
Allergy shots, or allergen immunotherapy injections, are a common treatment for patients with serious allergy symptoms. They are designed to reduce or prevent allergy attacks by exposing patients to small amounts of the substance responsible for their allergic reactions. While the shots are generally well-tolerated, reactions can occur and vary from mild to severe. Local reactions are the most common, with symptoms such as redness, swelling, or irritation at the injection site. Rarely, more severe systemic reactions can occur, affecting the entire body and requiring immediate medical attention. It is recommended that patients be monitored for at least 30 minutes after receiving an allergy shot to watch for potential reactions.
| Characteristics | Values |
|---|---|
| Type of reaction | Local, systemic, delayed |
| Symptoms | Redness, swelling, irritation, itching, bruising, hives, sneezing, nasal congestion, wheezing, throat swelling, chest tightness, difficulty breathing, coughing, generalized itching or flushing, fainting, low blood pressure, unconsciousness |
| Treatment | Antihistamines, ice, EpiPen, emergency medical treatment |
| Preventative measures | Take antihistamines before the shot, avoid exercising or hot baths/showers for at least 2 hours after |
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What You'll Learn
- Local reactions: redness, swelling, itching, irritation, and bruising at the injection site
- Systemic reactions: hives, sneezing, nasal congestion, wheezing, throat swelling, and chest tightness
- Anaphylaxis: a rare but serious systemic reaction with difficulty breathing and low blood pressure
- Delayed reactions: can occur up to two hours after injection and may include swelling, itching, or bruising
- Preventative measures: taking an antihistamine before the shot and being observed after can minimise reaction risks

Local reactions: redness, swelling, itching, irritation, and bruising at the injection site
Local reactions are the most common type of allergic reaction to allergy shots. These reactions are characterised by redness, swelling, itching, irritation, and bruising at the injection site. They can vary in size from a dime to a lemon. These symptoms are usually mild and subside within a few hours, but they can be effectively managed with simple at-home care. For instance, applying ice and taking an antihistamine, such as Benadryl, can help reduce the reaction.
It is important to note that local reactions can last longer than 24 hours or occur frequently. In such cases, it is advisable to inform your allergist, who may adjust your allergy shot schedule. While these local reactions are typically not a cause for concern, severe reactions that occur on a delayed basis require immediate medical attention.
To minimise the risk of local reactions, preventive measures such as taking an antihistamine before receiving an allergy shot are recommended. Additionally, individuals are advised to avoid exercising or taking hot baths or showers for at least two hours after receiving an allergy shot. This is because exercise and hot baths can increase blood flow, potentially causing the allergens in the shots to spread faster throughout the body.
Delayed reactions are uncommon and typically occur within a few hours to up to three days after the injection. These reactions can include swelling, itching, or bruising at the injection site. In rare cases, a severe systemic reaction may occur, characterised by symptoms such as difficulty breathing and a dangerous drop in blood pressure. If such a reaction occurs, it is considered a medical emergency, and the use of an epinephrine auto-injector (EpiPen) is recommended, followed by seeking further medical treatment.
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Systemic reactions: hives, sneezing, nasal congestion, wheezing, throat swelling, and chest tightness
Allergy shots are a form of immunotherapy that helps reduce or prevent allergy symptoms. While the shots are designed to reduce symptoms significantly, reactions to them can occur, ranging from mild to severe. Local reactions are the most common, with symptoms including redness, swelling, and irritation at the injection site. However, in rare cases, allergy shots can lead to systemic reactions, which affect the entire body.
Systemic reactions are rare but can be dangerous and even life-threatening. Symptoms of a systemic reaction include hives, sneezing, nasal congestion, wheezing, throat swelling, and chest tightness. These symptoms can indicate a severe allergic reaction, and immediate medical attention should be sought. It is recommended to use an epinephrine auto-injector (EpiPen®) and seek emergency medical treatment if a systemic reaction occurs.
Hives are characterised by raised, itchy welts on the skin that can range in size and appear anywhere on the body. They are often associated with allergic reactions and usually appear within minutes to hours of exposure to an allergen. Sneezing is also a common symptom of allergies, and it can be a sign of an allergic reaction to the shot. Nasal congestion, or a stuffy nose, can also occur as a reaction to the allergy shot, particularly in those with allergic rhinitis.
Wheezing, which is a whistling or squeaky sound produced while breathing, can indicate a severe reaction, especially when accompanied by other symptoms such as throat swelling and chest tightness. Throat swelling can be life-threatening as it may obstruct airflow, and chest tightness can indicate a severe allergic reaction, with the potential for anaphylaxis.
It is important to note that most systemic reactions are mild and can be effectively treated. However, severe reactions can occur, and patients are typically monitored for at least 30 minutes after receiving an allergy shot to watch for any signs of a reaction. Preventive measures, such as taking an antihistamine before the shot, can also help minimise the risk of reactions.
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Anaphylaxis: a rare but serious systemic reaction with difficulty breathing and low blood pressure
Anaphylaxis is a rare but severe allergic reaction that requires urgent medical attention. It can be life-threatening and even fatal if not treated promptly. Anaphylaxis occurs when the body's immune system overreacts to an allergen, releasing a flood of chemicals that cause a sudden drop in blood pressure and constriction of the airways, making it difficult to breathe.
The symptoms of anaphylaxis include difficulty breathing, extensive swelling, hives, a weak pulse, dizziness, confusion, loss of consciousness, abdominal pain, chest tightness, nausea, vomiting, and a feeling of doom or dread. Anaphylaxis can be caused by food allergies, insect stings, medications, latex, and in rare cases, aerobic exercise.
