What are allergy shots?
The allergy shot, also called allergy injection or subcutaneous immunotherapy (SCIT), is a form of treatment aimed at treating allergies. While allergy medications can be very effective in improving allergy symptoms, they just cover up the symptoms, so the allergy shot was devised as a way to treat allergies by targetingthe actual cause of allergies – the immune system (which is why allergy shots are also called “immunotherapy”).

Allergy shots are not new – they were first tried over 100 years ago, in 1911 when 2 London doctors (Leonard Noon and John Freeman) used a watery extract of boiled pollen to treat an allergic individual.   Since then, allergy shots have been studied extensively and improved to make them quite effective for the treatment of environmental allergies.

What are the benefits of allergy shots?
Allergy shots are effective in improving symptoms caused by pollens, molds, animals, dust mites, and cockroaches.    IF proper doses are used (some non allergy trained physicians often use doses which are too low to be effective), allergy shots are usually successful in up to 90% of patients with seasonal allergies and in 70%-80% of individuals with indoor allergies.  Symptoms do not improve overnight as it takes time to build up the dose and for the immune system to change to a less allergic state.  Symptoms gradually improve as the dose of the shots increases.   Full results are usually achieved within about 1 year of starting injections.   Because allergy shots interact with the immune system, many people continue to have benefits many years after they have completed their treatment.  Benefits of allergy shots include:

• Allergy shots decrease allergy symptoms by about 80%
• Allergy shots decrease the chance of developing new allergies by about 50%
  
• Allergy shots reduce the risk of developing allergic asthma  by 50-70%
  
• In allergic asthma, allergy shots result in a significant reduction in symptoms and medication use.   In many, the asthma can completely go away.    For example, a study published in 1968, which looked at children with asthma, demonstrated that 70% of the children who received allergy shots for 4 years no longer had asthma.   This compared to only 20% in the placebo group.
  

There are not many studies on eczema and allergy shots, but the data which is available demonstrates that allergy shots can be effective in improving eczema if it is associated with environmental allergies, not food allergies.

Currently, allergy shots are not recommended for the treatment of hives, angioedema, food allergies, or eczema if associated with food allergies.  

Who can receive allergy shots?
Generally, children age 5 and above, and adults can receive allergy shots.    
Allergy shots are a good treatment option if you have one of the following:

• Severe allergy symptoms which significantly affect quality of life, even while taking allergy medications
  
• Significant side affects from allergy medications
  
• Have a desire to avoid using medications for the long term
  
• Frequent ear or sinus infections which are felt to be from environmental allergies
  
• Allergic asthma
  

Allergy shots are generally not suitable for individuals with heart problems, taking beta-blocker drugs, or who have
poorly controlled asthma.   Individuals considering allergy shots should discuss their particular case with a board
certified allergist.  

What are the side effects of allergy shots?
Generally, shots are very safe.   Some reactions are possible since they contain particles that your body is allergic to.    The most common reaction is what is called a local reaction.  A local reaction is an area of redness and swelling which occurs at the injection site.   It may happen almost immediately after an injection, or develop an hour or two later.  A local reaction can be bothersome as it may be itchy, but it is not dangerous.  A local reaction usually goes away on its own within a few hours.

Much less frequently, individuals can develop allergic reactions with allergy shots.  Studies show that overall, about 2% of individuals may experience an allergic reaction.     The majority of the time, these reactions. are mild, with symptoms such as watery or itchy eyes, sneezing, itchy nose or ears, post nasal drip, or hives.   Very rarely, reactions can be very severe, with symptoms such as breathing difficulties, swelling in the throat, low blood pressure, or passing out.  Some deaths have been reported from allergy shots.  Most allergic reactions develop within 30 minutes of an 

injection, therefore individuals are required to wait in the doctor's office for 30 minutes after each injection so that the physican can  treat any reaction that might occur

Did you know?

 "Long-term follow-up on
immunotherapy studies demonstrates that allergy shots for 3 years...shows persistent long-term effects on clinical
symptoms after termination of
treatment and long-term, preventive effects on later development of asthma in children with seasonal rhinoconjunctivitis. It is so far the only treatment for allergic diseases that has been shown to be able to prevent
worsening of disease and development of asthma. In this light, allergy shots should be recognized not only as first-line therapeutic treatment for allergic rhinoconjunctivitis, but also as
secondary preventive treatment for
respiratory allergic diseases"

Lars Jacobsen; Erkka Valovirta  How
Strong is the Evidence That Immunotherapy in Children Prevents the Progression of Allergy and Asthma?
Curr Opin Allergy Clin Immunol.  
2007;7(6):556-560

Rush immunotherapy

The typical build up for allergy shots takes 3-6 months and it can take 2-3 months before you
begin to notice significant improvement in symptoms.

Another way to build up allergy shots is to "rush" it.  With a "rush" build up, the equivalent of the first 10-15 doses are
given in 4-8 hours, instead of  7-15 weeks.  This means that you should reach the full dose of allergy shots in nearly half the time it would normally take, and people often start to notice an improvement in symptoms within about a month.  This is a procedure that is not offered by most allergists, but which I have been doing on frequent basis at for years.  Please contact our office if you would like more information on how rush immunotherapy can help you control your allergies more quickly.