Allergy shots, also called immunotherapy, are a form of treatment that
reduces a person's allergic reaction to a particular allergen.
Allergy shots can reduce symptoms of
(hay fever) and allergic
. Allergy shots are less effective against molds and are not a useful
method for treating
Allergy shorts are a series of injections with a solution containing the
allergens that cause an allergic reaction. Treatment begins with a weak
solution given once or twice a week. The strength of the solution
gradually increases with each dose. The incremental increases of the
allergen cause the child's immune system to become less sensitive
to the substance by producing a "blocking" antibody. Once
the strongest dose is reached, the child's sensitivity has
decreased, and the injections are given monthly to control allergic
The term allergy refers to a person's immunologic sensitivity to
any substance that causes an allergic reaction.
can become obvious in the first few months of life in the form of nasal
, rash, or
following food intake. Allergies affect all races and occur in all parts
of the world.
Depending on the severity and nature of the allergies, allergen avoidance
and allergy medications alone may not effectively manage symptoms in
children. Allergens that doctors most commonly use in immunotherapy
treatments for allergic
, and allergic asthma include extracts of inhalant allergens from tree,
grass, and weed pollens; mold spores; and dust mites. The doctor selects
the treatment based on the patient's particular patterns of
Allergy shots are not recommended for food allergies. However, if these
allergies are left untreated, infants and children may be more likely to
develop chronic allergies, asthma, and respiratory infections later in
life. Furthermore, knowing and managing the child's sensitivities
to food help in isolating the antigens that respond to immunotherapy.
Parents can follow a few simple steps to reduce the child's risk to
Parents considering allergy shots for their child should be referred to a
board certified allergist. An allergist will follow specific steps to
determine if allergy shots are necessary. The allergist will consider the
child's age and general health status in deciding to start allergy
treatments. The allergist will also inquire as to the child's
environment (indoor and outdoor) and related symptoms to decide if testing
is necessary. Allergy testing provides convincing evidence of specific
antibodies to which the child is reacting. A pediatric allergist can
diagnose the specific cause of the allergic reaction and
provide the correct allergen extracts. He or she may also consider the
following factors when deciding whether a child would benefit from allergy
Allergy shots are also effective in treating allergic asthma. Allergy
shots can help relieve the allergic reactions that trigger asthma episodes
and decrease the need for asthma medications.
The allergist may decide to conduct skin testing on a child to determine
the specific allergen that is causing a reaction in the child. In a skin
test, a small dose of suspect antigens is injected under the skin. The
physician looks at the injected area 20 minutes later; if it is red, with
a raised area (wheal) in the center, the reaction is positive.
Skin testing should only be performed under the supervisions of a board
certified allergist. The child should be followed closely during a skin
test, because occasionally skin testing causes a severe reaction. This
condition is unusual, since the amount of allergen used is small; however,
it can happen if the child is highly sensitive to the allergen.
Once the testing is finished, the allergist prepares an allergen abstract
(serum) specially for the child. If the child is sensitive to multiple
allergens, the physician may mix similar abstracts in one vial. Preparing
the vials in combination extracts ensures that the child receives only one
shot for each group of extracts, thus reducing the number of injections
needed for effective therapy.
The first intramuscular injection (shot) is important because based on
this experience the parent and child build an attitude toward future
injections. If the child is old enough to understand, the nurse or
physician will explain why the child must receive the injection. The
procedure should be explained in simple terms, and should proceed quickly
and as gently as possible. The child should be allowed to express his
and resentment of needles.
