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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.
Allergies: Should I Take Shots for Insect Sting Allergies?
Get the facts
- 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 had 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 autoimmune disease or take certain kinds of medicines (such as beta-blockers or ACE inhibitors).
- 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 pain, itching, redness, swelling, and hives near the site of the sting.
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 aren't needed if you have mild, local allergic reactions to insect stings. Only about 5 to 10 people out of 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 95 out of 100 people who have localized reactions don't ever have a whole-body reaction to an insect sting.
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, up to 60 of those 100 people will have another life-threatening reaction in the future. But if those 100 people get allergy shots, only 5 of them will have another life-threatening reaction.1 This treatment is most effective after an entire course of allergy shots is complete.
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 in the past, you may want to get a series of allergy shots on a faster schedule. For this you get allergy shots every few hours on one 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.
Your doctor may advise you to have allergy shots for insect stings if:
- Allergy tests showed that you are sensitive to allergens from the venom of one or more insects.
- You had a life-threatening allergic reaction to an insect sting.
- You have whole-body reactions to insect stings but cannot carry an allergy kit with you at all times.
- You work outside and have worse reactions each time you are stung.
- You have only been stung once but had a moderate to severe reaction.
- Allergy tests showed that you are not sensitive to allergens from the venom of insects.
- You have an autoimmune disease (such as lupus) or are taking heart medicine (such as beta-blockers or ACE inhibitors).
- Your allergic reaction to insect stings doesn't affect your whole body.
- You are younger than 16 and had a mild skin reaction all over your body (systemic reaction) without any other symptoms.
- You tried allergy shots before, but the shots triggered a moderate to severe allergic reaction.
Compare your options
What is usually involved?
What are the benefits?
What are the risks and side effects?
- You have a series of allergy shots every week.
- After 4 to 6 months of weekly shots, you get a shot every 4 weeks.
- How long you receive monthly shots depends on the type of insect sting you are treating.
- If you have had a severe allergic reaction, allergy shots can prevent symptoms from future insect stings or make your symptoms less severe.
You may have:
- Redness and warmth at the injection site. (This is the most common side effect.)
- Large local reactions that include itching, hives, or swelling of the skin near the injection site.
- A serious whole body reaction (anaphylaxis), which may include having a hard time breathing or swelling in the deep layers of the skin. In rare cases, this allergic reaction can be life-threatening.
- You avoid insect stings.
- If you get stung, you take medicine, such as antihistamines, for itching and other symptoms and then get medical help.
- You carry an allergy kit in case of a severe allergic reaction.
- You will avoid having shots.
- You won't have to spend the money on a long series of shots.
- You won't have to travel to a clinic for regular shots.
- You could have a moderate to severe allergic reaction to an insect sting.
- You could have a whole-body allergic reaction, especially if you've had one before.
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 needed. 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
What matters most to you?
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.
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.
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.
My other important reasons:
My other important reasons:
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
What else do you need to make your decision?
Check the facts
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 "Get the Facts." 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.
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 "Get the Facts." Allergy shots work by putting small amounts of insect venom into your body, making you less sensitive over time to the venom.
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 5 to 10 out of 100 people with localized reactions to insect stings later have a more serious, whole-body allergic reaction.
- FalseNo, that's not right. Only about 5 to 10 out of 100 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 "Get the Facts." Only about 5 to 10 out of 100 people with localized reactions to insect stings later have a more serious, whole-body allergic reaction.
Decide what's next
Do you understand the options available to you?
Are you clear about which benefits and side effects matter most to you?
Do you have enough support and advice from others to make a choice?
How sure do you feel right now about your decision?
Use the following space to list questions, concerns, and next steps.
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
|Primary Medical Reviewer||E. Gregory Thompson, MD - Internal Medicine|
|Specialist Medical Reviewer||Rohit K Katial, MD - Allergy and Immunology|
- Golden DB, et al. (2011). Stinging insect hypersensitivity: A practice parameter update 2011. Journal of Allergy and Clinical Immunology, 127(4): 852–854.e23.
- Golden DB (2009). Insect allergy. In NF Adkinson Jr et al., eds., Middleton's Allergy: Principles and Practice, 7th ed., vol. 2, pp. 1005–1017. Philadelphia: Mosby Elsevier.