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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.

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Facts and Figures about Allergies

May is allergy and asthma awareness month. This information is from the Asthma and Allergy Foundation of America. 

What Is an Allergy?

  • An allergy is when your immune system reacts to a foreign substance, called an allergen. It could be something you eat, inhale into your lungs, inject into your body, or touch.
  • An allergic reaction can cause coughing, sneezing, hives, rashes, itchy eyes, a runny nose, and a scratchy throat. In severe cases, it can cause low blood pressure, breathing trouble, asthma attacks, and even death if not treated promptly.
  • There is no cure for allergies. You can manage allergies with prevention and treatment.
  • Allergies are among the country’s most common, but overlooked, diseases.

How Common Are Allergies?

  • More than 50 million people in the U.S. experience various types of allergies each year.
  • Allergies are the sixth leading cause of chronic illness in the U.S.

How Many People Seek Medical Care for Allergies?

  • Allergic conditions are one of the most common health issues affecting children in the U.S.
  • Each year in the U.S., it is estimated that anaphylaxis (a severe allergic reaction) to food results in 90,000 emergency room visits.

How Many People Die From Allergies?

  • The most common triggers for anaphylaxis are medicines, food, and insect stings. Medicines cause the most allergy-related deaths.
  • Black people and older adults in the U.S. have the highest rates of death due to allergic reactions to medicines, food, or unknown allergens.

What Are the Costs of Allergies?

  • The cost of nasal allergies is between $3 billion and $4 billion each year.
  • Food allergies cost about $25 billion each year.

What Are Indoor and Outdoor Allergies?

  • Indoor and outdoor allergies can lead to sinus swelling/pain, itchy/watery eyes, nasal congestion, and sneezing. Airborne allergens can cause seasonal (sometimes called “hay fever” or “rose fever”) or constant (called “persistent”) allergies.
  • Many people with allergies often have more than one type of allergy. The most common indoor/outdoor allergy triggers are: tree pollen, grass pollen, weed pollen, mold spores, dust mites, cockroaches, cat and dog dander, and rodent urine.

How Common Are Seasonal Allergies?

  • In 2018, approximately 24 million people in the U.S. were diagnosed with seasonal allergic rhinitis (hay fever). This equals around 8% (19.2 million) of adults and 7% (5.2 million) of children.
  • Seasonal allergic rhinitis is an allergic reaction to pollen from trees, grasses, and weeds. This type of rhinitis occurs mainly in the spring and fall when pollen from trees, grasses, and weeds are in the air.
  • In 2018, white children were more likely to have hay fever than Black children.
  • The same triggers for indoor/outdoor allergies also often cause eye allergies.

How Common Are Skin Allergies?

Skin allergies include skin inflammation, eczema, hives, chronic hives, and contact allergies. Plants like poison ivy, poison oak, and poison sumac are the most common skin contact allergy triggers and cause symptoms days after the exposure. But skin contact with cockroaches and dust mites, certain foods, or latex may also cause skin allergy symptoms.

  • In 2018, 9.2 million children had skin allergies.
  • Children birth to age 4 are most likely to have skin allergies.
  • In 2018, Black children in the U.S. were more likely to have skin allergies than white children.

How Common Are Food Allergies?

Nine foods cause most food allergy reactions. They are milk, soy, eggs, wheat, peanuts, tree nuts, sesame, fish, and shellfish.

  • About 32 million people have food allergies in the U.S.8,9 o About 26 million (10.8%) U.S. adults have food allergies.8 o About 5.6 million (7.6%) U.S. children have food allergies.
  • In 2018, 4.8 million (6.5%) children under 18 years of age had food allergies over the previous 12 months.
  • In 2018, 6% of Black and Hispanic children had food allergies over the previous 12 months, compared to 6.6% of white children.7 o Food allergy has increased among U.S. children over the past 20 years, with the greatest increase in Black children.
  • Milk is the most common allergen for children, followed by egg and peanut.
  • Shellfish is the most common allergen for adults, followed by peanut and tree nut.
  • Sesame is a rising food allergy. It impacts an estimated 1 million people in the United States. It was declared a major allergen in the United States in 2021.

How Common Are Drug Allergies?

  • Severe drug reactions account for 3% to 6% of all hospital admissions worldwide. Drug allergy accounts for less than 10% of these severe drug reactions.
  • The most commonly reported drug allergy is to penicillin, with up to 10% of people saying they are allergic to these drugs. However, less than 10% of these people (or less than 1% of 3 the total population) are actually allergic to penicillin drugs when evaluated for these allergies.

How Common Is Latex Allergy?

  • About 4.3% of the general population has a latex allergy.
  • Latex allergy is more common in certain occupations. Approximately 9.7% of health care workers have a latex allergy.

How Common Is Insect Allergy?

People who have insect allergies are often allergic to bee, wasp, and ant stings. Cockroaches and dust mites may also cause nasal or skin allergy symptoms.

  • Insect sting allergies affect 5% of the population.
  • As many as 100 deaths occur each year in the United States due to insect sting anaphylaxis.

The post Facts and Figures about Allergies appeared first on Oklahoma Allergy and Asthma Clinic.

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