Allergy Shots

Allergy shots or Immunotherapy is often recommended for those patients who are not getting adequate clinical benefit from avoidance and medications. They can be done for insects i.e. honeybee, hornet, wasp, yellow jacket and/or environmental allergens such as trees, grass, ragweed, dust mites, pets and molds. They cannot currently be done for foods. Over time shots help to reduce your symptoms and minimize your need for medications by desensitizing your immune system. They also help to decrease incidences of eczema and can lower your risk for developing or having flare-ups of your asthma.

Allergy shots need to be started out at once a week for a period of 5-10 months but can extend to 12 months if more localized or systemic reactions occur. This phase is called the build-up or work-up phase. Patients are allowed to come in 2-3x’s per week if desired during this time to expedite this process. If coming more frequently an interval of 48 hrs. is needed in between shots. For venom only the build-up phase is 18 shots if no reactions are reported. It is important to commit to a weekly regimen so we can continue to advance your dosages. After the build-up phase is completed, a once a month maintenance phase starts that lasts 5 years. 80%-90% of patients who have completed 5 years of the maintenance phase experience a lifetime benefit.

Allergy shots are not medicine but contain the allergens you are exposed to naturally in your environment. For this reason it is considered holistic treatment. The body’s immune system is gradually desensitized to your allergens so you do not get itchy, sneezy, and/or congested. Studies have shown that patients who receive allergen immunotherapy demonstrate significant improvement in symptom control for allergic rhinitis and asthma, have a decrease in the development of new sensitivities and a reduction in pharmacy, outpatient and total health care costs.

Allergy shots can be started at age 5 and above. Consent forms are obtained with the first appointment to start shots. Each time you come in your dosage will be increased during the work up phase unless a significant reaction is reported. Depending on the size of the reaction your next dose may be decreased, kept the same or only slightly increased. Reactions which are common at the injection site include redness, swelling, itchiness or a hive. If the size of the redness is 5 cms or bigger or includes golf ball sized swelling or larger then your next dose may be adjusted to a lower dose. A hive larger than a nickel should also be reported.

It is important to report a reaction as soon as you are aware of it, on the same day or the next day during office hours. This allows us to adjust your dosage accordingly for the next time you visit.

Localized reactions are common when getting allergy shots and can usually be handled by using Benadryl spray, ice, and antihistamines. Anaphylaxis or a systemic reaction is a rare but frightening reaction that can occur in less than 1% of patients. It is quickly reversed by epinephrine therefore all our allergy shot patients are given a prescription for an Epi Pen at the beginning of Immunotherapy. A demonstration and instruction on how to use it is given at the first shot appointment and you are asked to carry it for 24hrs on the day of your shot.

It is imperative that you call the office immediately and seek medical advice or go to the nearest Emergency Room if this reaction was to occur.

Please expect a longer visit on your first allergy shot appointment so we may review our policies and procedures. After your allergy shot you will be sent out to the lobby to wait 20 mins so we can monitor you for any signs of a reaction.


Q: What will happen if I start allergy shots and then go away to college?

A: If you are on allergy shots and then plan to go away to college we can arrange vials for you to take with you. Most colleges and universities have a health center that is willing to give shots from our vials provided to you. You should check with your university clinic to be sure. If not, another allergist nearby to your school may be willing to give your shots.

Q: Can I continue to get allergy shots if I become pregnant?

A: Allergy shots can be continued while you are pregnant. You will be maintained at whatever dosage you have reached until you deliver. If you are in the weekly phase of shots then you will go to monthly for the duration of your pregnancy. Once you deliver then you will go back to weekly or your monthly schedule.

Q: Do I continue to take allergy medicine while getting allergy shots?

A: Yes, you should continue to take whatever nasal sprays and antihistamines we have prescribed. These meds may be used as needed when you’re doing well with your allergy shots.

Q: What if I need an allergy shot when I am on vacation?

A: Schedule a shot right before you leave and one as soon as you get back to maintain your weekly or monthly schedule. If six weeks or more has gone by and you are a monthly shot patient we will have to lower your next dose to avoid a large local or systemic reaction.

Q: What if my allergy shots are not helping me?

A: We recommend 6-12 months of allergy shots (Immunotherapy) before our patients will notice a significant response. Our shots are 90% effective. Approximately 10% of our patients discontinue their shots because of a lack of clinical response after 1 year on shots.

Q: What do allergy shots cost? Are they covered by insurance?

A: We charge for vial make-up which includes 9 shots/vial. (CPT code 95165 x 9) Patients receive 1-3 vials depending on the number of allergens given. We also charge for your shot administration (CPT code 95115 one shot or 95117 two shots or more) during each visit to the office. Since we participate with most insurances, we will submit these charges to your insurance carrier first. You may need to check and see if you have a co-pay or deductible. Many insurances do pay for allergy shots since they recognize the health benefits associated with them. Typically co-pays are lower since you are seeing the nurse and not the doctor. We do draw our allergy shots up 1-2 days in advance of your appointment. As the source material in allergy shots are subject to degradation any shots that are 2 weeks or older will need to be discarded. A discard fee of $10 is charged to the patient since we can no longer use the shots originally intended for you.

Q: I have been getting monthly allergy shots but have missed getting them for the last 4 months. Can I pick up where I left off?

A: No, unfortunately if you are at monthly maintenance you would have to go back to weekly shots for a period of time determined by the Doctor or PA. The risk of anaphylaxis is too great. It is important to commit to a monthly schedule.