The Asthma Center

Allergy injections

Allergy Injections

Allergy injection therapy (allergen immunotherapy or allergy shots) is a treatment for reducing specific sensitivity to allergens by actually changing the underlying mechanism of allergy that causes symptoms rather than treating symptoms alone.  It is thought to work by causing changes in the immune system which ultimately decreases allergic sensitivity.  These immunologic changes include:

  • Rise in IgG antibodies that block allergen binding to the IgE antibody
  • Decrease in the production of IgE antibody
  • Decrease in the release of the chemical mediators that cause allergic reactions

Immunotherapy (allergy shots) has been recognized as an effective treatment for hayfever for more than 90 years.  Recently studies have confirmed the value of immunotherapy in allergic asthma management and sinusitis treatment.  A 2004 study confirmed what allergists have known for years: that immunotherapy for sinusitis led to significant reduction of sinus symptoms (decrease in sinus pain, nasal green/yellow mucus, nasal congestion), reduction of antibiotic use, improved quality of life and a reduction in nose/sinus surgical procedures.  In addition, if allergens are provoking your asthma symptoms, immunotherapy can treat the underlying allergen sensitivity, thus reducing your asthma symptoms. 

Treatment is carried out over a long period (generally 3 – 5 years).  Allergy injections are initially administered in very weak solutions.  The dose of allergen solution is gradually increased until a high dose maintenance level is achieved.  The goal is to achieve a high maintenance dose which affords the best symptom relief.  Improvement of symptoms usually lasts for years after completing a successful course of allergy injections. 

Allergy shots should only be given under the direct supervision of a physician, skilled in the management of anaphylaxis (a sudden and severe allergic reaction), who is present in a facility fully equipped to manage a reaction.  If you receive allergy injections under any other circumstances you are putting yourself at serious risk. 

You should remain in the office for at least 20 minutes after receiving your injection(s).  You should also carry epinephrine with you the day of your injections.  EpiPen® and Twinject™ are epinephrine products that are antidotes for any significant adverse reactions that may occur outside the office. 

If you receive beta-blocker medications, you cannot receive immunotherapy since you might not respond to emergency treatment in the event you have a reaction to your injections. 

In Europe, allergy extract immunotherapy has been given under the tongue or orally as a home treatment.  Much higher doses of extract are used and local reactions in the mouth are common.  Physicians at The Asthma Center have seen severe systemic anaphylaxis with this treatment.  Sublingual allergic immunotherapy is not an FDA approved use of allergy extracts at this time, not is it recommended or approved by national practice guidelines.