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When Should You Not Get Allergy Shots?

by Ella

Allergy shots, or allergen immunotherapy, are a long-term treatment aimed at reducing sensitivity to allergens. They are particularly effective for people who suffer from environmental allergies such as pollen, dust mites, mold, or pet dander. While allergy shots can provide significant relief, they are not suitable for everyone. Several factors, such as underlying health conditions, age, pregnancy, and potential reactions, can influence whether allergy shots are the right choice for a person. In this article, we will explore the circumstances under which you should avoid allergy shots, helping you make an informed decision about your allergy treatment.

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How Do Allergy Shots Work?

Before diving into when you should avoid allergy shots, it’s essential to understand how they work. Allergy shots involve injecting small amounts of specific allergens into the body to gradually build immunity. This process typically occurs over two phases:

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Build-up Phase: The patient receives injections one to two times a week, with increasing doses of the allergen, for three to six months.

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Maintenance Phase: After reaching the effective dose, injections continue every two to four weeks for three to five years.

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The goal is to desensitize the immune system, leading to fewer allergic reactions or a complete absence of symptoms. However, this treatment may not be suitable for everyone, and there are circumstances where individuals should avoid or delay getting allergy shots.

When Should You Not Get Allergy Shots?

1. Severe or Uncontrolled Asthma

People with severe or uncontrolled asthma should be cautious when considering allergy shots. Allergy shots can sometimes trigger asthma symptoms, particularly during the early stages of treatment when the immune system is still adjusting to the allergens. If you suffer from frequent asthma attacks or have trouble controlling your symptoms with medication, allergy shots may pose a significant risk.

For those with moderate to severe asthma, it is essential to have a discussion with your allergist before starting treatment. Your allergist may recommend additional asthma control measures or alternative treatments like sublingual immunotherapy (SLIT), which may be safer for people with respiratory issues.

2. Heart Conditions or Cardiovascular Disease

Individuals with heart conditions, such as hypertension (high blood pressure), coronary artery disease, or a history of heart attacks, should exercise caution when considering allergy shots. In rare cases, allergy shots can cause a systemic reaction, including anaphylaxis, which can stress the cardiovascular system. If you are taking beta-blockers, medications commonly prescribed for heart disease, the risk is even higher. Beta-blockers can interfere with the emergency treatment of anaphylactic reactions, making it difficult to manage allergic responses effectively.

If you have a heart condition, your allergist may advise against allergy shots or work with your cardiologist to determine whether immunotherapy is safe for you.

3. Pregnancy

Pregnant women are generally advised to avoid starting allergy shots during pregnancy. Although continuing a maintenance dose of allergy shots while pregnant is usually considered safe, initiating the treatment during pregnancy may not be recommended due to the increased risk of severe allergic reactions in the build-up phase.

Pregnancy causes changes in the immune system, and the body’s response to allergens and injections can be unpredictable. To reduce the risk of an adverse reaction, it’s best to delay starting allergy shots until after pregnancy. If you are already receiving allergy shots and become pregnant, consult your doctor to evaluate whether you should continue with your maintenance doses or temporarily suspend treatment.

4. Autoimmune Disorders

Allergy shots may not be appropriate for people with autoimmune disorders such as lupus, multiple sclerosis (MS), rheumatoid arthritis, or Hashimoto’s thyroiditis. These conditions cause the immune system to attack healthy tissues in the body, leading to inflammation and other complications. Since allergy shots are designed to modify the immune system’s response to allergens, they can potentially worsen autoimmune conditions or trigger flare-ups.

If you have an autoimmune disease, discuss your condition with your allergist. They may recommend alternative treatments or take extra precautions to monitor your response to immunotherapy closely.

5. Children Under Five Years Old

Allergy shots are typically not recommended for children under the age of five. Young children’s immune systems are still developing, and they may not tolerate allergy shots as well as older children or adults. Additionally, younger children may have difficulty understanding the need for frequent injections and sitting still during the treatment process.

