WHAT IS CLUSTER IMMUNOTHERAPY?

Allergen immunotherapy (“allergy shots”) is a process that involves giving increasing doses of the offending allergenic substances to desensitize the person and help the body tolerate the allergen.  All desensitization procedures begin with a build-up or escalation phase, whereby the dose of allergen is steadily increased to achieve a target maintenance dose.  Traditional allergen immunotherapy escalation schedules involve 20 weeks of weekly injections to achieve the maintenance dose.  A cluster allergen immunotherapy protocol reduces the escalation phase by 50% (from 20 weeks to 10 weeks) by giving “clusters” of injections during the first 5 weeks of escalation therapy.

WHAT IS THE TIME COMMITMENT INVOLVED?

Visits 1 & 2:  After a brief physical exam by a physician or physician’s assistant, you will receive a total of 3 injections given 30 minutes apart followed by an additional 30 minute observation period in the office.  Each visit requires approximately 2 hours.
Visits 3, 4 & 5:  After a brief physical exam by a physician or physician’s assistant, you will receive a total of 2 injections given 30 minutes apart followed by an additional 30 minute observation period in the office.  Each visit requires approximately 1.25 hours.
Visits 6-10:  You will receive 1-3 injections simultaneously (depending on the number of allergen extracts prescribed) followed by 30 minutes of observation.  Each visit requires approximately 40 minutes.

WHAT RISKS ARE INVOLVED WITH CLUSTER IMMUNOTHERAPY?

All desensitization protocols involve a risk of causing allergic reactions which can range from swelling at the injection site to potentially serious reactions involving respiratory symptoms or a sudden drop in blood pressure.  For this reason we require you to remain in the office throughout the observation period, during which time a physician or physician’s assistant will be immediately available to evaluate and treat an allergic reaction.   Although almost all potentially serious allergic reactions will occur during the observation period, we will require you to carry auto-injectable epinephrine to be self-administered in the event of a delayed allergic reaction after leaving our office.  We will, of course, teach you how to use it.

WHAT CAN I DO TO REDUCE THE RISK OF AN ALLERGIC REACTION?

  • Take an over-the-counter long acting antihistamine (e.g., Allegra, Zyrtec or Claritin) at least 1 hour before coming for each injection visit.
  • Do not engage in strenuous exercise or outdoor play for the remainder of the day following your injections.
  • Always carry auto-injectable epinephrine (e.g. EpiPen, Auvi-Q) to be administered in the event of an allergic reaction involving hives, facial swelling, throat swelling, cough, shortness of breath, abdominal cramping, nausea, vomiting or dizziness, then proceed directly to the nearest hospital E.R. or call 911 for transport if necessary.

WHAT HAPPENS AFTER I COMPLETE THE CLUSTER PROTOCOL?

After completing the cluster escalation, you will transition to the maintenance phase of allergen immunotherapy, which lasts for a total of 4-5 years.  During the 1st year of maintenance immunotherapy you will receive injections every 2 weeks.  During years 2-5 you will receive maintenance injections every 4 weeks.  A small percentage of patients will need to continue maintenance injections every 2 weeks during years 2-5 for optimal results.  Each visit requires approximately 40 minutes.

HOW MUCH WILL CLUSTER IMMUNOTHERAPY COST?

Your out-of-pocket expenses are determined by your insurance plan.  Our insurance specialists will review your insurance coverage and advise you of the costs involved.