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How Are the Allergy Vaccines Administered?

There are two ways to administer the allergy vaccines:

  1. by injection (known as subcutaneous injection immunotherapy or SCIT)
  2. orally, usually applied under the tongue or sublingual area (known as sublingual immunotherapy or SLIT)

For both modalities the treatment consists in administering progressively larger doses of the allergens that came positive in the test.

In other words: the first step (once a decision for immunotherapy is done) is to perform an allergy test. The test will show which is/are the allergens responsible for the symptoms the patient has. Once this is determined, these same allergens are going to be used to make the vaccine. (The vaccine contains only “natural substances” being the same allergens to which the patient reacts. There is a common misconception that the allergy vaccines contain “cortisone”. While many practitioners inject a form of usually depot cortisone, this is not a vaccine; it is done as needed and does not lead into a long term relief of symptoms).

By administering small and repeated doses of the vaccine a change in the responsiveness of the patient’s immunological system is induced. These changes will occur by administering progressively larger doses of these same allergens starting by a very small dose, and increasing to larger doses. As a figure of thought one could think in building a column:

Brick after brick needs to be applied, initially the bricks will be underground as a foundation (think of the initially very small dosages that have no ostensible effect –“the bricks are not yet seen”-) then one starts laying the bricks above the level of the ground, and keeps going up. These bricks above the level of the ground, refer to the doses of vaccine that will be producing a clear therapeutic effect.

For injections (“allergy shots”, subcutaneous immunotherapy or SCIT) the patient needs to come to the doctor’s office to receive treatment. After each injection the patient needs to wait 30 minutes before leaving the office as there is always the risk of eliciting a severe allergic reaction by the administration of the allergy shot. (This is a very small risk, but not zero). It does not matter if the patient has already received that dose and tolerated it well as still one day the patient can react.

As driving implies the risk of crushing but does not deter us from driving, rather we just exercise caution, the same reasoning applies to immunotherapy: A good technique will minimize these risks to a degree of making these reactions simply a rarity.

NOTE: Some practitioners allow their patients to receive their shots at home. This is a controversial practice. I elect not to allow my patients to inject themselves at home. Even though the risk of a reaction is low I would rather be present if such a reaction were to occur.

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