Although the healthcare professional will record the allergy shot in the
medical record, the parent may want to keep an updated record of the
treatment for quick reference during emergencies and when the child is
The following injections sites are recommended for children:
After the injection, the parent and nurse should take time to praise the
child for his cooperation. Infants and small children should be cuddled
and given affection for a few minutes so they do not associate the
experience only with the
. A small child may be given a toy to divert attention. Older children may
be allowed to select the site for the injection. In addition, nasal sprays
are in the early 2000s being developed as a painless alternative to
Strict adherence is essential to an effective immunotherapy program for
children. Parents should maintain as exactly as possible the injection
schedule that the allergist prescribes. They should also report
immediately to their healthcare provider any adverse reactions to the
Children who receive allergy shots may develop serum sickness or other
problems in reaction to the treatment. Serum sickness, an allergic
reaction to serum contained in the allergy shot, may occur with the first
injection or as a delayed reaction. Children may have a
moderate fever, local redness and
, or pain at the site of injection and a generalized skin eruption, most
commonly urticaria (
) associated with severe itching. The child may be uncomfortable but not
seriously ill. A more severe and less common variety of serum sickness
includes several of the following symptoms: malaise, protein in the urine,
joint pains, swelling of mucous membranes with hoarseness and cough,
. A rare and still more severe variety of serum illness produces extreme
weakness approaching collapse; the child's temperature may be
subnormal and the pulse weak. The rarest and most severe reaction, called
, produces immediate shock and can be fatal.
The symptoms of serum disease, particularly urticaria, may occur when a
child acquires sensitivity to several drugs. Penicillin is the most
frequent and important offender, and in these circumstances the symptoms
are often delayed until days or even weeks after the penicillin therapy
begins. Any of the symptoms of serum sickness may be mimicked. Immediate
severe reactions to penicillin are almost unknown in children but can
occur in adults.
There is an increased risk of a reaction with a variation of allergy shots
which "rushes" the first phase of the treatment. In this
treatment, steadily increasing doses of allergen extract are given every
few hours instead of every few days or weeks. Rush immunotherapy should
only be performed in a hospital under close supervision. Also, children
who take medication that contain beta blockers for unstable heart
conditions should not be given allergy shots unless the allergist thinks
the benefits of starting immunotherapy outweigh the risks associated with
suspending cardiac inhibitors.
—A foreign substance that provokes an immune reaction or allergic
response in some sensitive people but not in most others.
—Inflammation of the membrane lining the eyelid and covering the
eyeball; congestion of the conjunctiva, with mucus secretion.
—An immune system reaction to a substance in the environment;
symptoms include rash, inflammation, sneezing, itchy watery eyes, and
—Also called anaphylactic shock; a severe allergic reaction
characterized by airway constriction, tissue swelling, and lowered blood
—A special protein made by the body's immune system as a
defense against foreign material (bacteria, viruses, etc.) that enters
the body. It is uniquely designed to attack and neutralize the specific
antigen that triggered the immune response.
—A substance (usually a protein) identified as foreign by the
body's immune system, triggering the release of antibodies as
part of the body's immune response.
—A disease in which the air passages of the lungs become inflamed
and narrowed, causing wheezing, coughing, and shortness of breath.
—A treatment for phobias which involves exposing the phobic
person to the feared situation. It is often used in conjunction with
relaxation techniques. Also used to describe a technique of pain
reduction in which the painful area is stimulated with whatever is
causing the pain.
—An agent or class of drugs which exerts an action opposite to
that of another.
—A board certified physician specializing in the diagnosis and
treatment of allergic conditions in children.
—Inflammation and swelling of the mucous membranes that line the
—An itchy rash usually associated with an allergic reaction. Also
known as hives.
Berger, William E.
Allergies and Asthma for Dummies.
New York: John Wiley & Sons, 2000.
Lockey, Richard F., et al.
New York: Marcel Dekker Inc., 2004.
Dozor, Allen J. "Kids Health and Safety: Baby Allergy
(September 2004): 94.
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American College of Allergy, Asthma, and Immunology (ACAAI)
, March 4, 2000. Available online at
http://www.allergy.mcg.edu/advice/it.html (accessed December 13,
"Immunotherapy (Allergy Shots)."
Available online at http://www.njc.org/medfacts/shots.html
(accessed December 13, 2004)