Venom Allergies
Venom Immunotherapy (Allergy Shots for Insect Stings) at Advanced Specialty Care
What Is Venom Immunotherapy?
Venom immunotherapy is a treatment that helps reduce allergic reactions to insect stings, such as from bees, wasps, hornets, or yellow jackets.
Small amounts of purified insect venom are injected and gradually increased at regular intervals.
Over time, your body becomes less sensitive to the venom. If you are stung by a venomous insect after treatment, you are less likely to have a serious allergic reaction.
What is the treatment schedule?
Injections are given once a week while the dose is gradually increased. Some people may receive injections two or three times a week to reach the full dose more quickly—especially if it’s close to the season when stings are more common.
It typically takes about 18 injections to reach the maintenance dose—this is the dose that offers full protection. However, this may vary depending on how sensitive you are and how your body reacts to the treatment.
Once the maintenance dose is reached:
- Injections are given every 2 weeks, then every 3 weeks, and eventually every 4 weeks.
- During the second year, the interval may extend to every 5 to 6 weeks.
Most patients continue with injections for about 5 years. Some may be able to stop sooner, while others may need longer treatment depending on their history.
How effective is venom immunotherapy?
Venom immunotherapy is very effective. About 95% of patients who receive the full treatment will not have a serious allergic reaction if stung again. If a reaction does happen, it is usually much milder—such as a few hives or mild swelling.
What are the alternatives to venom immunotherapy?
If you choose not to receive venom immunotherapy, it’s very important to be prepared in case of a sting. This includes:
- Carrying epinephrine at all times
- Having a fast-acting antihistamine, such as diphenhydramine (Benadryl)
- Calling 911 immediately after using your epinephrine
Are there any risks?
Most people tolerate venom immunotherapy well. Common side effects include:
- Redness, swelling, or itching at the injection site
A small number of patients may experience a generalized allergic reaction following the injection.
For this reason, patients are required to wait 30 minutes in the office after receiving their injection. Severe or life-threatening allergic reactions are rare, but they can occur. A provider is always present in the office to manage any adverse reactions.
When should I not get a venom injection?
There are certain times when it’s best to delay your injection to reduce the risk of a reaction. Do not receive your injection if:
- You are having an asthma flare-up or significant allergy symptoms
- You have a respiratory infection (like a chest cold or bronchitis)
- You are taking beta blockers or ACE inhibitors (commonly used for high blood pressure or eye conditions)
If you are prescribed one of these medications, please speak with your allergy provider before your next injection.
Questions or Concerns?
If you have any questions about your treatment plan, side effects, or medications, talk to your allergy specialist. Your safety and comfort are our top priorities.
Most patients tolerate allergy injections well, however two types of reactions can occur: localized and generalized.
How to Recognize a Reaction
1. Localized Reactions
Most common type of reaction, occurs only at the injection site. You may notice:
- Redness
- Swelling
- Itching
These mild symptoms usually go away within a few hours and do not require treatment. If the area is uncomfortable, you may:
- Apply a cold compress
- Take an oral antihistamine
Large Localized Reactions
If the swelling:
- Is larger than two inches in diameter
- Makes it uncomfortable to move your arm
- Lasts into the next day
Please tell the nurse at your next visit. While this is not dangerous, it may mean your dose needs adjustment.
2. Generalized Reactions
These are rare but potentially serious reactions that affect areas of the body other than the injection site. Symptoms may include:
- Hives or itching
- Flushing (redness of skin)
- Swelling of the throat
- Coughing, wheezing, or chest tightness
- Sneezing, tearing, or nasal congestion
- Dizziness or feeling faint
- Nausea, abdominal discomfort, vomiting, diarrhea
In rare cases, these reactions can be severe or life-threatening (anaphylaxis).
Important Safety Instructions
Always have your epinephrine available.
For your safety, it is mandatory to remain in the clinic’s waiting area for 30 minutes after every allergy injection, even if you’ve never had a reaction before.
This waiting period allows medical staff to monitor for signs of a reaction and provide prompt treatment if needed.
How to Reduce the Risk of Reactions
Reactions are more likely when:
- Allergy symptoms are active
- You are exposed to high levels of allergens
- You are sick (cold, flu, sinus infection, etc.)
To minimize risk:
- Do not come for an allergy injection if:
- You are wheezing
- Your allergy symptoms are uncontrolled
- You have a respiratory infection (cold, flu, bronchitis, sinusitis, etc.)
- Always inform the nurse before your injection if:
- You have any new or worsening symptoms
- You are taking any new medications
- There has been any change in your medical status
Planning a Pregnancy?
If you are considering pregnancy during your immunotherapy treatment, please discuss this with your allergist.
If you have questions or concerns about your allergy injections or possible reactions, don’t hesitate to contact our office.
Extracts:
As a courtesy our Billing Department will verify your allergy benefits; however we will not be held liable for misinformation given by your insurance. If you have an HSA, high deductible or co-insurance our Billing Department will call to notify you of your financial responsibility and collect payment prior to making the extract.
Administration of Extracts:
You may also be responsible for payment on the administration of each allergy injection. The office will not verify your coverage or notify the patient on these charges, but you may call your insurance and check your coverage on the code listed below:
CPT code charged for a single injection is 95115, OR
Multiple injections is 95117
CPT code charged for cluster injections is 95180 (with quantity of 2 or 3)
Verification of benefits is not a guarantee of payment. Determination of benefits is made once the claim has been processed. It is your responsibility to pay all balances deemed your responsibility by your insurance payer.
Co-Pays on Injections:
Co-pays on Injections are due at the time of service. If we are unable to acquire the co-pay amount prior to the injection we will wait until the first claim is adjudicated. After the correct amount is determined we ask that you pay all the past co-pays at your next visit and then each time you receive another injection.
Patient responsibility may be applied to your deductible (Contracted Rate), a co-insurance (% of Contracted Rate), or a co-pay (OV co-pay or Contracted Rate, whichever is less) based on your insurance benefits.
Resources & Information
American Academy of Allergy, Asthma and Immunology
611 East Wells Street
Milwaukee, WI 53202
1-800-822-2762
Allergy and Asthma Foundation of America
Washington, DC 20036
1-800-7ASTHMA
Allergy and Asthma Network / Mothers of Asthmatics, Inc.
2751 Prosperity Avenue, Suite 150
Fairfax, VA 22031
1-800-878-4403
American College of Allergy, Asthma and Immunology
85 West Algonquin Road, Suite 550
Arlington Heights, IL 60005
1-800-842-7777
The Food Allergy Network
10400 Eaton Place, Suite 107
Fairfax, VA 22030
1-703-691-3179
National Institute of Allergy and Infectious Diseases
31 Center Drive, MSC 2520
Bethesda, MD 20892
1-301-496-5717
The Complete Peanut Allergy Handbook
Author: Scott H. Sicherer and Terry Malloy
Understanding and Managing Your Child’s Food Allergies
Author: Scott Sicherer
The Peanut Allergy Answer Book: 2nd Edition
Author: Michael C. Young