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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

Oklahoma City Ranks Ninth for Most Challenging Cities for Allergies
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Oklahoma City Ranks Ninth for Most Challenging Cities for Allergies

The Asthma and Allergy Foundation of America (AAFA) released Feb. 23 its annual Allergy Capitals™ report for 2021 which identifies the most challenging cities for spring and fall allergies in the top 100 metropolitan areas in the United States. Oklahoma City was ranked ninth. Scranton, Pennsylvania took the top spot for 2021.

Cities are ranked based on three factors: spring and fall pollen scores, over-the-counter medicine use, and availability of board-certified allergists. Richmond, Virginia held the #1 title in 2020. The top 20 Allergy Capitals™ for 2021 are: 1. Scranton, Pennsylvania; 2. Richmond, Virginia; 3. Wichita, Kansas; 4. McAllen, Texas; 5. Pittsburgh, Pennsylvania; 6. Hartford, Connecticut; 7. Springfield, Massachusetts; 8. New Haven, Connecticut; 9. Oklahoma City, Oklahoma; 10. Bridgeport, Connecticut; 11. Albany, New York; 12. Virginia Beach, Virginia; 13. Buffalo, New York; 14. San Antonio, Texas; 15. Dayton, Ohio; 16. Riverside, California; 17. Las Vegas, Nevada; 18. Memphis, Tennessee; 19. Dallas, Texas; and 20. Louisville, Kentucky. Tulsa, Oklahoma was ranked 21.

“Allergies are a serious public health concern. More than 24 million people in the U.S. have seasonal allergic rhinitis, more commonly referred to as hay fever. Pollen allergies are a major cause. AAFA’s Allergy Capitals™ report helps more Americans make sense of the impact on individual and community health,” says Kenneth Mendez, CEO and president of AAFA. “Two notable parts of our 2021 report include the effect of COVID-19 and climate change on seasonal allergies. In 2020, fewer people felt the impact of pollen allergies. This is likely due to COVID-19 restrictions with more people staying indoors. But climate change continues to cause longer and more severe allergy seasons. If we don’t slow down the cycle, pollen production will only intensify. This means symptoms could worsen as climate change continues to evolve.”

Seasonal pollen allergies cause nasal, sinus, and other symptoms each spring through fall. Pollen can also trigger asthma attacks. Tree pollen season starts as early as January in some parts of the U.S. and continues through summer. In the fall, weed pollen including ragweed, causes symptoms. But relief is possible with the right treatment and by managing contact with pollen. Oklahoma City just had several allergy alert days in March for cedar and elm tree pollen which is always problematic in the winter months.

“It’s important people with seasonal allergies prepare. They should try their best to reduce exposure to pollen,” says Dr. Mitchell Grayson, chair of AAFA’s Medical Scientific Council and Director of the Division of Allergy and Immunology at Nationwide Children’s Hospital and The Ohio State University. “Schedule an appointment with your allergist to work on a treatment plan together to help reduce allergy symptoms when prevention is not enough.”

Treatment options include over-the-counter or prescription allergy medicines. Medications are most effective when started before allergy season begins.

“If medicines are not helping, it is important to establish care with an allergist to discuss what treatment options are best to reduce your allergy symptoms and attacks,” said Oklahoma Allergy & Asthma Board Certified Allergist (OAAC) Dr. Laura Chong.

The Allergy Capitals™ ranking is an annual research and educational project of AAFA, designed to help patients recognize, prevent and safely treat allergy symptoms. Through this ranking, AAFA raises awareness about the impact of seasonal allergies and provides helpful information designed to improve the quality of life for people who experience them. The ranking is based on local spring and fall pollen levels, use of allergy medication and the number of board-certified allergists in each metro area. Visit allergycapitals.com to see the full list, study methodology and learn more about allergy diagnosis, prevention and treatment.

To see the complete, 100-city list go to allergycapitals.com. The report lists overall annual rankings and breaks down a seasonal ranking for spring and fall.

The post Oklahoma City Ranks Ninth for Most Challenging Cities for Allergies appeared first on Oklahoma Allergy and Asthma Clinic.

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