ALL ABOUT ALLERGY SHOTS
Immunotherapy or "allergy shots" can be used to treat a variety of allergic problems. Over 85% of pa- tients on shots have a favorable response. Shots can be curative. They are effective in reducing the need for allergy medication. The following are answers to some of the most commonly asked questions about this form of treatment.
QUESTION 1. FOR WHAT CONDITIONS ARE ALLERGY SHOTS RECOMMENDED?
Allergy shots are recommended for patients with severe allergy symptoms not controlled with medication or for those unable to tolerate medications. Allergy shots are best suited for patients with perennial (year round) or prolonged seasonal symptoms. Shots are strongly recommended in patients who develop asthma symptoms after exposure to dust mite, cats, mold spores and pollens. Venom injections are required in those patients who have experienced severe, potentially life-threatening reactions after being stung by bees, wasps, hornets or yellow jackets.
QUESTION 2. HOW ARE THESE SHOTS GIVEN AND OVER WHAT TIME COURSE?
A treatment vial is customized for each patient. It consists of a mixture of protein extracts of the offending allergens previously identified by history and skin testing. From this vial, dilutions are made which will be injected at increasing strengths to build up productive antibody levels. Starting at very dilute concentrations, a series of injections are given underneath the skin over a strict time schedule. For traditional IT, initially shots are given once or twice a week. The interval between shots is increased with a goal of reaching a maintenance dose which is given every 2 to 4 weeks. It takes 4 to 5 months for symptoms to improve. After reaching the target maintenance dose, allergy shots are continued for 3 to 5 years in most patients.
QUESTION 3. DO ALLERGY SHOTS WORK?
Once the maintenance dose of allergen is reached, immunotherapy is effective in about 85% of patients being treated for allergic rhinitis and in about 70% of individuals with allergic asthma. Shots modify allergic symptoms making them more tolerable for the patient. They also reduce the need for additional medications and frequent doctor visits. In children, there is evidence suggesting that shots can modify the natural (?) history of allergic asthma.
QUESTION 4. WHAT ARE THE POTENTIAL RISKS OF ALLERGY SHOTS?
The major risk of shots is a systemic allergic reaction or anaphylaxis which usually occurs within 20 minutes after receiving the injection and is characterized by itching, hives and/or difficulty breathing. THIS REACTION MUST BE TREATED IMMEDIATELY WITH EPINEPHRINE! Because of the potential risk of anaphylaxis, shots must be given in a physician's office or another medical facility where emergency treatment can readily be administered. Local reactions to immunotherapy are common and do not require special treatment. These reactions can sometimes occur hours after the injection. If a local reaction from an injection is larger than the size of a quarter, you should inform your doctor, as an adjustment of the next dose may be required.
QUESTION 5. CAN ALLERGY SHOTS BE TAKEN DURING PREGNANCY?
Yes. Studies have shown that pregnant women can continue shots throughout pregnancy if they were previously receiving shots prior to becoming pregnant. There is no significant risk of this therapy to mothers or their babies. Immunotherapy, however, is never started during pregnancy.
QUESTION 6. ARE THERE ANY DRUGS THAT SHOULD NOT BE TAKEN WHILE RECEIVING IMMUNOTHERAPY?
Beta blocker medications used for heart problems, high blood pressure and/or migraines should not be taken while on shots. Examples of a few beta blockers include Inderal, Corgard, Lopressor, Tenormin and Metoprolol.
QUESTION 7. IS THERE ANY WAY TO REACH MAXIMUM DOSE ON THE ALLERGY SHOTS ANY QUICKER?
Patients who do not have asthma and the physician feels is a good candidate may be eligible for a "cluster desensitization". This method Allows an individual to build up quickly to the effective injection doses in 2 months as opposed to 5 months.
Where possible, you should eliminate household allergens according to instructions. Instruction sheets on avoidance are available for your use.
Long-term allergen injections (immunotherapy) may be required for the above allergic substances. This type of treatment can be accomplished for dust mites, molds and pollens but not for feathers, wool, foods or dog. If indicated, immunotherapy for cats is also available. Drug medications are usually required during the immunotherapy process. Favorable clinical results can be expected in about 85% of treated cases but may not occur until 9 to 12 months after beginning the injections.
The injected materials are extracts of various substances to which you are allergic. When these extract solutions are injected in the tissues under the skin, they cause "antibodies" to form which will protect you when you contact these substances in everyday life. However, stimulation of these antibodies or immunization must be done gradually in order to avoid allergic reactions. For this reason, the injections must be given gradually according to the schedule show below:
Twice a week.........
(For 11-13 wks) Once a week..........
(For 10 wks) Once every two weeks......
(For 26 wks) Once every three to four weeks..
(For 3-5 years)
If shots are proven to be effective within the first 12 months, they may be continued for up to 3 to 5 years to achieve the best long-term results.Back