If you are allergic to bee stings, a little bee sting may be just what you need. This sort of logic sounds counterintuitive, but this is the premise behind allergy shots, or immunotherapy. The shots introduce trace amounts of the allergen into the blood and the body responds by creating antibodies to the allergic substance, thus building immunity against the allergen. Usually reserved for more serious allergy cases, or when allergy medications fail, allergy shots can work well for hay fever, animal dander, or bee stings. Below, two allergy experts offer a basic introduction to the benefits of immunotherapy.
How do these shots work?
BETH CORN, MD: First, a person will have skin testing done to determine what they’re allergic to, and then an extract is prepared that includes that substance (or allergen). This might, for example, include tree pollen, or dust mites, or cat dander.
Then the person receives weekly injections of the substance that they’re allergic to. And each injection is a little bit more potent than the last. Eventually the person becomes desensitized to that allergen. After about six to eight months, one gets up to maintenance therapy and then comes in on a monthly basis to maintain this immunity.
It’s effective at least 80% of the time to help reduce symptoms and help reduce the need for medications.
GILLIAN SHEPARD, MD: It stops the immune system from overreacting; stops it from going crazy every time it “sees” a cat, or whatever one is allergic to.
How long does this treatment take?
BETH CORN, MD: Immunotherapy requires a weekly injection for about six to eight months. After this time, people can receive monthly maintenance shots to maintain this immunity.
GILLIAN SHEPARD, MD: Most people who get allergy shots, if they get them for pollens or dust mites that they are exposed to regularly, will normally receive therapy for a total of three to five years. It’s not a treatment that need last forever. If, however, you are receiving treatment for cat allergy, you will need treatment for as long as you own the cat. It’s very difficult to get somebody off shots for that.
Who is a good candidate for immunotherapy?
GILLIAN SHEPARD, MD: Nowadays, we have such effective medications that in most cases, patients will be put on medications first. Then if they fail medications, they have miserable symptoms despite the medicines, they have side effects from the medicines, or they can’t stand the idea of taking a medicine regularly, they may be good candidates for allergy shots. It certainly works very well. It’s just the nuisance factor of the time and effort that’s involved that is a deterrent.
Do people still need some amount of medication for their allergies, even if the shots work?
BETH CORN, MD: In those 85% of people who improve with allergy shots, some are relieved of their allergies permanently, and will not need medications again. And some patients will still need medications, but the combination of the allergy shot and the medication will make a patient feel well.
Are there some people who should not get allergy shots?
BETH CORN, MD: Yes. Very severe asthmatics would probably not be candidates for allergy shots. The most common side effect is a local reaction to the allergy shot at the site of injection. So if someone receives an allergy shot in their arm, for example, they might get a red raised area. In the worst-case scenario, someone could actually become very short of breath and have an anaphylactic reaction (a full-body reaction) to an allergy shot, which can be reversed with adrenaline. This is very uncommon.
Anyone who receives an allergy shot has to sit in the allergist’s office for thirty minutes so that any reactions can be monitored. If they do have a bad reaction, then it’s dealt with immediately.
GILLIAN SHEPARD, MD: Almost anybody can get allergy shots, as long as they’ve tried reasonable medications first and allergy shots seem to be appropriate for them.
We don’t start allergy shots if somebody is pregnant, but many patients who are getting allergy shots on a regular basis become pregnant during the course of treatment. When that happens, what we do is whatever dose they’re getting, we just repeat that dose once a month until they deliver the baby. We don’t increase the dose. There is no risk associated with the allergy shot, but if for some reason the patient should have a reaction to the shot, we would need to give her epinephrine, or adrenaline. If you give epinephrine to a woman who’s pregnant, it will affect the uterus, usually contracting it. And there’s a very, very small chance of a miscarriage. So that’s the only reason that we don’t increase the dose in pregnant women.
We also generally don’t give them if the patient is very elderly. They may be better managed by medication.
The treatment is very safe, and has been used for more than fifty years now. The materials are always tuned up and changing, and it’s extremely effective and safe.