The start of the new year often means taking a closer look at improving our health. If this examination involves your struggle with allergies, I’d like to talk to you about what is widely considered the most effective treatment: allergy shots, also known as immunotherapy.
Over the past 30 years, there has been a large amount of evidence confirming the efficacy of allergy shots in children and adults. Shots are prescribed for allergic rhinits, allergic conjunctivitis, allergic asthma and stinging insect hypersensitivity. The next few blogs will focus on various topics relating to allergy shots, also referred to as “subcutaneous immunotherapy” or SCIT.
What is the process if I need to go on shots?
- A skin test or blood test is used to identify relevant sensitivities and correlate them with the presenting symptoms.
- A prescription is written for the contents of a patient’s vial based on the skin test results. Science is constantly adding to understanding of how much of each allergen needs to be included in a maintenance allergy shot as well as what allergens can be mixed together in the vials.
- A maintenance vial (usually designated as red in color) is mixed and then diluted (ten-fold three to four times for most patients) to minimize the risk of an allergic reaction.
- It is now important to “build-up” to the effective dose working through the build up concentrations; progressing through green (1:1000), blue (1:100), yellow (1:10) and red (1:1) vials. This can take several weeks to months depending on the frequency of shots. Most patients will see significant improvement as they advance through their yellow and red vials.
- After building up, the frequency of shots is spread out. For example: every two weeks for six to 12 months, then every three weeks for six to 12 months, then once monthly until a complete three to five year duration is completed. The take home message is that shots are needed only every two to four weeks after the initial build-up stage.
- If three to five years of maintenance allergy shots are completed, patients can have a prolonged, if not lifelong, benefit. A common mistake is to stop allergy shots in the first one to two years, especially if one’s symptoms are resolved. However, it is very important to complete the full duration.
Shots are an investment that can pay long term dividends. Talk with your allergist about the risks and benefits. Don’t wait until you are miserable and finally decide to get shots. Shots need a head start on the season. Resolve to get that head start this year!
Next blog: “How often do I need to get an allergy shot?”