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Allergy Shots (Subcutaneous Injection Immunotherapy)


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Introduction. Unlike medications, allergy shots attack the underlying cause of allergic illnesses. The harmful immune responses that cause allergy symptoms are toned down by giving year-round injections of a personalized vaccine. The vaccine is medication-free and contain only natural allergens (allergy-causing substances) selected by allergy test results

Can Allergy Shots really help?

Yes, if you are in generally good health and:

1) Would like to reduce your reliance on medications.
2) Are allergic to unavoidable things such as pollen, molds, dust, or bees.
3) Have allergies that interfere with school, work, or fun activities. 
4) Can make a 3 to 5 year commitment to getting regular injections.

What are allergy shots like? Allergy shots are injected using a tiny, thin needle just into the fatty triceps area (back) of the upper arms. The first shot is a very weak dose of the vaccine (often 1/10,000 of the top dose), then the dose is stepped up with each visit. Patients with multiple allergies often require one injection in both arms. Each patient must wait one-half hour in clinic after each shot .

When are they given? The build-up phase consists of 25 to 30 visits.The frequency of injections is once or twice a week, meaning that it will usually take 3 to 6 months to “build-up”. Adult patients may also select a “cluster” schedule that requires multiple injections during initial scheduled visits. There may be a small increase in the chance of allergic reactions, but with the advantage of finishing the build-up in as soon as two months with fewer injections.

The maintenance phase begins when the most effective dose is reached. This dose may be less than the usual target dose depending on the patient’s progress. Once the maintenance dose is reached, there are longer periods between injections, typically every two to four weeks.

There are no set appointments for shots. You simply walk-in anytime during posted shot hours, trying to keep to the schedule as much as possible. There is some leeway, but if you are more than a week late the dose is repeated or dropped back. Long vacations can be accommodated with planning. The best results are seen with patients who “stick to” the schedule.

Are Allergy Shots safe? Allergy shots do not contain drugs, and allergic reactions are the only side effect of concern. Most patients will experience small, red, itchy bumps at the injection site within 30 minutes. Larger reactions in the arm are fairly common, but are usually treated by adjustments of the dose. “Systemic” reactions that could consist of allergy symptoms such as cough or a runny nose can happen occasionally. Life-threatening reactions (called “anaphylaxis”) are also possible, but rarely occur. Severe symptoms could include trouble breathing, fainting, and whole-body hives. Any reactions would occur soon after the injection, so it is necessary to wait for a half-hour in the clinic. We ask that you avoid heavy exercise for 1 hour before, and two hours after, the injections. Shot patients will be prescribed an Epipen autoinjector for the rare possibility of a severe late reaction after leaving the office.

How long before shots work? Allergy shots can start to work in the first few months, but improvement may not be seen for more than a year.

What are the costs? There are two main expenses: 1) the cost of the allergy vaccines and 2) the fee for the nurse to give each set of injections.The expense is highest in the first six months, when more shots are given. The amount you pay depends on your health insurance coverage and your responsibility for copays and deductibles (note that each shot visit is not subject to normal specialist copays, but there may be a smaller copay for injections). In general, insurances do a good job of covering the expenses of allergy shots. We encourage you to discuss the coverage with our front office staff and by contacting your insurer with any questions.

When do you stop shots? The usual goal is three to five years of the maintenance injections for patients who have simple pollen allergies. There are limited studies of grass allergy showing that patients did well for several years after stopping shots once they passed the three year mark. If the patient’s response is incomplete or “up and down”, we may decide to continue injections for a longer period of time.

Where else may shots be given other than Allergy Partners offices? In the interest of safety, shots must be given in a facility monitored by a physician or qualified healthcare provider skilled in the treatment of serious allergic reactions. Many primary care offices will give injections, but it is important to ask and arrange this possibility with them beforehand.

Please call Allergy Partners of Charlottesville with any questions or to schedule an appointment: 434 951-2191

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