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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

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OKC ranked 6th most challenging city in the U.S. for pollen allergies

The Asthma and Allergy Foundation of America (AAFA) released its annual Allergy Capitals™ report for 2022 on March 2. The report identifies the most challenging cities for spring and fall allergies in the top 100 metropolitan areas in the continental United States. Cities are ranked based on spring and fall pollen scores, over-the-counter medicine use, and availability of board-certified allergists/immunologists. Oklahoma City was ranked sixth most challenging city and Tulsa ranked 21st.

For the second year in a row, Scranton, Pennsylvania, takes the top spot based on its high spring and fall pollen scores and lower-than-average number of allergy/immunology specialists per patient. The top 20 Allergy Capitals™ for 2022 are: 1. Scranton, PA 2. Wichita, KS 3. McAllen, TX 4. Richmond, VA 5. San Antonio, TX 6. Oklahoma City, OK 7. Hartford, CT 8. Buffalo, NY 9. New Haven, CT 10. Albany, NY.

AAFA began identifying annual Allergy Capitals™ in 2003. Since that first report, seasonal allergies have worsened. Climate change has caused the growing seasons to get longer and warmer, leading to higher pollen counts in both spring and fall. The warmer temperatures also get trapped in urban areas, which impacts air pollution. Urban areas are also often designed to have wind-pollinating trees instead of fruiting (or insect-pollinating) trees.

“Climate change is a public health emergency. More than 24 million people in the U.S. have seasonal allergic rhinitis which is most often caused by pollen allergies,” says Kenneth Mendez, CEO and president of AAFA. “If we don’t slow down the warming temperatures, pollen production will only intensify. This means symptoms could worsen as climate change continues to evolve.”

Allergies can also trigger asthma episodes or attacks. Around 60-80 percent of the 25 million people in the U.S. with asthma have allergic asthma.

“We see spikes in emergency room visits that coincide with spikes in pollen seasons,” said Mendez. “Around 3,600 people per year die from asthma, so it is important to address and manage asthma and allergy triggers where you live.”

Black, Hispanic, and Indigenous populations bear the disproportionate burden of air pollution, asthma, allergies, and climate change. This is the result of long history of housing policies in the U.S. that discriminate against these groups. These policies have pushed people of color to live in undesirable neighborhoods with greater environmental and social risks. As a result of systemic racism in U.S. policies, governance, and culture, racial and ethnic minority populations are more vulnerable to the health impacts of climate change.

“AAFA’s Allergy Capitals™ report helps raise awareness of the impact of pollen and climate change on individual and community health,” says Melanie Carver, chief mission officer of AAFA. “While there are steps individuals can take to manage their allergies, we need communities to improve their city planning and take action on health disparities impacting higher risk populations.”

For people who are impacted by pollen allergies, there are options available to prevent or treat allergy symptoms.

A board-certified allergist can diagnose allergies, and determine the specific triggers that cause them, through simple tests. The allergists at Oklahoma Allergy & Asthma Clinic (OAAC) evaluate and manage patients of all ages.  The main clinic is on the Oklahoma Health Center campus.  For patient convenience, satellite offices are in Edmond, Norman, Midwest City and Yukon.

The post OKC ranked 6th most challenging city in the U.S. for pollen allergies appeared first on Oklahoma Allergy and Asthma Clinic.

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