Friends of ours tell us that they have started “allergen immunotherapy” for their young son and daughter, both of whom have severe seasonal allergies. I believe this type of therapy was also available when I was growing up, but I never learned much about it. Should I consider immunotherapy for my young children as well? Can you tell me more what the therapy entails, and what it does?
It’s not surprising that you heard about it in your younger years; to call allergen immunotherapy time-tested is an understatement. Commonly known as “allergy shots,” allergen immunotherapy predates Prohibition, and has been an effective treatment for patients living with severe allergies since Herbert Hoover sat in the White House.
Almost a century later, there is an ever-expanding array of once-a-day medication available to treat allergy symptoms. But immunotherapy remains the only treatment that can alter the natural course of an allergic disease like chronic rhinitis (hay fever) or allergic asthma, and permanently reduce the frequency and severity of allergy symptoms such as severe congestion, sinus pressure, grogginess and sleeplessness. Furthermore, ongoing research and refinement of immunotherapy guidelines have made immunotherapy treatments for outdoor and indoor allergies more effective than ever before. Perhaps this is why allergists and immunologists have noticed more and more Brooklynites, such as your friends, requesting allergen immunotherapy for their children.
Children can start immunotherapy as early as age five, and many children living in Brooklyn are just reaching that age. A full course of allergen immunotherapy takes time — usually three to five years, starting with weekly visits for injections for the first six months, and then monthly visits for the remainder. However the benefits of immunotherapy can last a lifetime, particularly for children living in New York City, where pollen, mold spores and dust mites can be found around every corner. In addition, the first FDA-approved oral, injection-free immunotherapy (specifically, for grass pollen allergies) became available in 2014. More are sure to come.
For those with milder allergy symptoms that occur seasonally, over-the-counter treatments and lifestyle adjustments may be all that is necessary. A common problem is that many of these patients do not even know that their springtime cold or upper respiratory infections have, in fact, been caused by a seasonal allergy.
A simple “scratch test,” performed by an immunologist, could probably have been used to identify that allergy in less than 30 minutes, and get the patient on the road to effective relief of symptoms. What matters most is getting started, and finding the right treatment for each individual patient. Many parents of pediatric patients who come to New York Methodist Hospital for allergen immunotherapy tell our doctors that they wish they had known that they were allergic to pollen when they, themselves, were younger. We tell them that there is no time like the present.
