Allergies: Should I take shots for insect sting allergies?
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Get allergy shots to make you less sensitive
to insect stings and reduce the risk of a severe allergic reaction (anaphylaxis).
Do not get allergy shots, and try other things such as avoiding
stinging insects and carrying an
allergy kit to deal with the risk of a severe allergic
reaction.
Key points to remember
Allergy shots usually are recommended only for people who have
already had a bad reaction that affects their whole body. If you have been
stung in the past and had a whole-body
allergic reaction to the sting, you have a high risk
of having a similar reaction if you are stung again.
If you had an
anaphylactic (life-threatening) reaction in the past,
allergy shots greatly reduce your risk of having another severe whole-body
reaction.1
You may not need allergy shots if you had a normal (localized)
reaction or a large localized allergic reaction to an insect sting in the past.
If you have taken
allergy tests that found one or more sensitivities to
insect stings, allergy shots can prevent life-threatening reactions and also
make you less worried about insect stings.
Allergy shots may not be
safe for you if you have an
impaired immune system or certain kinds of heart
problems.
Allergy shots can hurt a little, may trigger anaphylaxis in
some people, can be costly, and usually take 3 to 5 years to complete.
Minor allergic reactions occur around the site of the sting. This is
called a localized reaction, and it can cause redness,
swelling, fatigue, nausea, and a low fever.
A more serious
allergic reaction can spread throughout your entire body. This is called a
systemic reaction. It can cause symptoms such as
itching,
hives, and swelling of the tongue, throat, or other
body parts.
A life-threatening systemic allergic reaction called
anaphylaxis can cause severe symptoms such as confusion,
trouble breathing,
shock, and sometimes death.
Allergy shots work by
putting small amounts of insect venom into your body, making you less sensitive
over time to the venom.
Getting a series of allergy shots can
prevent a systemic allergic reaction or make it less severe. Allergy shots are
not needed if you have mild, local allergic reactions to insect stings. Only
about 1 to 10 people in 100 who have localized reactions to insect stings go on
to have a more serious, whole-body allergic reaction.2
This means that 90 to 99 out of 100 don't ever have a whole-body
reaction.
Allergy shots can greatly reduce your risk of having
another life-threatening reaction if you've had one before. Imagine a group of
100 people who have had a life-threatening reaction. Without allergy shots, 60
of those 100 people will have another life-threatening reaction in the future.
But if those 100 people get allergy shots, only 3 of them will have another
life-threatening reaction.1
After allergy
tests have identified the insect(s) you are allergic to, you can begin to get
the shots. At first, you will get weekly shots of small doses of venom and
allergens from the insect(s) that cause your allergies. After about 4 to 6
months of weekly shots, you will get a regular dose, called a maintenance dose,
every 4 weeks for another 4 to 6 months. Finally, you will keep getting monthly
shots for 3 to 5 years, depending on the type of stings that cause your
allergies. For example, fire ant allergies require longer treatment than other
stinging insect allergies.
If
you have had severe reactions to insect stings, you may get a series of allergy
shots every few hours on the same day or every few days. This helps to rapidly
increase your tolerance to an allergen. After the first shot, you must wait to
see if you have a reaction to the shot. If you don't have a reaction, you get
more shots throughout the day. You (or your child) may feel anxious about
receiving the next shot. So it may help to bring a book or something to
distract you while you wait.
This treatment usually works in 1 to
8 days instead of the standard treatment, which takes several months. You may
have this "rush" treatment if you have severe or life-threatening allergic
reactions to insect stings, are a long distance from any type of health care
center, have severe
allergic asthma, or are about to travel.
Allergy shots
are safe for most people. The most common side effects are redness and warmth
at the injection site. Some people may have large local reactions that include
itching, hives, or swelling of the skin near the injection site.
But allergy shots can trigger a more serious whole-body reaction, which
may include trouble breathing or swelling in the deep layers of the skin. In
rare cases, a person may have a life-threatening allergic reaction (anaphylaxis) to the shots. Because of this, the shots
are given in a clinic or other health care setting where emergency care can be
provided if needed.
Talk with your doctor if you have an
autoimmune disease (such as
lupus) or are taking medicine for heart problems (such
as
beta-blockers). Allergy shots may not be safe for
you.
Personal stories about allergy shots for insect stings
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I have had
systemic reactions to insect stings before, although none were
life-threatening. I work in the landscaping and grounds maintenance industry,
so I am outdoors almost every day mowing lawns, trimming hedges, tending
flowerbeds, and similar activities that really put me at risk of getting stung.
I carry an allergy kit to my work sites, but I wanted to do something to reduce
my sensitivity to stings and cut the risk that I might have a really bad
reaction. So I've decided to have immunotherapy.
