Hay Fever Site

A treatment for people with severe and persistent hay fever, whose symptoms are proving impossible to control and who find it difficult to lead normal lives, may be a treatment regime called immu­notherapy, also sometimes known as desensitization. Immunotherapy focuses on training the body to dampen down its production of anti­bodies when faced with a substance it sees as an invader (the allergen). Other allergy treatments are aimed at reducing the symptoms of aller­gic disease, but immunotherapy is actually capable of reducing the body’s sensitivity to allergens. As a result, the course of the disease is often automatically modified, providing long-term symptom relief.

You should seek advice from an allergy specialist prior to embarking on immunotherapy. The specialist will attempt to ensure that you are a suitable candidate who will definitely benefit from this expensive and time-consuming treatment and who is not at risk of possible adverse allergic reaction. If you are referred to an allergy specialist to discuss the possibility of immunotherapy, it is a great opportunity for you to also gather advice about other treatments. You may even then decide that you would prefer to give other treatments another try rather than undergo the prolonged regime of immunotherapy.

If you and the allergy specialist decide that immunotherapy is your best option, you will begin an individually tailored three- to five-year programme of weekly or fortnightly injections – referred to as vac­cinations or ‘allergy shots’ – starting just before the hay fever season commences. The injections are virtually pain-free and carried out in a hospital environment, to enable you to receive swift and proper atten­tion should you experience a life-threatening allergic reaction. You will be introduced to tiny dilute amounts of the problematic substance -called an allergy extract – to which you are known to be allergic; that is, the particular pollens and moulds. Your response is closely monitored for about an hour after the injection. If your response is manageable, progressively larger doses of the allergen are delivered over your next treatments, and this allows your body to adjust to the allergen and see it as less of a threat – this process is called desensitization. The eventual aim is for the severity of symptoms to be reduced, hopefully drastically and for many years to come. If you miss appointments, however, the dose of the next injection will require modification and consequently the total length of the programme will be extended.

When the injections are administered by an expert, side effects are rare. However, temporary swelling or itchiness at the site – known as allergen resistance – is occasionally experienced. If this happens, you are likely to be offered an antihistamine shortly before the next injec­tion is due.

In a range of studies, immunotherapy has exhibited its ability to give long-term benefits for existing allergies. It has also been shown to be capable of modifying the development of any new allergies and even of reducing the risk of developing asthma. However, this treatment is not an absolute cure, it does not offer benefit for everyone and for some people it is effective to only a very small degree. Still, most people who have undergone immunotherapy find that their symptoms are more bearable and also more responsive to other treatments. Some even find that it allows them eventually to stop taking their allergy medication.

International guidelines on injection immunotherapy, revised in 2007, confirmed the clinical efficacy of this technique for treating hay fever and asthma. Provided that the guideline recommendations are adhered to, its safety was also established. Immunotherapy is now seen as a suitable treatment for children with severe hay fever as it also re­duces the risk of asthma onset. Indeed, studies have shown that the earlier in life the treatment begins after an allergy reveals itself, the more chance there is of success.

In the UK, immunotherapy is often a last-resort treatment because of its expense to the National Health Service. However, in the long term both patients and the NHS make savings on the cost of medica­tions. It is to be hoped, therefore, that immunotherapy is soon made more widely available.

Interestingly, there is now a sublingual (placed under the tongue) tablet containing a grass pollen extract that can be taken at home without the need for injections, specialist doctors and medical centres. The tablet appears to be as effective as immunotherapy and has few side effects. It is now being offered to people with asthma who are not suitable candidates for injection immunotherapy.