Are allergy shots the same as immunotherapy (allergy injections)?

From the Guidelines

Allergy shots are indeed the same as immunotherapy, specifically subcutaneous immunotherapy (SCIT), as confirmed by the most recent study in 2024 1. This treatment involves receiving regular injections containing small amounts of allergens that trigger your allergic reactions. The process typically begins with a build-up phase of 1-2 weekly injections for 3-6 months, gradually increasing the allergen dose, as described in the 2011 study 1. This is followed by a maintenance phase with injections every 2-4 weeks for 3-5 years. Common allergens treated include pollens, dust mites, animal dander, and insect venoms. Immunotherapy works by gradually desensitizing your immune system to specific allergens, reducing sensitivity over time and decreasing allergic symptoms. Your body develops tolerance as it produces blocking antibodies that prevent allergens from triggering allergic reactions. This treatment is most effective for allergic rhinitis, allergic asthma, and insect sting allergies. While oral immunotherapy and sublingual immunotherapy are alternative forms, traditional allergy shots remain the most commonly used and well-established form of allergen immunotherapy, with the 2024 study 1 providing the most up-to-date guidance on treatment options for allergen immunotherapy. Some key points to consider when deciding on immunotherapy include:

• The build-up phase involves receiving injections with increasing amounts of the allergen, with a frequency of 1 to 3 times a week, as outlined in the 2011 study 1
• The duration of the build-up phase depends on the frequency of the injections but generally ranges from 3 to 6 months
• The maintenance phase involves injections every 2-4 weeks for 3-5 years
• Immunotherapy can be used to treat a range of allergies, including pollens, dust mites, animal dander, and insect venoms.

From the Research

Definition and Objectives of Allergen Immunotherapy

• Allergen immunotherapy, also known as allergy vaccine therapy, involves the administration of gradually increasing quantities of specific allergens to patients with IgE-mediated conditions until a dose is reached that is effective in reducing disease severity from natural exposure 2.
• The major objectives of allergen immunotherapy are to reduce responses to allergic triggers that precipitate symptoms in the short term and to decrease inflammatory response and prevent development of persistent disease in the long term 2.

Forms of Immunotherapy

• Subcutaneous injection has traditionally been the main route of antigen delivery for immunotherapy in the United States 3.
• Sublingual administration of allergen extract has become a widely used method of immunotherapy in other countries, particularly in Europe, and offers several potential advantages, including excellent safety and tolerability, increased access to immunotherapy, and improved method of antigen delivery to children 3.
• Sublingual immunotherapy (SLIT) has been shown to modulate allergen-specific antibody responses and to reduce the recruitment and activation of proinflammatory cells in target mucosa 4.

Safety and Efficacy of Immunotherapy

• Allergen immunotherapy is safe and has been shown to be effective in the treatment of stinging-insect hypersensitivity, allergic rhinitis or conjunctivitis, and allergic asthma 2.
• SLIT is established as a safe and efficacious treatment for patients with type I respiratory allergies, with the ability to elicit antigen-specific tolerance linked to the peculiar biology of oral antigen-presenting cells 5.
• SLIT has been studied in the treatment of food allergies, including hazelnut, peach, apple, milk, and peanut allergies, with substantial focus on the treatment of peanut allergy 6.

Administration and Monitoring of Immunotherapy

• Safe administration of allergen immunotherapy requires the immediate availability of a health care professional capable of recognizing and treating anaphylaxis 2.
• An observation period of 20 to 30 minutes after injection is mandatory, and patients should not be taking beta-adrenergic blocking agents when receiving immunotherapy because these drugs may mask early signs and symptoms of anaphylaxis and make the treatment of anaphylaxis more difficult 2.