For children with allergies, other treatments such as antihistamines, nasal sprays, or sublingual immunotherapy may be safer and more effective until they are old enough to start allergy shots. In some cases, an allergist may decide that the benefits outweigh the risks for younger children, but this decision will be made on a case-by-case basis.

6. Allergic Reactions to Components of the Shot

Although rare, some people may experience allergic reactions to components used in the preparation of allergy shots, such as preservatives or stabilizers. If you have a known allergy to any of the ingredients in the allergy shot solution, your doctor may advise against immunotherapy.

In such cases, your allergist may be able to formulate a custom solution without the allergenic components, or they may suggest alternative treatments like SLIT, which uses allergen tablets or drops that are placed under the tongue rather than injected.

7. Chronic Illness or Severe Health Conditions

Individuals with chronic illnesses, such as kidney disease, liver disease, or cancer, may not be ideal candidates for allergy shots. These conditions can weaken the immune system, making it harder for the body to respond appropriately to immunotherapy. In some cases, the strain of receiving frequent injections and the potential for systemic reactions may outweigh the benefits.

If you have a chronic illness, it is crucial to discuss your overall health with both your primary care physician and allergist to determine whether allergy shots are safe and effective for you.

8. Taking Beta-Blockers or ACE Inhibitors

Beta-blockers and ACE inhibitors are commonly prescribed for conditions such as high blood pressure, heart disease, and migraines. However, these medications can interfere with the treatment of allergic reactions, particularly anaphylaxis. Since allergy shots carry a small risk of causing severe allergic reactions, individuals taking these medications may face a higher risk if an emergency occurs.

Before starting allergy shots, make sure your allergist is aware of all the medications you are taking. In some cases, your doctor may be able to adjust your medications or recommend an alternative allergy treatment to reduce the risk.

9. Severe Allergies to Insect Stings or Food Allergies

While allergy shots are highly effective for environmental allergens such as pollen or dust mites, they are not typically recommended for severe allergies to insect stings, food, or latex. In these cases, avoidance strategies, emergency medications like epinephrine, and other forms of immunotherapy may be more suitable.

If you have a history of anaphylaxis or severe allergic reactions to foods or insect stings, your allergist may suggest alternative treatment options, including oral immunotherapy or avoidance-based management.

Alternatives to Allergy Shots

If allergy shots are not suitable for your situation, several alternative treatments can help manage allergy symptoms. These options include:

1. Sublingual Immunotherapy (SLIT)

SLIT is an alternative to allergy shots that involves placing allergen tablets or drops under the tongue. This method can be done at home, making it more convenient for some individuals. While SLIT is less invasive than injections, it is currently only approved for certain allergens, such as grass, ragweed, and dust mites.

2. Over-the-Counter Medications

Antihistamines, decongestants, and nasal corticosteroids are common over-the-counter treatments for allergy symptoms. While they do not address the root cause of allergies, these medications can provide temporary relief and are widely available.

3. Avoidance of Allergens

For some people, avoiding allergens is the best way to manage symptoms. This may involve making changes to your home environment, such as using air purifiers, keeping windows closed during pollen season, or washing bedding frequently to reduce dust mites and pet dander.

See Also: Do Allergy Shots Work for Food Allergies?

Conclusion

Allergy shots offer a promising long-term solution for many allergy sufferers, but they are not appropriate for everyone. Individuals with severe asthma, heart conditions, autoimmune disorders, or those who are pregnant should consult with their doctor to determine whether allergy shots are safe. Additionally, people with chronic illnesses or young children may need to explore alternative treatments.

By understanding the potential risks and consulting with an allergist, you can make an informed decision about the best approach to managing your allergies and improving your quality of life. If allergy shots are not right for you, alternatives such as sublingual immunotherapy, medications, and avoidance strategies can still offer significant relief.

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