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Allergy Shots

Lots of kids have allergies. In fact, allergies are the most common cause of chronic nasal congestion in children. If your child has allergies, allergen immunotherapy (allergy shots) may be a form of treatment to consider. Read on to find out about allergy shots and how to help your child deal with them.

Could My Child Benefit From Allergy Shots?
An allergy occurs when the body's immune system has an exaggerated reaction to a usually harmless substance. The most common causes of allergies are dust mites, molds, pollen, pets with fur or feathers, stinging insects, and some kinds of foods. The body reacts to the substance by releasing chemicals, one of which is called histamine. The results of this reaction may include runny nose, congestion, sneezing, itchy eyes, and ear itching or popping. Asthma may occur in some children.

The best way to prevent or control your child's allergy symptoms is to help him or her avoid the allergen, the substance that triggers the allergy. An allergist is a doctor trained to identify which substances are causing your child's allergy, and he or she can treat and help you prevent your child's allergy symptoms.

One way an allergist can determine the causes of your child's allergies is by testing your child's reaction to specific allergens by skin or blood tests. Based on the test results, your child's doctor may recommend treatments including medications as well as a plan for avoiding exposure to allergens. If control of your child's environment and treatment with basic allergy medications are not successful, allergy shots may be recommended as the next step.

How Do Allergy Shots Help?
Allergy shots help the body build a type of immunity to specific allergens that eventually can prevent or "block" the allergen from triggering symptoms when your child is exposed. These shots contain a purified form of the allergens that are causing problems for your child. The course of shots is usually given over a 5-year period. The dosage of the allergen is gradually increased over the first 4 to 6 months to a maintenance dose, which is generally given for up to 3 years.

If you decide to undertake allergen immunology, your child may begin receiving shots containing very small doses of allergen once or twice a week. The dose is slowly increased with each shot to allow the immune system to safely adjust and build immunity to the allergens. This is called the buildup phase. Your child may not get symptom relief from allergies until higher doses are achieved at the end of the buildup phase. Once the highest effective and safe dose is reached, the frequency of shots gradually decreases to weekly, then bi-weekly, and then possibly monthly. This is called maintenance.

Are Allergy Shots Safe?
Allergy shots are really like vaccinations: They boost the defenses of the immune system to help the body block the allergic reaction. In the hands of a well-trained and experienced health professional, allergy shots are safe and effective and can be given to children as young as 4 or 5 years old.

Allergy shots, which are given year-round, work better against some substances than others. Generally, the shots are most effective against insect venoms and allergens that are inhaled, such as pollens, dust, molds, and animal dander.

When your child receives allergy shots, he or she may experience a reaction near the site of the injection. A patch of skin on the arm approximately the size of a quarter may itch and swell. This reaction is a signal that the body is responding to the allergen. You can treat this reaction by applying ice to the area and giving your child an antihistamine. More serious reactions, such as hives and itching all over your child's body or wheezing and breathing difficulties, are unusual and occur in less than 2% of patients.

Although a shot may seem like an unusual way to treat allergies (why would you want to deliberately inject the very thing that is making your child sick into his or her arm?), allergy shots are an effective method of decreasing your child's sensitivity to the things that are triggering an allergic reaction. The substances used in the shots are chosen according to the allergens identified by your child's allergist during the initial allergy tests. The United States Food and Drug Administration (FDA) oversees the standards used in preparing the materials for allergy shots given in the United States.

The American College of Allergy, Asthma & Immunology (ACAAI) suggests parents check the following to make sure their children are receiving shots safely:

• Allergy shots should be administered only under the supervision of an allergist/immunologist or other doctor specifically trained in immunotherapy.
• If your child is ill, especially with asthma or respiratory difficulties, he or she should not receive further allergy shots until the doctor has declared it safe.
• To avoid adverse interactions, be sure to tell the person administering the injections beforehand of any current medications your child is taking.

Allergen immunotherapy isn't necessary for everyone with allergies. Many children get along fine by living in homes that are as free as possible of allergens or by taking allergy medication during peak allergy season. However, many children suffer from allergies year-round, and some just can't tolerate or are uncomfortable with their medications. Many of these children can greatly benefit from allergen immunotherapy.

Are There Serious Side Effects or Reactions?

Although allergy shots have been proven to be extremely safe when given properly, they do have the potential for rare but serious reactions. This is because your child's treatment involves exposure to the substances to which he or she is known to be allergic. A qualified allergist/immunologist will have all the medications and equipment necessary at the office to treat a serious reaction immediately.

Every time your child receives an injection, your doctor will have him wait 20 to 30 minutes in the office to make sure there is no adverse reaction. The doctor's staff will be watching for early signs and symptoms that may require emergency procedures and medications. If a severe reaction occurs, 98% of the time it will occur within 20 minutes of the shot and the reaction will usually respond to treatment with an injection of epinephrine (adrenaline). In the event of a severe reaction, the doctor will also most likely reduce the dosage of allergen the next time your child gets an injection to allow his or her system to build immunity more gradually.

Millions of people each year receive allergy shots in the United States without consequence; however, to ensure your child's safety, doctors recommend that immunotherapy be given in a controlled environment where the physicians and other health care personnel are trained to respond to an emergency. Board-certified allergists/immunologists have had a minimum of 5 years of training after medical school, which ensures that patients who have problems are cared for according to the highest standards.

In some cases, for convenience, the allergist/immunologist may work together with your child's primary care doctor so that some or most of the shots can be given by your child's doctor at his or her office.

How Can I Find an Allergist/Immunologist?

Your child's primary care doctor can usually recommend a qualified allergist/immunologist. Or you can ask a family member or friend who is seeing an allergist/immunologist for a recommendation. Also, the website of the American Academy of Allergy, Asthma Immunology, www.aaaai.org, has a listing of allergists by location.

Helping Your Child Cope

An allergy shot is given with a needle that is smaller than those used for most childhood vaccinations, which makes it less painful. For kids, the shots are more scary than painful. A parent's positive and supportive attitude can go a long way toward helping the child accept the treatment and achieve successful results. Treatment seems to go much better if the parent is confident and committed to their child getting the immunotherapy.

Allergy shots may seem a bit scary at first. But understanding the benefits of allergy shots and how they work will help you and your child come to accept the shots as routine.