Many kids have allergies
— in fact, they're the most common cause of chronic nasal congestion in children.
Allergen immunotherapy (allergy shots) can be an effective treatment
for certain allergies. Here are the basics on allergy shots and how to help a child
deal with them.
Why Allergy Shots Are Used
An allergy occurs when the body's immune system has an exaggerated reaction to
a usually harmless substance. Some common allergens (substances that trigger the allergy)
are dust mites, molds, pollen, pets with fur or feathers, stinging insects, and foods.
The body reacts to the trigger by releasing chemicals, one of which is histamine.
Allergic symptoms can include runny nose, congestion, sneezing, itchy eyes, and ear
itching or popping. Asthma
symptoms also might occur in some kids.
The best way to prevent or control allergy symptoms is to avoid triggers. An allergist
(a doctor trained to identify and treat allergies) will look for causes
of an allergy by testing a person's reaction to specific allergens with skin or blood
tests. Then, based on the test results, the allergist or another doctor can recommend
treatments, including medications and ways to avoid exposure to allergens.
If environmental control measures and treatment with basic
allergy medications are not successful, allergy shots might be recommended as the
How Allergy Shots Help
Allergy shots help the body build immunity to specific allergens, thus eventually
preventing or lessening reactions from exposure to the allergen. Allergy shots also
can help kids who have both allergies and asthma have fewer asthma flare-ups.
The shots contain very small amount of a purified form of the allergens that are
causing problems. The amount of the allergen is gradually increased over the first
3 to 6 months to a monthly maintenance dose, which is usually given for 3 to 5 years.
After years of getting allergy shots, a patient may have lasting relief from symptoms.
If your doctor recommends allergen immunology, your child might 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.
Once the highest effective safe dose is reached, the frequency of shots gradually
decreases to weekly, then biweekly, and then possibly monthly. This is called maintenance.
Some children get symptom relief from allergies during the buildup phase, but some
may not feel better until up to 12 months into the maintenance phase.
Are Allergy Shots Safe?
Allergy shots help the body build up a tolerance to allergens so that there is
less of a reaction to them. Given by a well-trained and experienced health professional,
allergy shots are safe and effective and can be given to children as young as 5 years
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, and animal dander. Allergy shots are not
useful for food allergies.
When receiving allergy shots, a child may experience a small reaction near
the site of the injection within a few hours of the shot. A patch of skin on the arm
near the site may get a little red, itch, and swell. This reaction can be treated
by applying an ice pack to the area and giving the child an antihistamine.
More widespread reactions, like hives and itching all over the body, are less common.
And more severe reactions (like wheezing, breathing difficulties, swelling in the
throat, and nausea) are rare.
Shots might seem like an unusual way to treat allergies, but they're effective
at decreasing sensitivity to triggers. The substances in the shots are chosen according
to the allergens identified from a person's medical history and by the allergist
during the initial testing. The U.S. Food and Drug Administration (FDA) oversees the
standards used in preparing the materials for allergy shots given in the United States.
Some other tips to make sure kids receive allergy shots safely:
Allergy shots should be administered only under the supervision of an allergist/immunologist
or other doctor specifically trained in immunotherapy.
A child who is ill, especially with asthma or respiratory difficulties, should
not receive further allergy shots until a doctor says it's safe.
To avoid adverse interactions, tell the doctor administering the injections beforehand
of any current medications your child is taking.
Allergen immunotherapy isn't necessary for everyone with allergies. Many kids get
along fine by living in homes that are as free as possible of allergens or by taking
allergy medication during peak allergy season.
But many kids battle allergies year-round, and some can't control their symptoms
with medications. For them, allergen immunotherapy can be beneficial.
Side Effects and Reactions
Allergy shots are extremely safe when given properly, but they do have the potential
for rare but serious reactions. This is because treatment involves exposure to the
substances to which someone is known to be allergic. A qualified allergist/immunologist
will have all the medications and equipment necessary at the office to treat a serious
Every time your child receives an injection, your doctor will have him or her wait
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 could require emergency procedures
and medications. If a severe reaction occurs, most of the time it will occur within
30 minutes of the shot and the reaction can be treated with an injection of epinephrine
In the event of a severe reaction, the doctor will probably reduce the dosage of
allergen in the next injection to allow your child's system to build immunity
Millions of people each year receive allergy shots without problems; however, to
ensure 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 might work together
with a child's primary care doctor so that some or most of the shots can be given
by the doctor at his or her office.
Finding an Allergist/Immunologist
A primary care doctor can usually recommend a qualified allergist/immunologist.
Or ask a family member or friend who is seeing an allergist/immunologist for a recommendation.
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. Still, for some kids any shot
can seem scary. A parent's positive and supportive attitude can go a long way
toward helping a child accept the treatment and achieve successful results. Treatment
seems to go much better when parents are confident and committed to their child getting
Allergy shots can seem a bit scary at first. But understanding their benefits and
how they work will help you and your child accept them as routine.