FAQs on Allergy Shots

Why do people choose allergy shots?

Most people on allergy shots chose that therapy because medications simply did not give them enough relief from their allergies. Others choose shots to reduce the number of sinus infections or asthma attacks that are triggered by allergic exposures and are not prevented by medicines. Many patients hope to reduce or eliminate their use of medications over the several years of allergy shot therapy. Others desire treatment that makes a long lasting change to a less allergic state possible. Parents may want to reduce their allergic child’s chance of developing asthma in the future by choosing several years of allergy shots.


What is in an allergy shot?

Allergy shots are not medication. Allergy shots contain extracts of natural proteins that are harvested from the natural world. Extract manufacturers carefully process and refine the pollen, dust, dander, insect venom or mold to produce a concentrated, purified liquid protein extract that can be injected under the skin with only a small chance of allergic reaction. The FDA regulates allergen extract manufacturers and helps to determine the potency of extracts. Allergy shot extracts for an individual patient are prepared by the Atlanta Allergy and Asthma Clinic Mixing Lab to exactly match the allergic sensitivities found on skin testing. Additionally for most allergens we know the “best dose” of protein to use in the allergy shot to get the best results from your treatment course. At Atlanta Allergy and Asthma Clinic you will always get the most up-to-date treatment recommendations. Our doctors consult regularly with the national experts on immunotherapy to ensure that we will be able to offer best practices.


How do allergy shots help my allergies?

Allergy shots educate the immune system in your body to better tolerate exposures to allergens in the real world. Repeated exposures to proper doses of extracts placed under the skin cause changes in the way your body’s cells “talk” to each other. Cells in the lining of your nose, eyes, and bronchial tubes become more and more tolerant of larger and larger exposures as the months of allergy shot therapy pass. This is an entirely different approach from using medications. Medications help to control allergic reactions but do not change how the body responds to exposures. By changing the body’s responses to allergens patients on allergy shots have a better quality of life and are more normal. If medications are stopped the allergy symptoms immediately return. In contrast most people who have finished 3-5 years of allergy shots continue to do well for years after the shots are stopped.


Why do I have to get the shots in a doctor’s office? Are they dangerous? Some people I know receive their shots at home.

Shots can rarely cause severe allergic reactions. But most reactions that happen are only local at the site of the injection. They can be ignored, treated with an ice pack, or helped with an over-the-counter oral antihistamine such as Benadryl or Zyrtec. Local reactions usually come up a few hours after the injection and are not dangerous. More dangerous reactions can occur and involve the skin or airway by causing hives, swelling, asthma symptoms, or more classic hay fever symptoms. These reactions occur most often within 20-30 minutes of the allergy shot and are best treated by an injection of epinephrine. Only about 1% of patients receiving allergy shots ever experience a reaction like this. This is why all patients on allergy shots should be observed following an injection.

Patients that are allowed to receive their shots at home are usually being treated by a physician who is not an allergist. This physician is also not following national guidelines for safety in immunotherapy. These shots are typically very weak compared to the recommended dose ranges and therefore may have a very small chance of causing a reaction. Of course these weaker shots may not help correct their allergy problems, either.


How often do I have to come in for a shot? How long do I have to get shots in order to get well?

Patients spend several months slowly increasing the strength of the shot week to week. Most patients come weekly during this buildup period. Some patients choose to come twice a week in order to more quickly increase the strength of the shot. Once the maintenance dose is reached only weekly shots are allowed. After a year of injections most patients spread out the shots to every other week. After 2-3 years of shots most patients can come monthly for their injections. People feel much better during their first year of injections, but may feel their best after 2-3 years of shots. Most patients stop their shots after 5 years.


Do allergy shots hurt very much?

Allergy shots are usually given in the back side of the upper arm just under the skin. They are not as painful as a flu shot or other vaccination. The needle is about the same as a typical needle used for insulin injections. Even young children rarely have issues with the pain from the shot. Atlanta Allergy and Asthma Clinic nurses daily witness children and adults receiving shots with little concern for pain. Having a small local reaction of redness and itching in the hours after the shot is somewhat common but well tolerated by most patients.


A friend told me that allergy drops under the tongue are not covered by insurance. Does my insurance cover allergy shots as a treatment?

Unlike sublingual drops, allergy shots are an FDA approved therapy and are covered by the vast majority of insurance plans. They are also covered by Medicare and Medicaid. In fact published economic studies demonstrate that allergy shots can yield savings to insurance plans by reducing the number of sick visits and medications used over a 5 year period. Allergy shots also become less expensive over time as the number of shot visits and amount of extract purchased decreases year after year. Obviously once the shots are discontinued the benefit goes on for years after at no additional cost. Drops under the tongue are done daily for years, do not spread out over time, do not decrease in cost to the patient over time, and may not give lasting benefit after they are discontinued. The proper dose of sublingual drops is a big issue as 28% of studies of sublingual drops show no benefit at all to the patient. This is not the case with allergy shots as the proper dose has been established for many allergens. While sublingual drops may be the best choice for a few patients, allergy shots remain the best studied, most effective for symptom control, most cost-effective, and has the best insurance coverage among the choices for desensitization today.