Do Allergy Shots Work? How Immunotherapy Improved My Hay Fever (Interview)

If you suffer from seasonal allergies, you may have heard about desensitisation treatment, or immunotherapy. What is it actually like having regular injections of things you are allergic to and is it worth it? Do allergy shots work for improving allergic rhinitis and respiratory allergy symptoms? Join us as we interview someone who has completed a course of immunotherapy for hay fever and hear about real world patient experience.

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A real life hay fever success treatment story

People often ask if allergy shots work, so we decided to speak with someone who has actually tried this desensitisation treatment. We spoke to Lisa, who has just finished 3 and half years of sub-cutaneous immunotherapy (allergy shots) to treat her severe allergic rhinitis, more commonly known as hay fever. We asked about her experience from diagnosis to the end of treatment, including whether allergy shots worked for her to improve her symptoms.

How did you get properly diagnosed with allergies?

The first thing I did was ask my doctor for a referral to an allergy specialist. As I was a new patient, it took me a few months to get an appointment.

At the first appointment we discussed my history of allergies and came up with a list of likely culprits to test for. Based on my symptoms, my specialist suggested testing for a number of different common allergy causing grass and tree pollens that grow locally, as well as house dust mites. We also tested for guinea pigs as I was reacting to our pets.

I then had skin prick testing for the allergens we suspected, and tested positive to most of them. I had very strong skin prick reactions to 6 types of grass and tree pollens (including rye grass and birch trees), dust mites and also tested positive to guinea pigs. We decided on individualized immunotherapy for the pollens and dust mites. I decided I could manage the guinea pig allergy as we wouldn’t have them as pets forever (or so I thought).

Why did you decide on injections (allergy shots) for treatment?

There are different types of allergy desensitisation treatments available for respiratory allergies. Other people in my family have used sub-lingual (under the tongue) drops or tablets to treat house dust mite allergy. After discussion with my allergist, I was advised that sub-cutaneous immunotherapy – injections under the skin – would be most effective for me. This would also allow my allergist to make up a specific mix of allergen extract containing the different types of pollens I was allergic to.

The plan was to have one injection for the two common types of house dust mites in one arm and another injection for the 6 types of pollens in the other arm.

How long did immunotherapy take?

As I was tested during the pollen season, we had to wait a few months until Autumn (Fall) to start treatment.

Treatment started with weekly injections of a very small amount, gradually increasing each week until I reached my full maintenance dose. After this, I only needed to come in for injections every 4 weeks.

The actual appointments took about an hour on average. Once I checked in with reception, the allergy nurse would call me through for my injections. After the injections, I was asked to stay in the waiting room for at least 45 minutes in case of reactions. The allergist would then speak to me, check the injection sites and I was free to leave. There were a handful of times when I needed to stay longer, either because the team was running late or because I had a worse reaction to the injections and needed further monitoring.

In total, I had injections over the course of 3 and a half years. This included the first 12 weeks of weekly injections, and then once a month after that.

Did you have any side effects from the allergy shots?

While not everyone dose, I did have some side effects from my allergy injections. The dust mite injections were not too bad and usually just ended up giving me a large red and itchy lump at the injection site. This started off small, but would grow to about the size of a cookie by the end of the day and last up to 24 hours. Sometimes I would also get a bruise and some soreness.

As I was so allergic to pollens, the pollen injections caused more side effects for me. I would always get a very large local reaction with redness, warmth and swelling of most of my upper arm. This would last for 2 to 3 days and then go away. I would take antihistamines before the injections, but often needed to take a second dose later in the day. Cold compresses helped with the itchiness.

Less common reactions

During my initial weekly ramp up doses, I had some worse reactions. Once I got up to what was supposed to be my maintenance dose, I had a more systemic reaction with throat tightness and coughing, and needed treatment with a Ventolin rescue inhaler. I don’t usually experience asthma, but the allergy injections caused an allergic asthma type reaction for me. After this reaction, we decided to reduce the next dose and keep my maintenance dose slightly lower for the duration of my treatment.

Because of the asthma symptoms, I carried Ventolin with me to all of my future appointments and needed to use it from time to time. My symptoms were definitely worse during the pollen season (spring). Sometimes my symptoms were also worse when starting a new vial of allergen extract.

Despite this, I’d say my symptoms were definitely manageable. Any discomfort from having a sore and itchy arm was only temporary. I took it as a sign that I definitely was very allergic and it cemented my decision to do the immunotherapy.

How much did your allergy desensitisation cost?

The cost of allergy immunotherapy can vary a lot between the different types (drops, tablets and injections). For injections, it can depend on how many allergens are being treated, whether you use a commercially made allergen extract or have one mixed for your needs, what your maintenance dose is and how long the treatment goes for.

Here in Australia I paid about $500 for my initial appointment and skin prick testing, but got a very reasonable amount back from Medicare. For the injections, I only had to pay for the vials of allergen extract. The injection appointments were bulk bulled through Medicare. However the vials themselves were quite expensive (around $200 each) and I needed one for house dust mites and one customized mix for the pollens. Some private health funds will give a partial rebate for the extracts. My maintenance dose was lower than expected due to my reactions, so overall I didn’t need as much extract as other people might. All together I would say the cost was about $1,600 before insurance.

So yes, it was expensive and I am very lucky that I could afford to pay for it. I am hoping that more will be done to fund these treatments and make allergy immunotherapy for allergic rhinitis/hay fever more accessible for everyone.

Now for the most important question – did the allergy shots work?

At the start of my treatment, my allergist was careful to tell me that he didn’t think that the immunotherapy would ‘cure’ my hay fever. The aim was to improve my symptoms – hopefully by about 50% – so that I could reduce the number of allergy medications I needed to take.

Happily, I can report that the end result was much better than we expected. If I had to estimate, I would say that I am about 80% better than before! I still take anti-histamine (mostly thanks to the guinea pigs, who are still with us!), but don’t really even need the nasal spray over spring. I occasionally get a runny nose and sneeze a little bit on high pollen days, but am now going outside and enjoying the outdoors with my family all year round. It was 100% worth the investment of time and any bad reactions along the way.

All of that time sitting in waiting rooms after allergy injections also gave me a chance to speak with other people at various stages of their immunotherapy journey. It was encouraging to hear stories from others who felt that allergy shots had made a huge difference and to share the excitement as people finished their treatment.

If your hay fever is getting you down, I highly recommend talking to your doctor about the treatment options available. Many people can get good control of hay fever symptoms with proper use of non-drowsy antihistamines and nasal rinses or sprays. If you are still struggling despite using allergy medications, definitely consider seeing an allergy specialist to find out if desensitisation with immunotherapy is right for you.

More about managing hay fever

Australia’s Allergy 250K project has some great resources on allergic rhinitis, including videos showing how to use nasal sprays correctly.

As well as allergy medications, there are also lots of practical things you can to help manage seasonal allergies. Be sure to check out these practical tips to reduce pollen exposure.

And if you are considering desensitisation, make sure to read our questions to ask before starting immunotherapy.

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