Should I take allergy shots (immunotherapy) for allergic rhinitis and allergic asthma?

Introduction

This information will help you understand your choices, whether you share in the decision-making process or rely on your doctor's recommendation.

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Key points in making your decision

There is no cure for allergic rhinitis or allergic asthma. Allergy shots may provide long-term relief of symptoms. Consider the following when making your decision:

Allergy shots will probably help you. They are effective for most people and can reduce symptoms if you are allergic to pollens, animal dander, dust mites, mold, or cockroaches.1 Allergy shots may prevent children with allergic rhinitis from getting asthma.1
You need to take allergy shots for 3 to 5 years.
You cannot be sure how long the shots will be effective after you stop getting them. For allergies to some grasses, shots have been effective for 3 or 4 years.1
Allergy shots work best when you are allergic to just a few allergens that are difficult to avoid.
If you have coronary artery disease, are using beta-blockers, are not able to communicate how the shots are working, are pregnant, or have an impaired immune system, allergy shots are not recommended.
Children may use allergy shots if they have persistent asthma made worse by allergens.
Children younger than 2 should not have allergy shots.
Children ages 3 to 4 may find it difficult to receive many shots over a long period of time. Talk with your doctor.
Your child's asthma needs to be well controlled before he or she gets allergy shots.
Medical Information

What are allergic rhinitis and allergic asthma?

Allergic rhinitis (often called hay fever) occurs when your immune system overreacts to particles in the air that you breatheyou are allergic to them. Your immune system attacks the particles, causing symptoms such as sneezing and a runny nose. The particles are called allergens, which simply means they can cause an allergic reaction.

Asthma is a long-lasting condition that results in difficulty breathing, wheezing, tightness in the chest, and coughing. When allergens such as pollens, dust mites, animal dander, cockroaches, and mold make your symptoms worse, it is known as allergic asthma.

What are the risks of allergic rhinitis and allergic asthma?

Allergic rhinitis can affect your health if you do not treat it. You may get complications such as sinus infections, plugged ears or ear infections, and sinusitis.

If you do not control allergic asthma, it increases your risk of complications from lung and airway infections, such as bronchitis and pneumonia.

What are allergy shots?

When you get allergy shots (immunotherapy), your allergist or doctor injects small doses of substances that you are allergic to (allergens) under your skin. This eventually decreases your reaction to the allergen and, over time, may reduce the symptoms of allergic rhinitis. Allergy shots are available for allergies to:

Pollen (ragweed, grasses, trees).
Dust mites and cockroaches.
Animal dander (dog and cat).
Mold (fungus).
For more specific information about getting allergy shots, see allergy shots for allergic rhinitis or allergy shots for asthma.

For more information, see the topic Allergic Rhinitis, Asthma in Teens and Adults, Asthma in Children, or Allergic Reaction.

Your Information

Your choices are:

Try to eliminate or avoid the allergen.
Continue to take medicine to control your allergy and/or asthma symptoms.
Get allergy shots in addition to taking medicine to control your symptoms.
The decision about whether to have allergy shots takes into account your personal feelings and the medical facts.

Deciding about allergy shots
Reasons to take allergy shots Reasons not to take allergy shots
Allergy shots are effective in treating allergic rhinitis and allergic asthma.1 The shots reduce symptoms in people who are allergic to pollens, animal dander, dust mites, mold, and cockroaches.1
Allergy shots may prevent the development of asthma in children with allergic rhinitis.1
You have tried medicine and have avoided allergens, and you still have severe symptoms.
You have tried medicine but can't deal with the side effects.
You want to treat the cause of your problem, not just the symptoms.
A life-threatening, whole-body reaction (anaphylaxis) to the shots, although rare, is possible.
If you have another medical condition, such as asthma or coronary artery disease (CAD), you are at increased risk for a severe reaction to the shots.
Experts do not know how long allergy shots are effective after you stop getting the shots. For allergies to some grasses, shots have been effective for 3 or 4 years.1
You may need to have shots for 3 to 5 years.
Allergy symptoms do not improve, or do not improve to the same degree, for everyone who uses allergy shots.
You are allergic to many different types of allergens.
Allergy shots are expensive.
You are pregnant.
You believe you can do more to avoid or eliminate allergens.
Your child with allergies is younger than 5.
Are there other reasons you might want to have allergy shots?
Are there other reasons you might not want to have allergy shots?
These personal stories may help you make your decision.

Wise Health Decision

Use this worksheet to help you make your decision. After completing it, you should have a better idea of how you feel about taking allergy shots. Discuss the worksheet with your doctor.

Circle the answer that best applies to you.

Other than my allergy, I am healthy.
Yes No Unsure
I have asthma, but it is under control.
Yes No Unsure
I am taking beta-blockers.
Yes No Unsure
I can do more to avoid or eliminate allergens.
Yes No Unsure
I am pregnant.
Yes No Unsure
I have tried avoiding allergens and using medicine, but nothing has helped.
Yes No Unsure
I understand that allergy shots do not work for everyone.
Yes No Unsure
I understand there is a risk of life-threatening anaphylaxis.
Yes No Unsure
My child with allergies is younger than 5.
Yes No NA*
My child has allergic rhinitis, and I want to reduce his or her risk of developing asthma.
Yes No Unsure
I understand I may need regular shots for 3 to 5 years.
Yes No Unsure
*NA = Not applicable

Use the following space to list any other important concerns you have about this decision.

What is your overall impression?

Your answers in the above worksheet are meant to give you a general idea of where you stand on this decision. You may have one overriding reason to take or not take allergy shots.

Check the box below that represents your overall impression about your decision.

Leaning toward taking allergy shots
Leaning toward NOT taking allergy shots
Return to the topics:

Allergic Reaction
Allergic Rhinitis
Asthma in Teens and Adults
Asthma in Children
Allergy Tests
References

Citations

Joint Task Force on Practice Parameters (2003). Allergen immunotherapy: A practice parameter. Annals of Allergy, Asthma, and Immunology, 90(1, Suppl 1): S1S40.

Credits

Author Debby Golonka, MPH
Editor Susan Van Houten, RN, BSN, MBA
Associate Editor Pat Truman, MATC
Primary Medical Reviewer Caroline S. Rhoads, MD
- Internal Medicine
Specialist Medical Reviewer Harold S. Nelson, MD
- Allergy and Immunology
Last Updated August 8, 2007
Medical Review: Caroline S. Rhoads, MD - Internal Medicine
Harold S. Nelson, MD - Allergy and Immunology
Last Updated: August 8, 2007
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ADDITIONAL INFORMATION

Allergic Reaction
Allergy Tests