Subcutaneous immunotherapy with extracts of pollen, house dust mites, mould and animal epithelium

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. One or two injections are administered per session at weekly intervals. The waiting period after each injection is half an hour. It usually takes 3 to 4 months to reach the maintenance dose with this form of treatment.

During the maintenance phase, which usually lasts between 3 and 5 years, the maintenance doses are administered once a month by the paediatrician or the child’s 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 involves a subcutaneous (under the skin) injection and is therefore much less painful than a vaccination, which is administered intramuscularly (into the muscle). Symptoms should begin to subside as early as the first year of immunotherapy. To achieve a long-term effect, the treatment should be continued for at least 3 years.

After a period of usually two years, an initial review of the immunological status takes place (by assessing the patient’s symptoms and, if necessary, carrying out further tests). A decision is then made as to whether treatment needs to continue or whether it can be discontinued.

With this treatment, local side effects – i.e. swelling at the injection site – are to be expected. Reactions similar to those associated with allergic conditions (e.g. pain or shortness of breath, redness over the whole body, hives, itching, swelling of the lips, eyes and tongue, a drop in blood pressure, dizziness, diarrhoea, or a shock reaction) are also possible, but 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 effective to cool the injection site with a cold pack, which can also be done at home.

Strenuous physical activity and exposure to high concentrations of allergens (e.g. house dust mites, cats, etc.) 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 treating doctor must also be informed immediately.