Allergy shots (SCIT)
Subcutaneous immunotherapy, also known as allergy shots or SCIT, is a form of long-term treatment that decreases symptoms for many people with allergic rhinitis, allergic asthma, conjunctivitis (eye allergy) or stinging insect allergy. Allergy shots decrease sensitivity to allergens and often lead to lasting relief of allergy symptoms even after treatment is stopped.1,2
Although the risk is low when SCIT is administered appropriately, life-threatening reactions do occur. Prevalence of severe reactions ranges from 1% for conventional immunotherapy to more than 34% for rush immunotherapy.1
Monitoring guidelines for anaphylaxis
Symptoms of an anaphylactic reaction can include swelling in the throat, wheezing or tightness in the chest, nausea and dizziness. Most serious reactions develop within 30 minutes of the allergy injections. This is why it is recommended that patients wait in their doctor's office for at least 30 minutes after they receive allergy shots, even though evidence shows that not all practices follow this guideline.1,2,5
Another form of allergy immunotherapy, called sublingual immunotherapy (SLIT), was approved in the United States. Rather than shots, SLIT involves administering the allergens in a liquid or tablet form under the tongue, usually on a daily basis.1,6
The US Food and Drug Administration (FDA) has approved four allergy tablet products. Allergy tablets do not need to be given in a medical setting after the first dose. However, the FDA-approved product information for the four SLIT tablets includes a warning about the possibility of severe allergic reactions from SLIT and a recommendation that an epinephrine auto-injector be prescribed to patients receiving allergy tablets, in the event a severe allergic reaction should occur.6,9
- Cox L, Nelson H, Lockey R, et al. Allergen immunotherapy: a practice parameter third update. J Allergy Clin Immunol. 2011;127(1 Suppl):S1-S55.
- American Academy of Allergy, Asthma, & Immunology website, Conditions & Treatments, Library, Allergy Library, Allergy Shots (Immunotherapy). Accessed 1/13/2020 at: https://www.aaaai.org/conditions-and-treatments/library/allergy-library/allergy-shots.
- EpiPen [prescribing information]. Morgantown, WV: Mylan Specialty L.P.; 12/2020.
- Epinephrine Injection, USP [prescribing & patient information]. Morgantown, WV: Mylan Specialty L.P.; 12/2020.
- Epstein TG, Liss GM, Murphy-Berendts K, Bernstein DI. AAAAI/ACAAI surveillance study of subcutaneous immunotherapy, years 2008-2012. J Allergy Clin Immunol Pract. 2014;2(2):161-167.
- American Academy of Allergy, Asthma and Immunology website. Sublingual immunotherapy for allergic rhinitis. Accessed 1/13/2020 at: http://www.aaaai.org/conditions-and-treatments/library/allergy-library/sublingual-immunotherapy-for-allergic-rhinitis.aspx
- Elenburg S, Blaiss MS. Current status of sublingual immunotherapy in the United States. World Allergy Organization Journal. 2014;7:24.
- Cox L. Sublingual immunotherapy for aeroallergaens: Status in the United States. Allergy Asthma Proc. 2014;35:34-42.
- Canonica GW, Cox L, Pawankar R, et al. Sublingual immunotherapy: World Allergy Organization position paper 2013 update. World Allergy Organizations Journal. 2014;7:6.