Lots of kids have allergies. In fact, allergies are the most
common cause of chronic nasal congestion in children. If your child
has allergies,
allergen immunotherapy
(allergy shots) may be a form of treatment to consider. Read on to
find out about allergy shots and how to help your child deal with
them.
Could My Child Benefit From Allergy Shots?
An
allergy
occurs when the body's immune system has an exaggerated
reaction to a usually harmless substance. The most common causes of
allergies are dust mites, molds, pollen,
pets
with fur or feathers,
stinging insects
, and some kinds of foods. The body reacts to the substance by
releasing chemicals, one of which is called
histamine
. The results of this reaction may include runny nose, congestion,
sneezing, itchy eyes, and ear itching or popping.
Asthma
may occur in some children.
The best way to prevent or control your child's allergy
symptoms is to help him or her avoid the
allergen
, the substance that triggers the allergy. An allergist is a doctor
trained to identify which substances are causing your child's
allergy, and he or she can treat and help you prevent your
child's allergy symptoms.
One way an allergist can determine the causes of your
child's allergies is by testing your child's reaction to
specific allergens by skin or blood tests. Based on the test
results, your child's doctor may recommend treatments including
medications as well as a plan for avoiding exposure to allergens.
If control of your child's
environment
and treatment with basic allergy medications are not successful,
allergy shots may be recommended as the next step.
How Do Allergy Shots Help?
Allergy shots help the body build a type of immunity to specific
allergens that eventually can prevent or "block" the
allergen from triggering symptoms when your child is exposed.
Allergy shots decrease the risk of developing asthma by 50% and
decrease the chance of developing new allergens.
These shots contain a purified form of the allergens that are
causing problems for your child. The course of shots is usually
given over a 5-year period. The dosage of the allergen is gradually
increased over the first 4 to 5 months to a monthly maintenance
dose, which is generally given for up to 3 years. After 5 years of
getting allergy shots, a patient may no longer seem to be
allergic.
If you decide to undertake allergen immunology, your child may
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. Your child may not get
symptom relief from allergies until higher doses are achieved at
the end of the buildup phase. Once the highest effective and safe
dose is reached, the frequency of shots gradually decreases to
weekly, then bi-weekly, and then possibly monthly. This is called
maintenance.
Are Allergy Shots Safe?
Allergy shots are really like vaccinations: They boost the
defenses of the immune system to help the body block the allergic
reaction. In the hands of a well-trained and experienced health
professional, allergy shots are safe and effective and can be given
to children as young as 4 or 5 years old.
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, molds, and animal dander.
When your child receives allergy shots, he or she may experience
a reaction near the site of the injection. A patch of skin on the
arm approximately the size of a quarter may itch and swell. This
reaction is a signal that the body is responding to the allergen.
You can treat this reaction by applying ice to the area and giving
your child an antihistamine. More serious reactions, such as hives
and itching all over your child's body or wheezing and
breathing difficulties, are unusual and occur in less than 2% of
patients.
Although a shot may seem like an unusual way to treat allergies
(why would you want to deliberately inject the very thing that is
making your child sick into his or her arm?), allergy shots are an
effective method of decreasing your child's sensitivity to the
things that are triggering an allergic reaction. The substances
used in the shots are chosen according to the allergens identified
by your child's allergist during the initial allergy tests. The
United States Food and Drug Administration (FDA) oversees the
standards used in preparing the materials for allergy shots given
in the United States.
The American College of Allergy, Asthma & Immunology (ACAAI)
suggests parents check the following to make sure their children
are receiving shots safely:
- Allergy shots should be administered only under the
supervision of an allergist/immunologist or other doctor
specifically trained in immunotherapy.
- If your child is ill, especially with asthma or respiratory
difficulties, he or she should not receive further allergy shots
until the doctor has declared it safe.
- To avoid adverse interactions, be sure to tell the person
administering the injections beforehand of any current
medications your child is taking.
Allergen immunotherapy isn't necessary for everyone with
allergies. Many children get along fine by living in homes that are
as free as possible of allergens or by taking allergy medication
during peak allergy season. However, many children deal with
allergies year-round, and some just can't be
controlled with their medications. Many of these children can
greatly benefit from allergen immunotherapy.
Are There Serious Side Effects or Reactions?
Although allergy shots have been proven to be extremely safe
when given properly, they do have the potential for rare but
serious reactions. This is because your child's treatment
involves exposure to the substances to which he or she is known to
be allergic. A qualified allergist/immunologist will have all the
medications and equipment necessary at the office to treat a
serious reaction immediately.
Every time your child receives an injection, your doctor will
have him wait 20 to 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 may require emergency procedures and
medications. If a severe reaction occurs, 98% of the time it will
occur within 20 minutes of the shot and the reaction will usually
respond to treatment with an injection of epinephrine (adrenaline).
In the event of a severe reaction, the doctor will also most likely
reduce the dosage of allergen the next time your child gets an
injection to allow his or her system to build immunity more
gradually.
Millions of people each year receive allergy shots in the United
States without consequence; however, to ensure your child's
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 may
work together with your child's primary care doctor so that
some or most of the shots can be given by your child's doctor
at his or her office.
How Can I Find an Allergist/Immunologist?
Your child's primary care doctor can usually recommend a
qualified allergist/immunologist. Or you can ask a family member or
friend who is seeing an allergist/immunologist for a
recommendation. Also, 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. For kids, the shots are more scary than painful. A
parent's positive and supportive attitude can go a long way
toward helping the child accept the treatment and achieve
successful results. Treatment seems to go much better if the parent
is confident and committed to their child getting the
immunotherapy.
Allergy shots may seem a bit scary at first. But understanding
the benefits of allergy shots and how they work will help you and
your child come to accept the shots as routine.
Updated and reviewed by:
William J. Geimeier, MD
Date reviewed: May 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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