Wondering if allergy shots can help? Here’s what to know

The arrival of spring is often cause for celebration — however, for some it can bring an onslaught of unwelcome symptoms: sneezing, itching, nasal congestion, watery eyes and more.

If this happens to you or someone in your family, perhaps you’ve wondered about getting allergy shots, also known as allergen immunotherapy.

Our immune system protects us from all kinds of foreign invaders, such as viruses and bacteria. But sometimes it also reacts to other substances in our environment, like pollen or bee venom, and these reactions can range from merely unpleasant to debilitating — even life-threatening, in some cases.

“Allergy shots help the immune system build up tolerance to things in the environment it doesn’t like,” says Niharika Rath, MD, FAAP, a board-certified pediatrician who specializes in allergies and immunology at Mary Bridge Children’s. “While the shots aren’t always a cure for allergies, over time they can lead to significant improvement in symptoms.”

Who can get allergy shots?

Allergy shots are intended for adults and children over the age of 6 who experience environmental allergies that interfere with their well-being. Environmental allergies include:

• Pollen from trees, grasses and weeds
• Pet dander from animals like cats and dogs
• Dust mites
• Mold

“Allergy shots might be a good choice for people whose allergy medications aren’t working for them anymore,” Dr. Rath says. “Or they can be a possible next step for people who want to reduce their reliance on these medications in the long term.”

Beyond environmental allergies, allergy shots can also be prescribed for people with a history of anaphylaxis (a life-threatening allergic reaction) to venoms from stinging insects, such as wasps, bees, yellow jackets and hornets. However, the testing required and risks involved in getting shots for these types of allergies differ from environmental allergies.

It’s also important to note that allergy shots may not be a safe option for people with certain conditions, such as uncontrolled asthma, or those taking certain medications, such as beta blockers.

What it’s like to get allergy shots

One of the of the most important things to know about allergy shots is that they aren’t a quick fix. People who pursue this form of therapy receive injections on a weekly basis for six to eight months and then on a monthly basis for three to five years.

“We formulate the shots depending on what you’re allergic to, so there’s no one-size-fits all approach,” Dr. Rath says. “We start out with a low dose and build up that dosage over time. We don’t really expect people to start seeing improvements in their symptoms until the six-month mark or more.”

Allergy shots are also not risk-free. Often, reactions are mild and can include:

• Skin irritation or minor swelling around the site of the injection
• Nasal congestion
• Itchy, watery eyes

Typically, these reactions resolve within 48 hours of receiving a shot. While less common, some people experience serious or life-threatening reactions, such as trouble breathing. Allergy specialists take several precautions to keep patients safe during this process.

“Before each shot, we ask most people to take an antihistamine, which helps reduce the chances of a reaction,” Dr. Rath says. “Also, most severe reactions happen within 30 minutes of exposure to an allergen, so we require a 30-minute observation period after each injection.”

People with conditions like asthma or who are at high risk for severe reactions may be required to carry an epinephrine auto-injector (commonly known as an EpiPen) to reverse life-threatening symptoms.

“If people are having serious reactions to injections or reactions that are getting progressively worse, then we’ll talk about backing off the dosage or reevaluating whether the shots are a good fit,” Dr. Rath says. “People can stop taking allergy shots at any point in the process, but without completing the full course of therapy, their allergy symptoms can return.”

How to get started with allergy shots

The first step to getting allergy shots is to make an appointment with an allergist who provides this type of therapy. You may need a referral from your primary care provider to make this appointment.

Following a consultation with an allergy specialist, patients undergo skin testing for environmental allergies. During these types of tests, small needles are used to introduce specific allergens to the skin. These needles do not penetrate the skin very deeply; most patients experience only brief, mild discomfort and itching.

Depending on the results of the skin test, you and the allergy specialist will discuss if allergy shots may be a good option for you. If you decide to proceed, the contents of your shots are formulated, which can take between two and six weeks.

Another consideration when starting allergy shots is timing.

“For people who have significant seasonal allergies, I recommend not starting the shots during the peak of that season,” Dr. Rath says. “If you’re getting heavily exposed to allergens in your environment and through the shots, it can increase the risk of reactions.”

Before starting the shots, it’s also important to consider the time commitment involved.

“Because we slowly build up the dosage over time, people should be committed to attending weekly appointments,” Dr. Rath says. “If patients consistently miss appointments, then it will take longer to see symptom improvement and to get to the stage where they only have to come in monthly.”

Most insurance plans cover allergy shots, though it’s best to check with your individual plan before proceeding.

For more information about allergy shots, talk to your pediatrician or visit Mary Bridge Children’s allergy and immunology services.