Q: Are Allergy Shots Effective?
If given in the correct doses, allergy shots are effective for nearly everyone. Allergy shots do not provide significant improvement of nasal symptoms if the primary underlying cause is either non-allergic rhinitis (irritant sensitivity) or a chronic sinus infection. Both of these conditions are commonly missed by inexperienced physicians. At times, only a CAT scan of the sinuses will reveal the presence of an underlying low-grade infection; as symptoms are extremely variable and physical examination is often unreliable.
Q: Who Needs Allergy Shots? Allergy shots are typically reserved for use in persons in whom the risk for anaphylaxis from the shot itself is judged to be lower than the potential benefits an individual might receive; this is usually only the case for persons with severe allergysymptoms,or frequent unavoidable allergen exposures, who's symptoms cannot be adequately controlled with conventional allergy medications such as antihistamines (Claritin / Allegra / Zyrtec etc.) and nasal steroids (Flonase / Nasonex / Nasacort etc.). Allergy shots are also used for persons with allergy medication intolerances (side-effects) and are recommended for all persons who have suffered anaphylaxis due to fire ant or bee stings.
Q: Are Allergy Shots Safe Enough for Self-administration and "Home" Use?
The great majority of adverse reactions to allergy shots occur during the initial "Build-up Phase". Injecting allergens into very allergic persons is a dangerous undertaking and can lead to severe allergic "shot reactions". For safety reason, responsible Fellowship-trained Allergist do not routinely offer their patients "home" allergy shots but rather, recommend "in-office" shot administration. Some untrained physicians inappropriately offer allergy shots to "low risk" patients (with minimal symptoms) and provide them with allergen injections that are below the Immunotherapy Practice Parameter recommended "probable effective dosing range". Persons with both asthma and allergy are at a higher risk for adverse reactions however; they are also likely to obtain improved asthma control when allergy shots are used in their medical management.
*The "Home" administration of allergy shots can be considered on a case by case basis for those who are tolerating allergy shots well (without experiencing adverse reactions) after receiving more than 6 months of in-office "Maintenance" level injections.