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A Guide To Allergy Immunotherapy

Allergy Experts Breathe Easy With Immunology

Depending on the severity and nature of your allergies, you can train your body to become less allergic. Allergen-specific immunotherapy is a preventive treatment for reactions to a variety of allergens, including pollens, plants, dust mites, insect stings, foods, and many more triggers. Before beginning the treatment, your allergist will help you identify trigger factors for allergy symptoms. This is done by skin or blood tests and confirms the substances your body has antibodies against. Once identified, immunotherapy is administered by giving gradually increasing doses of the substance to the allergic person. You may choose from allergy shots, sublingual tablets, or oral drops. This is done safely by a Board Certified Allergist and Immunologist in the office; follow up evaluations are performed to ensure that no adverse reactions take place.


How Does It Work?


If you have an allergy, your immune system overreacts to the substance by pumping out antibodies (Immunoglobin or IgE). These antibodies travel to certain cells that release specific chemicals; this is what causes allergic reactions. Immunotherapy works to slowly introduce an allergen safely into the body. The immune system slowly becomes used to it or desensitized, and it produces a blocking antibody that works to stop reactions and symptoms when the substance is encountered in the future.


Types of Immunotherapy


  • Subcutaneous Injections
    • This is the only treatment that actually changes the immune system. It can treat more than one allergy at a time and prevent the development of new allergies and asthma.
    • The duration of therapy is usually 3-5 years. Shots are administered every week or two in the first year followed by less and less in the following years. This may vary depending on the allergy.
    • Administered by Allergist in the office.
  • Sublingual Tablets or Drops
    • These treatments can only target one allergen at a time but have been shown to be just as effective.
    • The duration of therapy is usually 3-5 years. The patient is responsible for dissolving the sublingual treatment under their tongue for 1-2 minutes before swallowing. This is repeated at least 3 times a week, depending on the allergy.
    • Administered by yourself (if old enough) or parent in the home without direct medical supervision.


What To Expect

To ensure effectiveness, immunotherapy shots are given on a schedule that involves two phases:

  • Buildup Phase
    • Generally takes about 3-6 months
    • During this phase, shots are given 1-3 times a week.
    • In some cases, this phase is expedited as Rush Immunotherapy. In this case, several injections of increasing dosage are administered in a single visit. This quickens the buildup phase but increases the risk of having an adverse reaction.
  • Maintenance Phase
    • Generally continues for 3-5+ years
    • During this phase, maintenance shorts are given about once a month.


Your allergy symptoms won’t go away overnight, but they should improve during the first year of treatment. By the second year, you should experience noticeable improvement. By the third year, most people are completely desensitized to their allergens and no longer experience reactions.



The majority of people that receive immunotherapy do not experience adverse reactions. However, these treatments contain allergy-triggering substances and so reactions are possible, including:

  • Local Reactions – redness, swelling, or irritation at the injection site; begins a few hours post-injection and clears up soon after. If you experience a local reaction, this does not increase your chances of experiencing it after the next injection.
  • Systemic Reactions – less common and more serious; includes sneezing, nasal congestion, hives, throat swelling, wheezing, or chest tightness.
  • Anaphylaxis – rare and life-threatening reaction that can cause low blood pressure and trouble breathing; typically begins within 30 minutes of the injection.


While the risks of immunotherapy seem scary, your allergist will require you to stay in the office for at least 30 minutes after each shot (when the most serious reactions are likely to occur). You can decrease your risk of having a serious reaction by not missing any doses and staying consistent. In addition, your doctor may recommend taking an antihistamine medication before your treatment takes place.

If you or a loved one are considering immunotherapy for your allergies, visit the New York Allergy & Asthma Expert’s website, make an appointment online, or call us at (212) 517-3300.



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