Rudy, age 26
I have what
must be a mild allergy to bee stings. I've been stung three or four times over
the past decade, and I always swell up quite a bit—my whole arm or leg or
wherever the sting is—and break out in hives around the sting, too. But it
never gets any worse than that. For me, allergy shots would just be too much
bother and expense for something that only happens once in a great while, and
my doctor tells me it's not really necessary. My doctor and I make sure I have
an up-to-date allergy kit just in case, but I've never had to use it.
Max, age
57
Our daughter was 14 years old when she had
a pretty severe reaction to a yellow jacket sting. She had swelling over most
of her body and a bad outbreak of hives. She was very frightened. After talking
it over with our doctor and an allergist, we decided to have her take allergy
shots. They told us her risk of having another similar reaction was fairly
high, and we felt it was worth the cost and the bother of having the allergy
shots to reduce the risk. We also make sure she keeps her allergy kit close by.
Maureen, age
37
Our 7-year-old boy was stung on the
shoulder by a hornet at a family picnic. He was uncomfortable with a patch of
hives across his back, but he got over it without anything worse. After talking
things over with our pediatrician, we decided allergy shots wouldn't be needed:
The chances he'll have another reaction like that are pretty low. But we do
keep an allergy kit at home and with the nurse at school.
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to choose allergy shots for insect stings
Reasons not to choose allergy shots for insect stings
I won't use an allergy kit, because I don't want to give myself a shot.
I feel comfortable giving myself a shot if I need to.
More important
Equally important
More important
I am worried about getting stung and having a bad reaction.
I am more afraid of the allergy shots than of my reaction to the insect stings.
More important
Equally important
More important
I don't mind spending the time and money to have allergy shots if it means I can avoid a bad reaction to an insect sting.
I don't want to spend the time or money to have allergy shots.
More important
Equally important
More important
My other important reasons:
My other important reasons:
More important
Equally important
More important
Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having allergy shots
NOT having allergy shots
Leaning toward
Undecided
Leaning toward
What else do you need to make your decision?
Check the facts
1.
I had a serious (whole-body) reaction to an insect sting in the past. This means I have a higher chance of having another bad reaction if I get stung again.
TrueThat's right. If you have been stung in the past and had a bad reaction, you have a high risk of having a similar reaction if you get stung again.
FalseNo, that's not right. If you have been stung in the past and had a bad reaction, you have a high risk of having a similar reaction if you get stung again.
I'm not sureIt may help to go back and read "What are the types of allergic reactions?" If you have been stung in the past and had a bad reaction, you have a high risk of having a similar reaction if you get stung again.
2.
With allergy shots, small amounts of insect venom are injected into my body. This may prevent or reduce a bad reaction if I get stung again.
TrueThat's right. Allergy shots work by putting small amounts of insect venom into your body, making you less sensitive over time to the venom.
FalseNo, that's not right. Allergy shots work by putting small amounts of insect venom into your body, making you less sensitive over time to the venom.
I'm not sureIt may help to go back and read "How do allergy shots work?" Allergy shots work by putting small amounts of insect venom into your body, making you less sensitive over time to the venom.
3.
My chances of having a serious reaction to an insect sting are low. I was stung in the past, but I had only a slight skin reaction.
TrueThat's right. Only about 1% to 10% of people with localized reactions to insect stings later have a more serious, whole-body allergic reaction.
FalseNo, that's not right. Only about 1% to 10% of people with localized reactions to insect stings later have a more serious, whole-body allergic reaction.
I'm not sureIt may help to go back and read "How do allergy shots work?" Only about 1% to 10% of people with localized reactions to insect stings later have a more serious, whole-body allergic reaction.
Decide what's next
1.
Do you understand the options available to you?
2.
Are you clear about which benefits and side effects matter most to you?
3.
Do you have enough support and advice from others to make a choice?
Certainty
1.
How sure do you feel right now about your decision?
Not sure at all
Somewhat sure
Very sure
2.
Check what you need to do before you make this decision.
Moffitt JE, et al. (2004). Stinging insect
hypersensitivity: A practice parameter update. Journal of Allergy and Clinical Immunology, 114(4): 869–886.
Golden DB (2003). Stinging insect allergy. In NF
Adkinson Jr et al., eds., Middleton's Allergy Principles and Practice, 6th ed., vol. 2, pp. 1475–1486. Philadelphia:
Mosby.
Allergies: Should I take shots for insect sting allergies?
You can use this information to talk with your
doctor or loved ones about your decision.
Get the facts
Compare your options
What matters most to you?
Where are you leaning now?
What else do you need to make your decision?
