Subcutaneous immunotherapy with insect venoms (bee/wasp)

In immunotherapy, a distinction is made between an induction phase and a maintenance phase. During the induction phase, the dose is increased in small increments for safety reasons. The induction phase is usually carried out in hospital as an ultra-rapid treatment (Ultrarush) under intensive monitoring conditions within a few hours. The maintenance dose is reached within a few hours. For safety reasons, monitoring is required for several hours after the final injection. This treatment usually takes place from around 8.00 am to 5.00 pm.

During the maintenance phase, which usually lasts between 3 and 5 years, the maintenance doses are administered once a month by the paediatrician or attending doctor (if this is not possible, or during school holidays, the treatment can be carried out at the Allergy Outpatient Clinic at the UKBB). This is a subcutaneous (administered under the skin) injection and is therefore much less painful than a vaccination, which is administered intramuscularly (into the muscle). Protection is already in place after the induction phase, but to ensure that it is maintained, the
Maintenance treatment is necessary.

After three years, as is usually the case, an initial assessment of the immunological status (blood test) is carried out. A decision is then made as to whether treatment needs to continue for a further few years or whether it can be brought to an early conclusion.

With this treatment, local side effects – i.e. swelling at the injection site – are to be expected.Generalised reactions, similar to those that may occur following an insect bite (e.g. redness over the whole body, hives, itching, swelling of the lips, eyes and tongue, shortness of breath, a drop in blood pressure, dizziness, diarrhoea, shock), are also possible, but very rare.

For safety reasons, the monitoring periods are scheduled so that any reactions can be dealt with immediately. Should more severe allergic reactions occur later, the emergency kit should be used and medical assistance sought.

In the event of severe local reactions, the treating doctor will prescribe an anti-allergy medication, which can be taken one hour before the injection. It has proven helpful to cool the injection site with a cold pack, which can also be done at home. Strenuous physical activity should be avoided for up to 12 hours after the injection.

Due to the risk of complications, the treating doctor must be informed before each injection of any illnesses you have had, vaccinations you have received and any medication you are taking. If any problems (including infections, flu, etc.) arise shortly before or during treatment, the doctor must also be informed immediately.