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Allergy Shots

Allergy shots: Hope for long-term allergy relief

Allergy shots every month for several years certainly isn’t your idea of fun — much less your child’s. But it might be a worthwhile investment in the long run.

When persistent allergies don’t respond to medication — or the medication side effects are intolerable — allergy shots may offer the best relief.

How do they work?

Allergy shots (immunotherapy) are a series of injections meant to desensitize you to specific allergens — the substances that trigger an allergic response.

To be effective, allergy shots are given on a schedule. Typically you’ll receive a shot once or twice a week for about three to six months. After that, you’ll need a shot about once a month for three to five years. For the first three to six months, the allergen dose is gradually increased with each shot. This helps your body accept the allergen as the harmless substance it is.

Are allergy shots recommended for everyone with allergies?

Allergy shots are commonly used to treat allergic rhinitis (hay fever) and asthma. If you have seasonal hay fever or asthma, you may be allergic to pollens released by trees, grasses or weeds. If you have year-round hay fever or asthma, you may be sensitive to indoor allergens such as dust mites, cockroaches, mold or pet dander. Allergy shots may also control allergic reactions to stinging insects, such as bees, yellow jackets, hornets and wasps.

But the shots don’t work on all allergies or on all people with allergies. For example, they’re not effective for food allergies. Allergy shots may not be good for you if you have severe asthma, and you shouldn’t get allergy shots for hay fever or asthma if you take a beta blocker for heart problems.

Are any tests needed ahead of time?

Yes. Before starting allergy shots, your doctor may use a skin test to confirm that your reactions are caused by an allergy and determine which specific allergens cause your signs and symptoms. During a skin test, a small amount of the suspected allergen is scratched into your skin and the area is then observed for about 20 minutes. Swelling and redness indicate an allergy to the substance.

How long does it take to get relief?

Allergy symptoms won’t stop overnight. You’ll probably enjoy some improvement in your symptoms during the first year of treatment, but the most noticeable improvement often happens during the second year. By the third year, most people are desensitized to the allergens contained in the shots.

If your symptoms don’t improve after one year of regular allergy shots, your doctor will evaluate the situation. Perhaps the allergen dose needs to be adjusted or additional allergens must be added to the shots. Sometimes, allergy shots may be stopped in favor of other treatments.

How long will relief last?

It varies. For some people, successful treatment leads to a life without allergy symptoms. For others, shots must continue on a long-term basis to keep allergy symptoms at bay.

What about reactions?

Allergy shots are usually safe. But they contain the very substances that give you grief —so reactions are possible.

  • Local reactions. You may notice redness, swelling or irritation at the site of the injection. These normal reactions typically clear up within four to eight hours.
  • Systemic reactions. These widespread reactions are less common — but potentially more serious. You may notice sneezing, nasal congestion and hives. More severe reactions may include throat swelling, wheezing or chest tightness. The most severe reactions — known as anaphylaxis — can be life-threatening.

The possibility of a severe reaction is scary — but you won’t be on your own. You’ll be observed in the doctor’s office for up to 30 minutes after each shot, when the most serious reactions are likely to occur. If you have a reaction after you leave, return to your doctor’s office or go to the nearest emergency room.

Are there special considerations for kids?

For children with allergies, allergy shots may prevent allergy-related asthma later in life. Allergy shots may keep kids from developing new allergies as well. Allergy shots can begin as early as age 5.

Weighing the pros and cons

If you wonder whether allergy shots are right for you — or your child — there’s plenty to consider. Ask yourself these questions:

  • How severe are your symptoms? Allergy shots might be most worthwhile if your symptoms are severe or tough to manage. If you have seasonal allergies, the length of the season that gives you the most trouble might influence your decision.
  • Are you happy with your current allergy medication? Shots are uncomfortable — or even frightening, especially for kids. But shots might be appealing if your allergy medication isn’t working as well as you’d like or if you’re struggling with significant side effects.
  • Can you avoid your allergens? If the allergens that trigger your symptoms are unavoidable, allergy shots might offer an alternative to medication.
  • Are you prepared for long-term treatment? Allergy shots require frequent office visits for at least several years.
  • Is cost a concern? Find out whether allergy shots are covered by your health insurance plan.

Work with your doctor to better understand the pros and cons of allergy shots. Together, you can develop the best allergy management plan for you.

Injections: How to make them easier for your child

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Most babies and toddlers receive up to 20 shots by their second birthday, and kids with health conditions such as allergies, asthma or diabetes have far more experiences with needles and doctors. It’s no surprise that needle sticks and shots are the things kids often fear most when they need to see the doctor.

Many kids are so scared of shots that they become highly distressed the moment they see a needle. Once your child is all worked up, he or she is unlikely to calm down before the injection. You can anticipate your child’s distress and take steps to reduce it before you even reach the doctor’s office.

When infants get shots

Perhaps the most important thing you can do is to stay calm and collected. Although babies can’t talk, they do sense fear and anxiety, especially in their parents. Your anxiety fuels your baby’s insecurity and fear. If you feel yourself becoming anxious, take deep breaths and relax your muscles.

Other strategies include:

  • Bring a familiar and soothing object. Your baby’s favorite stuffed animal or blanket will serve as a comforting distraction.
  • Hold and talk to your child during a shot. Comfort your baby with hugs and caresses. Your voice also helps your baby feel secure, so softly sing a familiar song or whisper reassuring words.
  • Offer a pacifier or bottle.

Preparing older children for shots

Once children can talk, you can explain how shots protect them. Because shots hurt, children often assume they are harmful or even a form of punishment. Make sure your child understands that needles are the only way to get certain medicine inside the body to prevent illness. Never let your child talk his or her way out of getting a shot.

Be honest and tell your child that the shot will probably hurt. Compare the pain to that of a mosquito bite, and emphasize that it will probably last only a few seconds.

Children who know that they’re going to get a shot generally do much better than children who aren’t told in advance. Wait until the day of the appointment to mention the shot. If you bring it up days before the event, your child may worry obsessively about it. It’s even OK to share the information right before you go into the doctor’s office.

If you promise your child there will be no shots and then learn during the visit that one is needed, you’ve created a conflict. Instead say, “The doctor will tell us, but I am not aware of any needed shots.”

Distraction techniques

Reading aloud, talking or watching a video are all good waiting-room distractions. Just before the injection, you might ask your child to:

  • Take a deep breath and blow during the injection. Some parents even provide a party noisemaker.
  • Count out loud during the shot — you might say “by the time you count to five, the shot will likely be done.”
  • Squeeze your hand as hard as the shot hurts.

Crying is OK

Most children cry after injections. It’s their way of dealing with it. So don’t make your child feel bad about crying. After the injection, praise your child: “You did a really good job.” You may even want to do something special with your child as a reward for good behavior at the doctor.

Common side effects of shots

Some shots, particularly immunizations, cause minor, temporary side effects, such as a mild fever or sore arm. To minimize these effects, you can give your child acetaminophen (Tylenol, others) before or after a shot. Follow the label instructions for the correct dose.

You can also use an ice pack on the injection site to reduce redness and swelling. If you’re concerned that your child might be having a serious reaction related to an immunization, contact your doctor as soon as possible or seek emergency care.

Part of growing up

Most people, regardless of age, don’t like to get shots. Adults typically submit to injections because they realize the benefit of the medication is worth the tiny prick of pain. With your help, your children will learn how to do this, too.

© 1998-2007 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. “Mayo,” “Mayo Clinic,” “MayoClinic.com,” “EmbodyHealth,” “Reliable tools for healthier lives,” “Enhance your life,” and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.

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