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Allergen Immunotherapy

Purpose

Your individualized course of allergy shots (immunotherapy) is designed to decrease your allergic sensitivities. The vast majority of allergic patients (80-90%) will experience substantial reductions in their symptoms over time (months to years). Many also reduce or eliminate the need for other medications. Together with avoidance of offending allergens and medication allergy shots represent one of the recommended treatments for allergic rhinitis, allergic conjunctivitis, atopic dermatitis and asthma. Allergy shots are not useful for food/drug allergies or non-allergic conditions like infections.

Treatment Duration

The length of a treatment course varies on a case by case basis but in general a course requires 3 to 5 years of maintenance treatment for completion. Initially there is a build-up phase where the injections are given more frequently but as the High Dose, or maintenance dose, is reached the frequency of injections may be adjusted. The total duration of therapy can vary considerably from patient to patient. During your treatment you will be re-evaluated frequently by your physician. These visits will occur at least annually.

Schedule of Administration

Your series of injections begins at a low dose selected by your physician based on your skin test results and history. Over time the shots build gradually until you reach your High Dose. This High Dose is called the maintenance dose and you will stay on it for the duration of your treatment course unless it is changed by your physician. Maintenance therapy can be continued if you are pregnant BUT notify your OAAC physician when you become pregnant.

The build-up phase of the allergy shots can occur in different formats. Your physician will help you decide which is right for you. Most common is the weekly building schedule. Various accelerated schedules include: 2 or 3 time a week shots, clusters of several shots given on the same day and finally RUSH therapy where many injections are given on one day and then weekly shots follow until you are at your High Dose. RUSH therapy is associated with significantly more side effects (see below) and is not for every patient. However, it does bring you to the High Dose level in a month rather than slowly over many months. This is an advantage for some patients.

Safety

All allergy shots carry some risks for severe anaphylactic reactions. Therefore the injections need to be administered in a medical facility under medical supervision on a regular basis. Weekly or twice weekly shots from our clinic carry a risk of anaphylaxis of 0.015 to 0.02% of injections compared to nationally published risks of 0.1 to 0.3% of injections. RUSH therapy carries a nationally published risk of almost 40% of shots whereas our RUSH risk is closer to 10% of injections. This marked increase in risk however makes RUSH therapy unacceptable for many patients.

Recent News

Back to School with Asthma and Allergies
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Back to School with Asthma and Allergies

Where did the summer go? It’s almost back to school time for thousands of Oklahoma children. Is your family ready? Are your children starting a new school? Was your child recently diagnosed with an allergy, a food allergy and/or asthma? OAAC will help you be prepared for back to school!

First, if you need birth certificates, they can be ordered online oklahoma.gov/health/services/birth-and-death-certificates.html or by calling 877-817-7364. The cost is $15. Additional copies $15. There is an online/phone convenience fee of $5.

Need immunization records? You can access them online through the Oklahoma Immunization Information System Portal - shotrecords.health.ok.gov

Children with Asthma
Talk to your OAAC provider especially if your child’s asthma is not in control. Update or complete an Asthma Action plan to use at home and at school. You can download a plan from the OAAC website oklahomaallergy.com/wp-content/uploads/521-ASTHMA-ACTION-PLAN.pdf Update any medication orders. If your child is going to a new school, make an appointment to have a conversation with the school staff. Review when your child should take his/her asthma medications. Ensure your child or teen is using daily controller medications on schedule and quick-relief medication as needed.

Visit with the school’s nurse or school administrator about your child’s asthma. Take the medication, forms and supplies to school before or by the first day. For those with children who use a nebulizer, check with the school to see if you need to provide tubing and a face mask and/or the nebulizer itself.

Develop a healthy schedule which includes eating regular, nutritious meals and a set sleep routine.

Check with your child at the end of school day to see if he/she experienced any issues maintaining their asthma at school.

Children with exercise-induced bronchoconstriction may complain about participating in physical activities. However, it is very important for children to stay active, so work with school staff to develop strategies to keep your child symptom-free while exercising. These may include:
•    Using a short-acting inhaler 15 minutes prior to exercise
•    Drinking plenty of water before, during and after exercise
•    Choosing sports that are less likely to trigger symptoms.

Allergies at School

Depending on your child’s allergic condition, you may want to:
•    Tour the school to identify potential allergy triggers
•    Talk with your child’s teacher(s) and other relevant school personnel (such as sports coaches) about your child’s condition and treatment plan
•    If your child is at risk for life-threatening reactions, such as those to food or insect stings, complete an Anaphlyaxis Action Plan and show school staff how to administer autoinjectable epinephrine.

In the Classroom
There are many potential allergy and asthma triggers in schools. It is very important that your child’s allergies have been accurately diagnosed in order to determine what allergens to avoid. If your child has not been tested, make an appointment with the OAAC for testing.

Common asthma and allergy triggers in the classroom include:
•    Dust mites
•    Mold
•    Chalk dust
•    Animal dander

At Recess, Gym Class and After-School Sports
Recess may be the favorite time of the school day for many children, but for those with allergies or asthma, it can be a minefield of potential triggers.

If your child has allergic rhinitis (hay fever), you can view the daily pollen and mold counts (Monday-Friday) on the OAAC website and on social media. When levels are very high, plan accordingly if your child takes medication to control symptoms. When indoors, ask staff to keep windows closed to keep pollen out.

Insect bites can cause severe reactions in children with stinging insect allergy. Explain the symptoms to school staff and make sure your child always carries auto injectable epinephrine in case of an emergency.

Working as a team with your OAAC provider, your school staff and your family, back to school can be an easy transition with proper preplanning.

The post Back to School with Asthma and Allergies appeared first on Oklahoma Allergy and Asthma Clinic.

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