1. Get the Facts
Your options
Get allergy shots to make you less sensitive
to insect stings and reduce the risk of a severe allergic reaction (anaphylaxis).
Do not get allergy shots, and try other things such as avoiding
stinging insects and carrying an
allergy kit to deal with the risk of a severe allergic
reaction.
Key points to remember
Allergy shots usually are recommended only for people who have
already had a bad reaction that affects their whole body. If you have been
stung in the past and had a whole-body
allergic reaction to the sting, you have a high risk
of having a similar reaction if you are stung again.
If you had an
anaphylactic (life-threatening) reaction in the past,
allergy shots greatly reduce your risk of having another severe whole-body
reaction.1
You may not need allergy shots if you had a normal (localized)
reaction or a large localized allergic reaction to an insect sting in the past.
If you have taken
allergy tests that found one or more sensitivities to
insect stings, allergy shots can prevent life-threatening reactions and also
make you less worried about insect stings.
Allergy shots may not be
safe for you if you have an
impaired immune system or certain kinds of heart
problems.
Allergy shots can hurt a little, may trigger anaphylaxis in
some people, can be costly, and usually take 3 to 5 years to complete.
Minor allergic reactions occur around the site of the sting. This is
called a localized reaction, and it can cause redness,
swelling, fatigue, nausea, and a low fever.
A more serious
allergic reaction can spread throughout your entire body. This is called a
systemic reaction. It can cause symptoms such as
itching,
hives, and swelling of the tongue, throat, or other
body parts.
A life-threatening systemic allergic reaction called
anaphylaxis can cause severe symptoms such as confusion,
trouble breathing,
shock, and sometimes death.
Allergy shots work by
putting small amounts of insect venom into your body, making you less sensitive
over time to the venom.
Getting a series of allergy shots can
prevent a systemic allergic reaction or make it less severe. Allergy shots are
not needed if you have mild, local allergic reactions to insect stings. Only
about 1 to 10 people in 100 who have localized reactions to insect stings go on
to have a more serious, whole-body allergic reaction.2
This means that 90 to 99 out of 100 don't ever have a whole-body
reaction.
Allergy shots can greatly reduce your risk of having
another life-threatening reaction if you've had one before. Imagine a group of
100 people who have had a life-threatening reaction. Without allergy shots, 60
of those 100 people will have another life-threatening reaction in the future.
But if those 100 people get allergy shots, only 3 of them will have another
life-threatening reaction.1
After allergy
tests have identified the insect(s) you are allergic to, you can begin to get
the shots. At first, you will get weekly shots of small doses of venom and
allergens from the insect(s) that cause your allergies. After about 4 to 6
months of weekly shots, you will get a regular dose, called a maintenance dose,
every 4 weeks for another 4 to 6 months. Finally, you will keep getting monthly
shots for 3 to 5 years, depending on the type of stings that cause your
allergies. For example, fire ant allergies require longer treatment than other
stinging insect allergies.
If
you have had severe reactions to insect stings, you may get a series of allergy
shots every few hours on the same day or every few days. This helps to rapidly
increase your tolerance to an allergen. After the first shot, you must wait to
see if you have a reaction to the shot. If you don't have a reaction, you get
more shots throughout the day. You (or your child) may feel anxious about
receiving the next shot. So it may help to bring a book or something to
distract you while you wait.
This treatment usually works in 1 to
8 days instead of the standard treatment, which takes several months. You may
have this "rush" treatment if you have severe or life-threatening allergic
reactions to insect stings, are a long distance from any type of health care
center, have severe
allergic asthma, or are about to travel.
Allergy shots
are safe for most people. The most common side effects are redness and warmth
at the injection site. Some people may have large local reactions that include
itching, hives, or swelling of the skin near the injection site.
But allergy shots can trigger a more serious whole-body reaction, which
may include trouble breathing or swelling in the deep layers of the skin. In
rare cases, a person may have a life-threatening allergic reaction (anaphylaxis) to the shots. Because of this, the shots
are given in a clinic or other health care setting where emergency care can be
provided if needed.
Talk with your doctor if you have an
autoimmune disease (such as
lupus) or are taking medicine for heart problems (such
as
beta-blockers). Allergy shots may not be safe for
you.
Personal stories about allergy shots for insect stings
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
" I have had
systemic reactions to insect stings before, although none were
life-threatening. I work in the landscaping and grounds maintenance industry,
so I am outdoors almost every day mowing lawns, trimming hedges, tending
flowerbeds, and similar activities that really put me at risk of getting stung.
