It’s spring! Nature calls us to come outside and enjoy sunny skies, warm days, and verdant green landscapes. But it is also high allergy season for those who suffer from environmental allergies. It can be miserable out there, especially if over-the-counter allergy medications aren’t effective. Fortunately, there is a solution—allergy shots (also known as subcutaneous immunotherapy or SCIT) are available for all types of allergies. They are especially effective for:
- Seasonal allergies related to pollens from grasses, weeds, and trees
- Year-round allergies caused by mold, pet dander, dust mites, or cockroaches
- Venom allergies or allergic reactions from insect stings by bees, wasps, yellow jackets, or hornets
Are You a Candidate for Allergy Shots?
“Anybody who has allergies can be considered for allergy shots,” says Mili Shum, MD, an allergist and immunologist in the Department of Dermatology at University of Utah Health. “Usually people who request the shot are those for whom allergy medications are not effective or cause side effects, or they would rather not take the medications.”
There’s a broad list for those who could be candidates for allergy shots, including those with:
- Environmental allergies that aren’t well controlled by allergy medications
- Allergies with asthma
- Allergies with atopic dermatitis
- Insect venom allergies
- Unavoidable allergens, such as someone who harvests honey but has an allergic reaction to bee stings or has dog allergies with a dog at home
Even children with environmental and venom allergies can receive allergy shots. However, “We don’t want to traumatize children with allergy shots,” Shum says. “So, the decision to start shots is based on conversations with families and when children are able to tolerate the shots. Then, we give them.” In children who have experienced anaphylaxis—a severe reaction to an allergen that can cause trouble breathing, a weak and rapid pulse, nausea, vomiting, diarrhea, or fainting—to a venom allergy, then allergy shots are recommended to prevent anaphylaxis.
Those who should avoid allergy shots include those:
- With active medical conditions until those conditions are stabilized
- With active asthma until those conditions are stabilized
- Undergoing chemotherapy
- With significant cardiac conditions
- Pregnant people shouldn’t get build-up doses of allergy shots but can stay on the same doses that they were previously tolerating. For breastfeeding mothers, it is generally okay, but Shum advises to speak with your doctor.
The Build-Up Phase: Start Off with Low Doses
Once someone decides they would like to have the allergy shots, they should be aware that it is a process—a build-up phase and a maintenance phase. It can take up to six months for the shots to begin working. According to Shum, the build-up phase varies from clinic to clinic and can last up to 10 months. At University of Utah Health, patients generally come in once a week for 18 weeks for the build-up phase. The build-up phase begins with a low-dose injection of allergens and gradually builds up to a higher dose of allergens over time.
“Every time patients come in during the build-up phase, they get a higher dose until they get to the effective doses,” Shum says. “That's to minimize the risk of a reaction that you could have from getting the effective doses right away.”
The Maintenance Phase for the Win
Once an effective dose is reached, the maintenance phase begins. Patients come in every four to six weeks for a shot. The maintenance phase can last three to five years or more, so that the benefits from the shots continue even after the patient has stopped receiving the shots.
Although the allergy shots are 80-90% effective in reducing allergy symptoms, there may be cases where individuals still need to take medication, even if their allergies are better.
“For some people, getting the shots means they won’t need to take medication every day,” Shum says. “But say a patient had been taking five allergy medications, yet they still have bad allergy symptoms. Allergy shots might help them feel a lot better so that they can reduce their meds. But they might still need to take some medications regularly.”
Serious Side Effects Are Rare
Because you are getting injected with things you are allergic to, there is always the potential of an allergic reaction. That is why the initial doses are small and why patients are required to stay at the clinic for 30 minutes after receiving a shot. If a reaction occurs, it is usually swelling at the site of the injection and itchiness.
“The likelihood of a severe reaction is much less common than getting into a car accident,” Shum says. “But we still take it seriously, which is why we monitor for 30 minutes after every shot.”
Shum’s final advice is for patients to follow up with their doctor every year or sooner if there are any problems. “At that point, you reassess how the allergy shots are working, if any changes need to be made, and whether or not it should be discontinued or continued,” she says.