Rush Immunotherapy involves giving a person multiple allergy shots over a period of many hours to days, achieving a maintenance dose (or near-maintenance dose) in a very short amount of time. After the initial period of rush immunotherapy, a person is able to come into the allergist’s office typically only once a week for the next many weeks, then even less often. People undergoing Rush Immunotherapy also achieve benefit from allergy shots much faster, usually within a few weeks.
Rapid build-up schedules for allergy shots are used by some allergists in order to achieve a higher dose of allergy shots faster, which results in benefit of the shots sooner. These schedules also result in a person getting to a “maintenance dose” faster, as well as being able to come into the allergist’s office less often for allergy shots once this maintenance dose is achieved. There are two types of rapid build-up schedules –- Rush Immunotherapy and Cluster Immunotherapy.
Rush Immunotherapy has an allergic reactions in a large percentage of people, so various medications (such as antihistamines and corticosteroids) are often given in order to prevent or minimize these reactions. A person undergoing rush immunotherapy should be prepared to spend at least a couple of days in the allergist’s office, receiving many allergy shots over this time.
Cluster Immunotherapy involves giving two or more allergy shots at each visit, usually spaced apart by 20 to 30 minutes or so. This procedure is performed once or twice a week, and also allows for a person to get to their maintenance dose much quicker. While some studies have shown that cluster immunotherapy results in higher rates of allergic reactions than traditional schedules for allergy shots, other studies show no difference for rates of allergic reactions. Some allergists recommend medications, such as antihistamines, to minimize these reactions during cluster immunotherapy, while others do not.
Both rush and cluster immunotherapy offer an alternative to traditional schedules for allergy shots, allowing a person to achieve higher doses of allergy shots much quicker, and therefore get benefit sooner. However, both forms probably result in an increased rate of allergic reactions, particularly for rush immunotherapy; and both are more of a time commitment up front. With Rush Immunotherapy, typically takes a full day (or more), and Cluster Immunotherapy taking an hour or more for every visit initially.
Rush and Cluster Immunotherapy are commonly used for people with venom allergy. This allows for quicker protection against allergic reactions to future insect stings, and may actually be a safer way to treat people with venom allergies who have had problem with allergic reactions to their allergy shots.
Often, allergists have typical ways of giving allergy shots to their patients, and they tend to offer this typical build-up style to all of their patients. Most allergists do not simply give their patients the choice of build-up schedule.
How are allergy shots given?
The method of immunotherapy consists of starting at a small dose that will not cause an allergic reaction, with slowly advancing the dosage until the person becomes tolerant to large amounts of the extract. These injections are initially given once to twice a week until a maintenance, or constant dose, is achieved. This usually takes approximately 3 to 6 months. Once the maintenance dosage is reached, the allergic symptoms are largely resolved in most patients. Thereafter, the injections are given every two to four weeks.
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.
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