By Robert Stachler, MD, FAAOA
Allergy shots are given every week in the very beginning. This is referred to as the escalation phase. The time the doctor is building up the dose.
At some point in the immunotherapy process, the immune system will start to respond and start working to help you fight against the allergen (whatever you are allergic to). The body will start to feel better and you will have an improvement of your symptoms. This is called the symptom relieving dose. You will require fewer allergy medications to keep you from having the swollen face, the watery eyes, and the runny nose.
As time goes on, there will be a point when the patient has no noticeable response. This is called the maintenance dose. The shots will start to be spaced out to every 2 or 3 weeks.
During the process of building up to a maintenance dose, or with maintenance dosing, there may be times where it will take patients longer to build up based on their reaction to the presenting allergen. Missed shots, large local reactions, and systemic reactions can all add time to the immunotherapy process. This impacts how long it will take to eventually get to a maintenance dose.
Over all, it will take about 2.5 to 3 years to reach a state where a patient can stop the allergy shots. It takes that long for the body to build up the immune system to recognize the allergens as foreign and make memory cells that will make antibodies against the allergy. After this time you are “theoretically immune” to the allergen and may never have an allergic reaction to that substance for the rest of your life.
There are always exceptions to this rule. There are instances where patients have finished immunotherapy and their allergy profile changes over time. Sometimes it is necessary to retest or restart shots later in life (usually after 7-10 years) due to this change.