Allergy Shots (Immunotherapy)

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Published:  December 4, 2023

What are allergy shots?

Allergy shots, also known as allergen immunotherapy, are a long-term treatment that decreases symptoms for patients with seasonal allergies (hay fever), perennial allergic rhinoconjunctivitis (an allergy to dust mites, mold spores, pet dander, cockroach), allergic asthma, eczema, and stinging insect allergy.

Allergy shots result in “desensitization” to allergens. Patients can then have increased exposure to their allergic triggers without developing troublesome symptoms.

Who do we consider for allergy shots?

  • Patients with severe year-round or seasonal allergies.
  • Patients who have unavoidable exposure to their allergic triggers.
  • Patients who have complications from their allergies – such as asthma, recurrent sinus infections, recurrent ear infections and eczema.
  • Patients who do not respond to appropriate medications.
  • Patients who do not tolerate allergy medications.
  • Patients who do not want to be on medications long term given medications are not a cure but are rather just “masking the symptoms.

How do allergy shots improve allergy symptoms?

Exposure via the subcutaneous route triggers a protective or “non-allergic” immune response to the treating allergens. This allows one to develop “tolerance” or an “immunity” to the allergens.

What is the procedure followed at Weiss Medical for allergy shots?

  • The protocol followed in our practice includes a build-up phase and a maintenance phase.
  • Patients first start out in the “build-up phase” in which they come in once a week for seven months. Some patients choose to come in twice a week
    (if allowed by insurance).
  • During the “build-up phase” patients have up to 13 days to remain on schedule. If there are 14 days or longer between allergy injections, the dose will need to be adjusted down (based on how long it has been between injections).
  • Once the “maintenance or target dose” is reached, the allergy shots are gradually spread out to once a month. Patients then have up to 6 weeks
    to remain on schedule.
  • When new vials are prepared during the maintenance phase, the dose needs to be lowered and quickly built up with 3 biweekly visits. This typically occurs once a year.
  • Patients are generally maintained on allergy shots for five years. Patients are retested prior to stopping allergy shots.
  • Allergy shots are administered via very small subcutaneous needles.
  • After a patient receives their allergy shots, we have them wait for 20 minutes in the office.

What are the risks of receiving allergy shots?

  • The only medical risk associated with allergy shots is an allergic reaction. The most common reaction is localized redness, pain and itchiness at the site of the injection.
  • Systemic allergic reactions can also occur, but they are very rare. It is generally believed to occur in 1 per 100,000 injections. In addition, the majority of allergic reactions occur in the first 20 minutes, which is why we have patients wait for 20 minutes.
  • As an extra safety precaution, we insist that all patients who receive allergy shots in our office carry Benadryl and an Epipen for at least two hours after receiving their injections.

Do allergy shots work?

  • 85 – 90% of patients improve with allergy shots.
  • Different patients respond to different doses. The textbook answer is it takes 6 – 9 months to achieve a clinical improvement. Some patients notice an improvement within a few weeks of starting allergy shots. Other patients might not notice a significant improvement until maintenance doses are achieved. Still other patients need to have their maintenance doses increased above the typical dose to achieve the desired benefit.

Can everyone receive allergy shots?

No. There are certain patients that cannot receive allergy shots:

  • Less than five years old
  • Patients who are on Beta Blockers
  • Patients who have unstable cardiac disease

Here at Weiss Medical, we realize that allergy shots are a very big commitment. We do not make the recommendation lightly when we suggest this form of treatment. Given many of our patients “do not have time for us” we make sure we are as accessible and convenient as possible. This means:

  • Open 7 days a week. The Riverdale office is open from Monday – Saturday and the Paramus office is open Monday – Friday and Sundays. Please see our website for details.
  • We have early morning hours and late evening hours.
  • Whenever the office is open, we are available for allergy shots.
  • There is always at least one nurse in the office to ensure that patients are seen in an efficient manner.


If you have questions about allergy shots, please call our office or schedule an appointment online.