There are many ways to cope with allergies, but the most popular is the use of so-called specific immunotherapy, or desensitization. Many parents are afraid to have their children vaccinated with small doses of the allergen administered into the child’s body. The medical community considers this method effective and promising. According to Dr. Zygmunt Nowacki, PhD in medical sciences, Zygmunt Nowacki, this method affects the future course of allergic disease – the use of specific immunotherapy may result in a milder course of the allergy, or even eliminate it completely. “The effects for the future are enormous – if a child does not experience symptoms for several or a dozen years, that is our shared success,” explains the allergist in the video “When can a child undergo desensitization?”.
Can a child undergo desensitization?
Dr Zygmunt Nowacki lists the following criteria that determine whether immunotherapy should be used in a child:
- having reached the age of 5
However, there are exceptions to this rule. For example, a child who has experienced a severe allergic reaction to an insect sting should undergo immunotherapy as soon as possible to prevent another allergic reaction - confirmed by skin tests or blood serum tests types of allergy
Skin testing is a reliable and safe method that does not cause any complications. An additional advantage is that the tests are relatively inexpensive. However, skin tests cannot be performed on some children. The reasons vary – extensive skin lesions caused by atopic dermatitis, hives, dermographism and many other conditions. A psychological barrier is also common: the child is simply afraid of needles. In such situations, blood serum tests are performed – they are more expensive than skin tests, but equally effective. Dr Jacek Jóźwiak, PhD in medical sciences, Jacek Jóźwiak discusses contraindications to skin testing in the video “What should you watch out for when undergoing allergy tests?” - a stable course of the disease – this can be achieved by giving the child appropriate medication.
When is immunotherapy effective?
Unfortunately, desensitization injections (immunotherapy) cannot prevent all reactions directed against specific proteins. The effectiveness of the injections depends on whether the specific allergens can be identified. The injections will not help when the child’s symptoms are related to viral infections or the effects of irritants.
The diseases that can be treated with immunotherapy include:
- allergic rhinitis (hay fever) – if the symptoms are triggered, among other things, by inhaled environmental allergens such as dust mites, mold spores, and tree, grass and weed pollen, desensitization injections may be a good solution
- allergic conjunctivitis – red and itchy eyes are a concern for many children. The problem particularly affects children allergic to tree and grass pollen. Children feel an irresistible urge to rub their eyes, which often leads to secondary infections
- asthma (but not in all patients) – in this case, desensitization injections will be effective only when the symptoms are mainly triggered by a limited number of known allergens. If viral infections are the cause of the asthma, immunotherapy will not be effective. Most allergists recommend desensitization injections for children with well-controlled asthma when it is accompanied by symptoms of allergic rhinitis
- insect allergy – desensitization injections using insect venom are an important and potentially life-saving treatment. Their effectiveness has been demonstrated, among other cases, for bee, hornet and both large and small wasp venom.
There is also a possibility that desensitization may help with allergies to pets.
Diseases that cannot be treated with immunotherapy:
- food allergies
- atopic dermatitis
- hives.
Where should you start?
It should be remembered that immunotherapy must be tailored to the individual child. The doctor caring for the child should ask about the living environment (this will help determine which allergens inside and outside the home may affect the child’s health). The doctor should also be familiar with local and regional allergens. The next step is detailed allergy testing, which will help guide the treatment process.
Immunotherapy most often uses dust mites, animal-derived allergens, mold spores, and weed, tree and grass pollen. The doctor should not select too many allergens, as there is a possibility that the young patient will not receive the expected benefit (protection against each allergen individually).
Types of specific immunotherapy
Subcutaneous immunotherapy
It involves administering the allergen as subcutaneous injections. Treatment takes place in two stages. The first is an introductory period lasting several weeks, during which increasingly larger doses of allergens are administered at weekly intervals until the so-called maintenance dose is reached. The second stage is maintenance treatment, during which injections are usually given at monthly intervals. Each injection is administered in a doctor’s office.
Sublingual immunotherapy (oral)
It involves administering the allergen under the tongue in the form of drops or dissolvable tablets. This treatment method does not require visits to a doctor’s office – the patient takes the medication at home.
Treatment course
Initially, most children receive one or two injections per week. The treatment duration should be tailored to the individual child. The standard vaccination plan assumes that a beneficial effect can be achieved by administering the vaccine for at least 8 to 12 months. If the child’s health does not improve significantly during this time, the treatment plans should be reviewed (for example, different allergens may be selected). If the child’s condition improves during the first year of treatment and then continues to improve during the second year, most specialists will recommend continuing the injections with maintenance doses for the next 3 or 4 years.
Are the injections safe?
Doctors say that the vaccines are safe and provide many benefits for young allergy sufferers. However, it should be noted that the allergist injects the child with a protein capable of triggering an allergic reaction. As the dose increases, children may experience allergic reactions. Fortunately, the frequency of more significant reactions is low. Choosing the right specialist is important – they should have extensive experience working with young patients.
If parents decide to treat their child with immunotherapy, they should be aware that they also bear responsibility for the effectiveness of this method. If they are unable to devote their time to administering the injections and following the vaccination schedule, starting immunotherapy makes no sense.
information Anna Włoszek
Bibliography: Allen J. Dozor and Kate Kelly, “Asthma and Allergy – Caring for Children,” Poznań 2005.
The “Everything You Want to Know About Allergy” series is published in cooperation with the video portal www.JaAlergik.pl.