Immunotherapy (Allergy Shots)
What is immunotherapy?
Immunotherapy is a treatment used to alleviate allergic symptoms of hay fever or asthma by administering injections of substances such as pollens, mold spores, dust mites, animal danders, or insects to which an individual has been found to be allergic by skin testing.
Although the precise mechanism of its effect is the subject of current research, immunotherapy "turns down" allergic reactions to environmental allergens.
Effectiveness
Immunotherapy gradually decreases your sensitivity but improvement is usually not noticed for at least 4-6 months. However, continuation of injections leads to further improvement. Sensitivities to allergens are diminished with immunotherapy resulting in less symptoms and the need for fewer medications. While it is not common to achieve a complete cure, the vast majority of people derive a significant benefit from immunotherapy. If little or no improvement is noted after 12 months of treatment, you and your physician may decide to discontinue immunotherapy.
How are injections given and for how long?
Allergy injections are initially administered weekly in increasing doses during the "build-up" phase which typically takes 5-6 months. Allergy vials are lettered from A to E, with the E vial being the lowest concentration and the A vial being the highest concentration. You will start out getting shots twice per week for 8-12 weeks. You will then get your shots once a week. Once you have reached your "maintenance" dose, which is usually the highest dose taken from vial A, the frequency of injections will gradually spread out to once every two weeks, then once every three weeks, then once every four weeks. We recommend that your immunotherapy be administered at our facility. This is to optimize your care and safety, and to provide close supervision and monitoring. It is very important to be compliant in taking your medications, and to be compliant with your shot appointments so that you are not set back in your build-up phase. If you are not compliant with the above instructions, Dr. Schroeder has the right to terminate your immunotherapy treatment for your safety. Non-compliance can increase your risk of having severe allergic reactions.
After achieving good results for 3-5 years, you have the option of tapering and discontinuing allergy injections. Some patients will continue to do well, others may require additional medication, and some patients will require going back on allergy shots indefinitely to control their symptoms.
Reactions
Immediate and delayed local reactions such as swelling, itching, or redness at the site of the injection are common. These reactions typically subside in less than 24 hours.
Large local reactions and generalized systemic reactions occur in 1-5% of patients receiving immunotherapy. These reactions occur at any time; however, they are common during the "build-up" phase. Most generalized reactions are mild and may consist of any or all of the following symptoms: swelling and itching at the injection site; itchy eyes, nose, or throat; nasal congestion or runny nose; tightness in the throat or chest, coughing, or wheezing; and hives or generalized itching. Rarely, more severe generalized reactions occur which can lead to shock, severe shortness of breath and in extreme circumstances, even death.
Allergy injections must be administered in a medical facility where a physician is present so that reactions may be promptly and properly treated. Additionally, since virtually all serious systemic reactions will develop within 20 minutes of the injection, we require that you wait 20 minutes after every injection for observation. This is for your safety. Since certain medications can increase your risk of having a reaction, you should notify the medical staff of any changes in your medications. We should also be notified if you become pregnant.
Again, it is very important that you continue your allergy medications to help avoid reactions.
I have read and discussed the above information on immunotherapy with my physician and understand it. I have been given the opportunity to ask any and all questions that I may have and am satisfied that they have been fully answered. I understand fully the risks involved with immunotherapy and agree to abide by and follow the medical directions given to me by Dr. Vinita Schroeder. If I do not abide by these rules, I understand that Dr. Vinita Schroeder can discontinue my immunotherapy treatment due to my non-compliance.