(Allergy Shots)
Board Certified in Pediatric and Adult Allergy and Immunology
Please read and be certain that you understand the following information prior to signing this consent for treatment.
You will be asked to initial each page and sign the consent form at the end of this document.
Allergy shots are a process by which an attempt will be made to build up resistance or tolerance in your immune system to the things to which you are allergic. The effect is different in each person. Frequently, patients may need to take antihistamine/decongestants, nasal sprays, or asthma therapy with their injections in order to feel well.
ALLERGY SHOTS ARE A SUPPLEMENT TO ENVIRONMENTAL CONTROL AND MEDICAL MANAGEMENT WHERE THOSE MODES OF THERAPY HAVE FAILED TO BRING ABOUT THE DESIRED BENEFIT.
It must be understood that allergy shots are a time and a financial commitment. They are used to prevent disease; they will not help you when you are having symptoms.
In order to be considered for allergy shots, you must have documented allergy to an allergic substance. This may be documented with allergy skin testing. For more information about skin testing, see the skin testing handout. In addition, you should have symptoms upon exposure to the allergenic substance.
The allergy shot is a mixture of the allergens to which you are allergic. When you begin receiving your allergy shot, this mixture is diluted so that your body will be less likely to react to the shot. Your allergens may be divided into one or more shots. Each week the dose is increased until a maximum level is reached. This is called the maintenance dose.
Provided the patient adheres to the schedule and things go as planned, this phase will take approximately six months. Weekly injections with gradually increasing doses.
Shots are then given every two, three, and eventually at four week intervals.
Most patients do not see a significant improvement in their symptoms for six months or greater. Initially, you may actually see a worsening of symptoms when first starting allergy shots.
It is currently recommended that immunotherapy be continued for a period of 3-5 years, at which point the need for further allergy shots is reassessed.
If you miss more than two weeks of your allergy shots or you have been recently ill, schedule changes may need to be made.
Expected Results: A majority of patients improve while on allergy shots, which means that symptoms are reduced, but not necessarily completely eliminated.
Because you are receiving materials to which you are allergic, it is possible that a reaction may occur. There are two types of reactions:
These reactions usually occur within 30 minutes after the injection, although rarely may occur hours later, and include redness, swelling, and itchiness at the site of injection (similar to a mosquito bite, but the reaction can be larger).
Local reactions are common and are usually restricted to a small area around the site of the injection. However, they may involve the entire upper arm, with varying degrees of redness, swelling, pain, and itching. These reactions are more likely to occur as you reach the higher concentrations and higher volume injections.
When to Notify Staff: You should notify the medical staff if your local reaction is uncomfortable or exceeds two inches in diameter or lasts until the following day.
Home Care: Should they become uncomfortable at home, ice packs and an antihistamine can be taken.
Systemic reactions occur rarely, but are the most significant adverse reaction because of the potential danger of progression to collapse and death if not treated. Although it is the rarest of the recognized complications, death has occurred as a result of allergy immunotherapy.
An increase in your nasal/eye allergy symptoms.
Include varying degrees of rash, flushing, swelling, and/or itching of more than one part of the body. There may be mild to moderate discomfort, primarily from the itching. This reaction may occur within minutes to hours after an injection.
Rare and is characterized by swelling of any part of the body, inside or out, such as the ears, tongue, lips, throat, intestine, hands or feet, alone or in combination. This may occasionally be accompanied by asthma and may progress to the most severe reaction, anaphylactic shock. Angioedema may occur within minutes after the injection and requires immediate medical attention.
A very rare complication, but is a serious event characterized by acute asthma, vascular collapse (low blood pressure), unconsciousness, and potentially death, usually occurring minutes after a shot.
The previously listed reactions are unpredictable and may occur with the first injection or after a long series of injections, with no previous warning. All generalized reactions require immediate evaluation and medical intervention.
If a localized or generalized reaction occurs, the vaccine dosage may be adjusted for subsequent injections. Appropriate advice and treatment will be available from our office staff after a reaction.
All patients receiving immunotherapy injections should wait in the clinic area at least 30 minutes following each injection.
If you have a reaction, you may be advised to remain in the clinic longer for medical observation and treatment, and your future waiting times may lengthen.
If a generalized reaction occurs after you have left the clinic area, you should immediately return to the clinic or go to the nearest emergency medical facility.
If you cannot wait the 30 minutes after your injection, you should not receive an injection. Most systemic reactions are not life threatening if treated promptly.
If you do not remain in the clinic area for the designated time, the doctor may recommend the discontinuation of immunotherapy.
Under no circumstances will injections be permitted without the immediate availability of emergency medical treatment. If the prescribed injections are given elsewhere, our clinic must be provided with the name and address of the physician who will assume the responsibility for your injections. You will be asked to complete the "Request for Administration of Immunotherapy at an Outside Medical Facility." Our office will then contact the designated facility and confirm their availability for administration of your immunotherapy injections.
IF YOU HAVE ASTHMA, YOU SHOULD CARRY YOUR INHALER WITH YOU. In most cases your physician will prescribe a self-injectable epinephrine device that you should carry with you on allergy shot days.
We do not want you to have allergy shots if you:
Individuals with asthma are required to have a measure of their breathing (either a peak flow or pulmonary function test) prior to receiving a shot.
If your peak flow or pulmonary function is decreased, you will not be able to receive your allergy shot on that day. Proper medical treatment should be instituted and shots rescheduled.
For best results, we would like you to be committed to getting your shots on time. Immunotherapy may be discontinued at the discretion of your doctor if injections are frequently missed, as there is an increased risk of reactions under these circumstances.
If you need to be away for an extended period of time, please let us know and arrangements may be made for you to receive your immunotherapy elsewhere.
Once you are receiving your allergy shots, you are expected to see your physician on a regular basis at least once per year or often, more frequently if you have asthma. These visits are important so that the doctor can determine the effectiveness of therapy and modify it if necessary.
Your initial prescription includes all vaccine vials that are required to reach a "maintenance" dose. In order to utilize these vials prior to their expiration date, you will need to receive injections at least once a week on a regular basis. Following the suggested schedule by your physician will allow you to reach maintenance earlier, well before the expiration date of your extract.
If you become pregnant while on immunotherapy, please notify the office staff immediately, so your doctor can determine an appropriate dosage schedule for the injections during pregnancy.
Immunotherapy doses will not be advanced during pregnancy, but may be maintained at a constant level.
Please notify the office staff if you start any new prescription medication, particularly medication for high blood pressure, migraine headaches, and glaucoma.
Patients receiving allergy shots should not be on beta blockers because they function by blocking the effects of epinephrine which may be used to treat allergic reactions. If you require the regular use of a beta blocker you should not take allergy shots.
If you have any questions concerning anything about Immunotherapy, please direct the questions to one of our medical personnel.
This short video explains how the allergy vaccine preparation will work and the timeline.
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