic, or who have an active infection. Patients who have a bad outcome from reactions almost always had uncontrolled asthma, or a delay in appropriate treatment. Accurate numbers are hard to come by, but most experts estimate the risk of a fatal reaction to an allergy shot at somewhere between 1 in 1,000,000 to 1 in 2,000,000.

More common are reactions at the shot site, consisting of pain and swelling. Many patients experience significant itching as well. We treat these reactions with ice, antihistamines, topical creams, ibuprofen, and sometimes prednisone.

No. The shot program is administered by our nursing staff. Dr. Menich sees his regular clinic during that time. He can provide the occasional medication refill or answer a brief question, but an allergy shot visit isn’t a good time to evaluate new problems or acute illnesses.

Yes, you should continue other medications. Dr. Menich will screen them prior to starting your AIT, to make sure you’re not on any that interfere with the immunotherapy. While you’re getting shots, it’s important that you notify us if you start any new medications, particularly those of the class called ‘beta-blockers’, usually used to treat blood pressure and cardiac problems.

A mild cold or stomach bug isn’t a problem. You shouldn’t receive a shot if you have a high fever, or are having wheezing or breathing problems.

No problem. We may have to adjust the dose slightly, but treatment can continue.

Come in for shots on a regular basis; the serum is costly, and requires storage space and staff time. Follow the safety guidelines, to keep risk to an absolute minimum. Tell us if something comes up. It really is that simple.