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Allergy and Immunology
What is immunotherapy?

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Immunotherapy is the most effective form of therapy when medications are not adequately controlling your allergy symptoms. Immunotherapy works especially well for individuals significantly allergic to airborne (not food) allergens which cannot be avoided, including pollens, house dust, molds and animal danders.

If immunotherapy is recommended by your allergist, an allergy treatment program will be tailored for you based on your clinical history and skin-test reactivity.

The injections are designed to modify your sensitivity so that re-exposure to the offending allergy-producing substance results in decreasingly severe reactions or a "blocking effect." This "blocking effect" is produced by introducing the allergen, the substance causing the reaction, requiring the immune system to develop blocking antibodies. The ultimate goal is to reduce your allergic reactions.

Injections will be started at very small doses. With each injection, the dose will be raised as tolerated until you reach a "maintenance dose" that has been predetermined. Some patients are not able to reach this predetermined dose of allergen and may begin to have reactions from the injection process. These reactions can include a sore or swollen injection site. Occasionally, an increase in your original symptoms will occur. These types of symptoms are most always seen in the first 20 minutes following an injection.

This is why all patients are required to wait 20 minutes following an injection before leaving our office.

Rarely, you may note a pattern of increased symptoms occurring several hours after injections. This and all other reactions must be reported to the nurse before the next injection is given. Severe reactions indicate that the allergen dose must be adjusted. If you experience a serious reaction, such as generalized itching or difficulty breathing, return immediately to the Allergy Department for treatment.

Immunotherapy injections will be given frequently (once or twice a week) while the allergen dose is being raised. This frequency reduces your risk of reaction and is intended to get you to the maximum therapeutic dose as rapidly as is practical. After this dose (called the maintenance dose) has been achieved, your interval between injections will be gradually decreased, to once per month if tolerated. When more than four weeks between shots has elapsed, the maintenance dose must be reduced to avoid complications.

Improvement should not be anticipated immediately. Relief of symptoms with immunotherapy may be achieved after only a few months, but more frequently you should expect a trend of improvement over a six to 12 month period. Allergy shots do not cure allergies, they help you function with them.

The length of time you will be maintained with injections depends on your response to treatment. The goal is to have you free of symptoms for one year. The average duration of treatment has been suggested from three to four years, but in many instances treatment is required beyond this time frame.

Duration and therapy considerations will be tailored especially for you. This emphasizes the importance of regular follow-up evaluations with your physician every three to 12 months, depending on the severity of your allergies.

Medication does not affect allergy injections. Do not withhold any medications on the day of your appointment. If you are having significant allergy symptoms or are suffering from an infection, injections are usually deferred until you are well.

Allergy injections should always be given in a medical facility by trained personnel with a physician available at all times. Never receive your injections at home, even if given by a physician or nurse. If you have concerns or questions about your treatment, please feel free to discuss them with Allergy Department staff.

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