Immunotherapy ("Allergy Injection") Information

GOALS OF IMMUNOTHERAPY
The purpose of allergy immunotherapy is to increase your tolerance to the substance(s) encountered in your everyday environment to which you are allergic (e.g. pollen, animal danders, dust mites, molds). The immune system has a natural ability to build up a tolerance to common proteins such as self-proteins, particularly when these proteins are present in high quantity. The same kind of tolerance can be induced to allergens through a series of allergy shots. This is achieved by injecting you with small quantities of the actual substances (allergens) you are sensitive to eventually building up to high quantities. The identification of agents you may be sensitive to is accomplished by skin testing. Shot extracts then are mixed to contain a diversity of allergens which are individualized for your particular situation. The decision whether to initiate allergy injections will be based upon both your individual medical history and your skin test results.

INDICATIONS FOR IMMUNOTHERAPY
1. Inability to control your symptoms with conventional allergy and asthma medications and avoidance measures.
2. Symptoms are well controlled only with many medications over long periods of time so that management is difficult and inconvenient.
3. Medications required to control symptoms have unacceptable side effects, or excessive costs.
4. Allergic problems have potential serious complications (e.g. otitis, sinusitis, asthma) or interfere with daily activities (sleep, work, school etc.).

EFFECTIVENESS OF IMMUNOTHERAPY
The medical literature suggests that significant reductions in symptoms can be expected during immunotherapy in at least 9 out of 10 patients. If immunotherapy often can be discontinued after 4-5 years of maintenance dose shots, but continuing beyond five years may also be helpful for severely allergic patients. Studies show at least 2/3 of patients will experience many years (at least) three or more of continued symptom relief even after stopping. Generally allergy shots may reduce symptoms for years after stopping shots, provided at least 3-5 years of high dose shots are received.

SCHEDULE OF IMMUNOTHERAPY
1. Building Phase – Initially, allergy injections are given once or twice weekly for approximately 9-16 weeks. After this period, injections are given monthly (“maintenance phase,” see next paragraph). Some patients choose to get two or three sets of allergy shots at each build up visit at 20 minute intervals with the lower strength doses to allow a more rapid buildup to high effective doses. During the building phase, the dose of allergen extract can be increased even if you miss one week, but if you miss 3 or 4 weeks, the previous dose is repeated. Missing over 4-5 weeks will require a decrease in your dose. Please try to come in at least weekly while building doses and at least monthly if on maintenance doses. It is always fine to come in early or more frequently and may further stabilize allergies.
2. Maintenance Phase – While it typically takes 2-4 months, it can take up to one year for immunotherapy to reach maximum effectiveness. Symptoms may continue through your first allergy season on injections. For this reason, the decision on the effectiveness of the immunotherapy is not made until you have gone through two years of allergy seasons. At this point at least 90-95% of patients usually show benefit. Progress will be reevaluated on an annual basis.

If you would like additional detailed information on immunotherapy, contact us and make an appointment at our clinic.