If you or someone around you is experiencing anaphylaxis, it is important to seek emergency medical help immediately. Call 911 or administer first aid if you are trained to do so. The person may need cardiopulmonary resuscitation (CPR) if they stop breathing. Lay the person flat unless they are having trouble breathing; in that case, help them sit up to make it easier. If the person is unconscious, put them on their side and open their airway by lifting their chin.
The only treatment for anaphylaxis is epinephrine (adrenaline), which can be injected into the thigh using an epinephrine auto-injector (EpiPen®). Even with treatment, the person will need to go to the nearest emergency room for further monitoring and care. It is important to note that anaphylaxis can sometimes occur in two waves, with the second wave happening hours or even days after the initial reaction. This is called biphasic anaphylaxis, and it underscores the importance of seeking medical attention even if symptoms seem to improve after the first treatment.
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Delayed reactions: can occur up to two hours after injection and may include swelling, itching, or bruising
Allergy shots are a form of immunotherapy that helps reduce or prevent allergy symptoms. They are typically administered over a long period, ranging from three to five years. While the shots are designed to reduce allergic reactions, reactions to the shots themselves can occasionally occur. These reactions can vary from mild to severe and may even be life-threatening in rare cases.
Delayed reactions to allergy shots are relatively uncommon, but they can occur up to two hours after the injection. These reactions are typically localized, affecting only the injection site. Common symptoms of delayed reactions include itching, swelling, and bruising. These symptoms are usually mild and can be effectively managed with simple at-home care or over-the-counter antihistamines. However, it is important to monitor these reactions, as they can, in rare cases, persist or worsen over time.
If a patient experiences a delayed reaction, they should inform their allergist or allergy nurse during their next visit. Depending on the severity and frequency of the reaction, the allergist may adjust the patient's allergy shot schedule or dosage. Patients with persistent or severe delayed reactions may be prescribed an epinephrine auto-injector (EpiPen®) to carry with them on allergy shot days. This allows them to administer emergency treatment if a severe reaction occurs outside of a medical setting.
While delayed reactions are typically localized and mild, severe systemic reactions can occasionally occur. These reactions affect the entire body and can be life-threatening. Symptoms of a severe systemic reaction include chest tightness, difficulty breathing, coughing, wheezing, hives, generalized itching or flushing, mouth or throat swelling, fainting, and a dangerous drop in blood pressure. Patients experiencing these symptoms should use their EpiPen® and seek immediate emergency medical treatment.
To minimize the risk of delayed reactions, patients are advised to take preventive measures such as taking antihistamines before receiving an allergy shot. Additionally, patients are required to remain at the allergist's office for at least 30 minutes after receiving a shot to ensure they can be monitored and treated promptly for any potential reactions.
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Preventative measures: taking an antihistamine before the shot and being observed after can minimise reaction risks
Allergy shots are a form of allergen immunotherapy that helps reduce or prevent allergy symptoms. They are typically administered in two phases: the buildup phase and the maintenance phase. During the buildup phase, patients receive injections with increasing doses of allergens over six to ten months. This phase helps the body develop a tolerance to the allergens. The maintenance phase follows, where injections are given less frequently, usually every three to four weeks, to maintain the tolerance.
While allergy shots are generally safe, reactions can occur. Local reactions are the most common, manifesting as redness and swelling at the injection site. Rarely, more severe systemic reactions can occur, affecting the entire body. These reactions can be dangerous and include symptoms such as asthma, hives, anaphylaxis, difficulty breathing, and a drop in blood pressure.
To minimise the risk of reactions, patients are typically advised to take preventative measures. One such measure is taking an antihistamine before the allergy shot. Antihistamines have been shown to improve the safety and efficacy of allergy shots by reducing the frequency and severity of allergic reactions. They can also help increase the target maintenance dose. While there are concerns that antihistamines might mask minor reactions, no studies have supported this claim. Instead, antihistamines have been found to reduce moderate to severe allergic reactions.
Another crucial preventative measure is staying at the allergist's office for observation after receiving the shot. Patients are typically asked to remain for at least 30 minutes to be monitored for potential allergic reactions. This observation period allows for prompt treatment in case of any adverse reactions. During this time, patients should be vigilant for symptoms such as shortness of breath, increased heart rate, or unconsciousness, which require immediate medical attention.
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Frequently asked questions
Reactions to allergy shots vary from mild to severe. Mild reactions occur at the injection site and may include redness, swelling, itching, or bruising. These symptoms are not typically cause for concern and can be managed with simple at-home care. More severe reactions, known as systemic reactions, can affect the entire body and may include hives, sneezing, nasal congestion, wheezing, throat swelling, chest tightness, coughing, generalized itching or flushing, fainting, and difficulty breathing.
Severe reactions typically occur quickly, while mild reactions can occur within a few hours of the injection. Delayed reactions, which are rare, can occur several hours and up to three days after the injection.
If you experience a severe reaction, also known as a systemic reaction, you must seek immediate emergency medical treatment. First, use your prescribed epinephrine auto-injector (EpiPen®) to inject epinephrine into your leg, then call 911. For mild reactions, you may need to take an antihistamine (e.g., Benadryl) and apply ice to reduce the reaction. Be sure to inform your allergy nurse or allergist about any reactions you experience.

























