Yes, Allergy Immunotherapy Shots Are Given Subcutaneously
Allergen immunotherapy injections must be administered subcutaneously in the lateral or posterior portion of the arm, specifically at the junction of the deltoid and triceps muscles. 1
Route of Administration
The subcutaneous route is the standard and required method for allergy immunotherapy injections. This route is specifically chosen because:
- Subcutaneous injections create a reservoir of allergen extract that is slowly absorbed, which is the intended mechanism of action 1
- Intramuscular injection must be avoided as it causes too-rapid absorption and significantly increases the risk of systemic reactions 1
- The skin should be pinched and lifted off the muscles to ensure proper subcutaneous placement and avoid intramuscular or intravenous injection 1
Specific Injection Technique
The proper technique requires:
- Location: Posterior portion of the middle third of the arm at the deltoid-triceps junction, which has the greatest amount of subcutaneous tissue 1
- Needle: 26- to 27-gauge with ½- or 3/8-inch nonremovable needle 1
- Syringe: Calibrated small-volume syringe specifically designed for immunotherapy 1
- Skin should be wiped with alcohol swab before injection 1
Critical Safety Consideration
The subcutaneous route is not just preferred—it is mandatory for safety. The grading system for systemic reactions is specifically designed for "subcutaneous allergen immunotherapy" 1, and all safety protocols, including the required 30-minute post-injection observation period, are based on subcutaneous administration 1.
Note: While sublingual immunotherapy (SLIT) exists as an alternative form of allergen immunotherapy 2, 3, when the term "allergy shots" or "immunotherapy injections" is used, this specifically refers to subcutaneous administration.