I carry an allergy kit to my work sites, but I wanted to do something to reduce
my sensitivity to stings and cut the risk that I might have a really bad
reaction. So I've decided to have immunotherapy. "
— Rudy, age 26
" I have what
must be a mild allergy to bee stings. I've been stung three or four times over
the past decade, and I always swell up quite a bit—my whole arm or leg or
wherever the sting is—and break out in hives around the sting, too. But it
never gets any worse than that. For me, allergy shots would just be too much
bother and expense for something that only happens once in a great while, and
my doctor tells me it's not really necessary. My doctor and I make sure I have
an up-to-date allergy kit just in case, but I've never had to use it.
"
— Max, age
57
" Our daughter was 14 years old when she had
a pretty severe reaction to a yellow jacket sting. She had swelling over most
of her body and a bad outbreak of hives. She was very frightened. After talking
it over with our doctor and an allergist, we decided to have her take allergy
shots. They told us her risk of having another similar reaction was fairly
high, and we felt it was worth the cost and the bother of having the allergy
shots to reduce the risk. We also make sure she keeps her allergy kit close by.
"
— Maureen, age
37
" Our 7-year-old boy was stung on the
shoulder by a hornet at a family picnic. He was uncomfortable with a patch of
hives across his back, but he got over it without anything worse. After talking
things over with our pediatrician, we decided allergy shots wouldn't be needed:
The chances he'll have another reaction like that are pretty low. But we do
keep an allergy kit at home and with the nurse at school. "
— Kimberly, age 24
3. Your Feelings
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to choose allergy shots for insect stings
Reasons not to choose allergy shots for insect stings
I won't use an allergy kit, because I don't want to give myself a shot.
I feel comfortable giving myself a shot if I need to.
More important
Equally important
More important
I am worried about getting stung and having a bad reaction.
I am more afraid of the allergy shots than of my reaction to the insect stings.
More important
Equally important
More important
I don't mind spending the time and money to have allergy shots if it means I can avoid a bad reaction to an insect sting.
I don't want to spend the time or money to have allergy shots.
More important
Equally important
More important
My other important reasons:
My other important reasons:
More important
Equally important
More important
4. Your Decision
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having allergy shots
NOT having allergy shots
Leaning toward
Undecided
Leaning toward
5. Quiz Yourself
Check the facts
1.
I had a serious (whole-body) reaction to an insect sting in the past. This means I have a higher chance of having another bad reaction if I get stung again.
True
False
I'm not sure
That's right. If you have been stung in the past and had a bad reaction, you have a high risk of having a similar reaction if you get stung again.
2.
With allergy shots, small amounts of insect venom are injected into my body. This may prevent or reduce a bad reaction if I get stung again.
True
False
I'm not sure
That's right. Allergy shots work by putting small amounts of insect venom into your body, making you less sensitive over time to the venom.
3.
My chances of having a serious reaction to an insect sting are low. I was stung in the past, but I had only a slight skin reaction.
True
False
I'm not sure
That's right. Only about 1% to 10% of people with localized reactions to insect stings later have a more serious, whole-body allergic reaction.
Decide what's next
1.
Do you understand the options available to you?
2.
Are you clear about which benefits and side effects matter most to you?
3.
Do you have enough support and advice from others to make a choice?
Certainty
1.
How sure do you feel right now about your decision?
Not sure at all
Somewhat sure
Very sure
2.
Check what you need to do before you make this decision.
I'm ready to take action.
I want to discuss the options with others.
I want to learn more about my options.
3.
Use the following space to list questions, concerns, and next steps.
Credits and references
Credits
Author
Caroline Rea, RN, BS, MS
Editor
Maria G. Essig, MS, ELS
Editor
Susan Van Houten, RN, BSN, MBA
Associate Editor
Pat Truman, MATC
Primary Medical Reviewer
William M. Green, MD - Emergency Medicine
Specialist Medical Reviewer
Harold S. Nelson, MD - Allergy and Immunology
References
Citations
Moffitt JE, et al. (2004). Stinging insect
hypersensitivity: A practice parameter update. Journal of Allergy and Clinical Immunology, 114(4): 869–886.
Golden DB (2003). Stinging insect allergy. In NF
Adkinson Jr et al., eds., Middleton's Allergy Principles and Practice, 6th ed., vol. 2, pp. 1475–1486. Philadelphia:
Mosby.
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.
Moffitt JE, et al. (2004). Stinging insect
hypersensitivity: A practice parameter update. Journal of Allergy and Clinical Immunology, 114(4): 869–886.
Golden DB (2003). Stinging insect allergy. In NF
Adkinson Jr et al., eds., Middleton's Allergy Principles and Practice, 6th ed., vol. 2, pp. 1475–1486. Philadelphia:
Mosby.
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