ALLERGY SHOTS THE PROS AND CONS

An allergy shot every month for several years certainly isn't your idea of fun — much less your child's. But it might be a worthwhile investment in the long run.

When persistent allergies don't respond to medication — or the medication side effects are intolerable — allergy shots may offer the best relief.


How do they work?

Allergy shots (immunotherapy) are a series of injections meant to desensitize you to specific allergens — the substances that trigger an allergic response.

To be effective, allergy shots are given on a schedule. Typically you'll receive a shot once or twice a week for about three to six months. After that, you'll need a shot about once a month for three to five years. For the first three to six months, the allergen dose is gradually increased with each shot. This helps your body accept the allergen as the harmless substance it is.


Are allergy shots recommended for everyone with allergies?

Allergy shots are commonly used to treat allergic rhinitis (hay fever) and asthma. If you have seasonal hay fever or asthma, you may be allergic to pollens released by trees, grasses or weeds. If you have year-round hay fever or asthma, you may be sensitive to indoor allergens such as dust mites, cockroaches, mold or pet dander. Allergy shots may also control allergic reactions to stinging insects, such as bees, yellow jackets, hornets and wasps.

But the shots don't work on all allergies or on all people with allergies. For example, they're not effective for food allergies. Allergy shots may not be good for you if you have severe asthma, and you shouldn't get allergy shots for hay fever or asthma if you take a beta blocker for heart problems.


Are any tests needed ahead of time?

Yes. Before starting allergy shots, your doctor may use a skin test to confirm that your reactions are caused by an allergy and determine which specific allergens cause your signs and symptoms. During a skin test, a small amount of the suspected allergen is scratched into your skin and the area is then observed for about 20 minutes. Swelling and redness indicate an allergy to the substance.


How long does it take to get relief?

Allergy symptoms won't stop overnight. You'll probably enjoy some improvement in your symptoms during the first year of treatment, but the most noticeable improvement often happens during the second year. By the third year, most people are desensitized to the allergens contained in the shots.

If your symptoms don't improve after one year of regular allergy shots, your doctor will evaluate the situation. Perhaps the allergen dose needs to be adjusted or additional allergens must be added to the shots. Sometimes, allergy shots may be stopped in favor of other treatments.


How long will relief last?

It varies. For some people, successful treatment leads to a life without allergy symptoms. For others, shots must continue on a long-term basis to keep allergy symptoms at bay.


What about reactions?

Allergy shots are usually safe. But they contain the very substances that give you grief —so reactions are possible.

Local reactions. You may notice redness, swelling or irritation at the site of the injection. These normal reactions typically clear up within four to eight hours.
Systemic reactions. These widespread reactions are less common — but potentially more serious. You may notice sneezing, nasal congestion and hives. More severe reactions may include throat swelling, wheezing or chest tightness. The most severe reactions — known as anaphylaxis — can be life-threatening.
The possibility of a severe reaction is scary — but you won't be on your own. You'll be observed in the doctor's office for up to 30 minutes after each shot, when the most serious reactions are likely to occur. If you have a reaction after you leave, return to your doctor's office or go to the nearest emergency room.


Are there special considerations for kids?

For children with allergies, allergy shots may prevent allergy-related asthma later in life. Allergy shots may keep kids from developing new allergies as well. Allergy shots can begin as early as age 5.


Weighing the pros and cons

If you wonder whether allergy shots are right for you — or your child — there's plenty to consider. Ask yourself these questions:

How severe are your symptoms? Allergy shots might be most worthwhile if your symptoms are severe or tough to manage. If you have seasonal allergies, the length of the season that gives you the most trouble might influence your decision.

Are you happy with your current allergy medication? Shots are uncomfortable — or even frightening, especially for kids. But shots might be appealing if your allergy medication isn't working as well as you'd like or if you're struggling with significant side effects.

Can you avoid your allergens? If the allergens that trigger your symptoms are unavoidable, allergy shots might offer an alternative to medication.
Are you prepared for long-term treatment? Allergy shots require frequent clinic visits for at least several years.

Is cost a concern? Find out whether allergy shots are covered by your health insurance plan. Work with your doctor to better understand the pros and cons of allergy shots. Together, you can develop the best allergy management plan for you.