The purpose of allergy shots is to decrease sensitivity to inhalant allergens. It
is hoped that the decreased sensitivity will result in decreased respiratory
symptoms. However, respiratory symptoms from asthma and rhinitis (nasal symptoms)
will only improve to the extent that: 1) they are actually caused by the specific
inhalant allergen for which injections are given, and 2) the allergic sensitivity
is actually decreased by the series of injections. In actual fact, respiratory
symptoms may not all be on an allergic basis, and the allergy shots are not
always effective in decreasing sensitivity. The ability of allergy shots to
reduce allergic sensitivity appears to be greater for some allergens than for
others. For example, there is less evidence that allergy shots are beneficial for
mold sensitivity than there is for pollens. Your physician must weigh the
evidence that allergy shots to the allergen suspected of causing a clinical
problems can reduce sensitivity. Additionally, the judgment must also be made
that there will be substantial clinical benefit if allergic sensitivity were
reduced (remember, not all asthma is due to allergy) since allergy shots are an
extensive and prolonged undertaking and are not completely without risk (allergic
reactions can occur from the injections).
The procedure for allergy shots involves beginning with weekly injections of
small amounts of dilute antigen and increasing the dose and concentration slowly
over several months. Once a maximum dose is reached, a monthly maintenance
schedule is established. This takes at least 4 months and often longer. Missed
doses slow the procedure by preventing safe increases. Extended periods without
injections require that the dose be reduced to assure safety.
Side effects of allergy shots relate to the possibility of an allergic reaction
to the allergy shots. This happens in approximately 1% of injections. As long as
this is treated promptly with an injection of epinephrine, the danger from the
reaction is small. However, it is important that you wait in the doctor's office
for at least 30 minutes after receiving each injection.
Assessment of benefit from allergy shots for inhalant allergens generally
requires at least a 1 to 2- year trial. Failure to be convinced of substantial
benefit indicates the allergy shots should be considered a treatment failure and
be discontinued. If convincing benefit is apparent, then the allergy shots are
continued until there is a 2-year period without any symptoms. Consideration is
then given to discontinuing the allergy shots to see if the problem is in
remission. However, there is always the possibility that symptoms suppressed by
the allergy shots will return once they are stopped.
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