When should I consider allergy shots?

If allergies send you to bed or medications produce unpleasant side effects, immunotherapy might be for you. This treatment builds up long-term immunity to one or many allergens by continually exposing patients to greater doses of them. Covered by most insurance plans, immunotherapy typically reduces symptoms by 90 percent. That said, it’s also a lot of work. Over three to six months and well before allergy season, patients receive one or two injections a week of specific allergens in increasing concentrations. Then, once or twice a month over the next three years, patients get maintenance shots of the maximum concentration reached during the buildup phase. Some people maintain their improvement indefinitely, but others relapse. Most relapses occur within three years of stopping treatment.

If that sounds like a lot of trouble, hang on. Easier immunotherapy treatments are on the way. First, if you’re needle-shy, ask your doctor about sublingual immunotherapy, a method that substitutes under-the-tongue pills or drops for the shots. The dose is higher, but the treatment appears to be safer, and experts say the results compare well with injections. Unfortunately, because the Food and Drug Administration hasn’t yet approved this form of treatment for seasonal allergies (some insiders say that could change before the end of the year), it’s considered off-label, which means doses aren’t standardized and payment has to come out of pocket. Second, a Johns Hopkins University study found that a yet-to-be-approved shot derived from plant DNA could offer long-term immunity in just six shots. That drug is currently in phase-two clinical trials and could be available in a few years.