Allergy Shots: Underused Treatment?

Many Scowl At Mention Of Allergy Shots But Experts Say They Can Offer Lasting Relief

(WebMD) 

Meanwhile, allergy shots continue to be covered by insurance companies – usually in full or with a modest co-pay. But even before Claritin went over the counter and changed the insurers' rules, allergy shots still seemed to make good economic sense, at least in the medical community.

In April 2000, Respiratory Reviews published a study indicating that a patient's out-of-pocket drug costs for treating year-round allergic rhinitis was $1,200. But researcher Timothy J. Sullivan III, MD, of Emory University, calculated that the same patient would pay only $800 for the first year of allergy shots – the most expensive year. In following years, when allergy shots are done monthly or even less frequently, those costs drop to between $290 and $170. Over six years, that amounts to a $1,300 to $2,900 savings with allergy shots, that study shows.

And there's the August 1999 study in TheNew England Journal of Medicine that shows allergy shots to treat grass pollens can provide up to three years of additional relief after treatment has ended. "Once you stop antihistamines and other drugs, you're right back where you started," says Zitt. Even a couple of missed doses can do that.

Allergy Shots and the Triggers They Fight

Allergy shots are effective against all sorts of allergy
triggers that float in the air, including:

• Tree pollens


• Grass pollens


• Weed pollens


• Mold spores


• Dust mites


• Cat dander


• Insect stings

But when it comes to other types of allergy triggers – such as food allergies and skin reactions – there is not enough research to support allergy shots, according to the American College of Allergy, Asthma and Immunology.

Before allergy shots begin, allergists identify the specific allergen(s) with the skin scratch test, avoiding a common problem; patients who "self-diagnose" themselves, and may reach for antihistamines under the assumption they have seasonal hay fever when they could also be allergic to year-round dust mites, mold, or cat dander.

Allergy shots benefit some patients more than others. Those with hay fever tend to fare best, with more than 90% getting
"significant" relief, says Li. Allergy shots are also extremely
effective for mild-to-moderate asthma, specifically when attacks are caused by allergies, or bee sting and other insect sensitivity.

"Allergy shots are also effective for those with cat and
dust mite allergy, but the challenge there is that there continues to be
significant continued exposure – and avoidance of the allergen is the most
important factor in preventing symptoms," Li tells WebMD. "That's what
makes mold allergies especially difficult. You really need to stop leaky pipes and other sources causing mold. That's why I personally have less confidence in mold allergy shots compared to the excellent results seen for pollen, cat, and dust mites."

Danger, Danger

Although there is a minimal risk of severe allergic reaction from allergy shots, the injections pose little risk as long as they are administered with slowly increasing doses. The reason why allergy shots typically take three to five years is because giving more "hefty" doses in a shorter time frame could trigger potentially life-threatening anaphylactic shock -- an intense reaction to an allergy trigger in which the airway can close.

Who Should Avoid Allergy Shots

Allergy shots are not recommended for those with heart disease or severe asthma. In addition, allergy shots should not be started during pregnancy but can be continued during pregnancy if they started before conception.

have to give adrenaline," says Zitt. "And you don't want to do that
during pregnancy, to heart patients, or those with severe asthma. But if you're not building up resistance, there's not that concern and allergy shots are extremely safe, well-tolerated, and highly effective for most people with allergies."