When it comes to allergies, the best treatment is
obvious to those who administer it -- and largely avoided by those who need
An estimated one in three Americans suffers from seasonal or
year-round allergies caused by pollen, mold, insects, dust mites, and other
common irritants. And allergy shots -- medically known as allergen
immunotherapy -- are considered by most experts to be the most effective way to
bring long-term relief of allergy
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With each injection, patients are given increasingly higher
doses of the actual allergy trigger until their body becomes resistant to it --
preventing the allergic reaction. By comparison, antihistamines, inhaled steroids, and other allergy medications -- which usually
must be taken daily -- treat the resulting symptoms caused by the allergy
trigger, but not the allergens themselves.
As Good as or Better Than Drugs
"There have been no good head-to-head study comparisons
between immunotherapy and allergy medications," says allergist James Li,
MD, of the Mayo Clinic. "Most physicians recognize that antihistamines have
significant, but a fairly modest benefit. But the degree of benefit with
allergy shots is quite substantial, at least equal to or exceeding many
But despite their effectiveness, allergy shots are largely
ignored by most patients, whom either suffer through the allergy season in
silence or pop pills to temporarily ease their misery. A survey by the American
College of Allergy, Asthma and Immunology (ACAAI) shows that two in three
people with allergies would never consider getting allergy shots.
Why People Stay Away
First, there's the allergy testing -- multiple scratches into
the skin with different allergy triggers to identify what the person is
allergic to. Then there's the time involved -- weekly injections for three to
five months to gradually build resistance followed by several years of monthly
"maintenance" shots. And there's the pain with each allergy shot.
There's also the time it takes for the allergy shots to show
noticeable results; usually, several months after those weekly
"building" doses are completed. Relief of symptoms can be seen after a
few days of antihistamine pills.
And there's the biggest reason, at least according to most of
the allergy sufferers surveyed by the ACAAI three years ago: The cost. Do the
math and a doctor's visit -- anywhere from $25 to $100 each, repeated 25 times
or so in the first year alone (and then monthly until patients are relatively
symptom-free for two years) -- is a lot more expensive than a bottle of
over-the-counter Claritin, right? And if insurance doesn't pick up the bill,
allergy shots may be all but impossible for some people to afford.
Allergy Shots May Be Cheaper
It's precisely because Claritin has gone over the counter that
these days, taking once-a-day medications may be more expensive than allergy
shots, say experts.
"Many of the standard medications used for common allergies
like hay fever are no longer paid by Medicare, Medicaid, and many private
insurance companies," says Myron Zitt, MD, chief of allergy and immunology
at the Queens Long Island Medical Group in Babylon, N.Y., and clinical
associate professor of medicine at the State University of New York, Stony
Brook, School of Medicine.