Are Allergy Shots Safe Treatments for Children?

Immunotherapy for Kids with Allergies - Timing and Safety

 Allergy Shots (Immunotherapy) and Children

Many parents are concerned that allergy shots could be unsafe for their children. In fact, many children could likely not only safely receive shots, but could significantly benefit from this form of treatment for allergies.

Allergy shots, or immunotherapy, can treat much more than hayfever (allergic rhinitis.) They may also be used to treat allergic conjunctivitis (eye allergies) and allergic asthma in children.

They may, in fact, even help to prevent the development of asthma in children with allergies.

There are several factors to consider if you are thinking about having your child receive allergy shots and many questions remain. What is the best age for your child to have allergy testing? At what age should a child begin allergy shots? Are there pros or cons to beginning allergy shots when a child is young, or in contrast, are there benefits or risks from waiting until a child is older? Let's take a look at the most common questions parents have when it comes to allergy shots and their kids.

When Should a Child be Tested for Allergies?

Before going into the best age to begin allergy shots, it's important to talk about when to have your child tested for allergies, as this step comes first. Parents often believe that allergy testing for children has to wait until a child is a certain age, for example, school age.

This is not true, and allergy testing can be done for children even one month of age. The best time to test is when you believe knowing the source of your child's symptoms (whether allergic rhinitis or asthma) outweighs the discomfort of the procedure, and this age will be different for every child.

Your best bet is to talk to your pediatrician or allergist in order to have her help you weigh these factors.

What Age Should Allergy Shots Begin?

As with allergy testing, there is really no such a thing as being too young to get allergy shots. That said, a child must be old enough to be able to communicate with a parent or medical personnel if he is experiencing symptoms of an allergic reaction to an allergy shot. The child must also be old enough to cooperate with the allergy shot itself, and this will be different for each child.  If going to the allergy clinic is so traumatic to the child that he or she cries and screams at every visit, it's likely that his parent will eventually stop taking him for allergy shots, and the therapy won’t be successful.

Most experts on allergy shots feel that the age at which most children can tolerate allergy shots is five years old. Except in certain circumstances, for example, when a child is very mature or when allergy shots are desperately needed, waiting until a child is at least six years old is often best. Of course this can vary, some children may not be mature enough for allergy shots until age eight, or ten, or even twelve. Mentioning this does not mean that a 10 year old who is not yet mature enough to handle allergy shots is "behind" or that your parenting techniques leave something to be desired.

As with most childhood milestones, children mature at different ages and in different ways. A child who is not mature enough at 10 for allergy shots may be more mature in other ways than a child who is mature enough for allergy shots at age six.

How Can You Tell if Your Child is Mature Enough for Allergy Shots?

Some allergists will recommend giving a child a shot of saline (salt water) to see how well he tolerates the process before committing the child to allergy shots. Another clue as to whether a child will tolerate allergy shots is how well he does with allergy testing.

If the child cries or screams during allergy testing, he will probably not do well with allergy shots.

Another way to assess your child's readiness is to talk to him about how allergy shots work (of course, in age appropriate terminology.) Having an idea about the "whys" behind shots may help some children be ready earlier than if they did not have an understanding of the reason behind the shots.

Safety of Allergy Shots in Children

As with any form of medical treatment, adverse reactions may occur with allergy shots. In fact, it's important to weigh the possible negative effects (side effects) against the potential benefits with any form of treatment, whether it is a pill your child will be taking, shots as noted here, or any form of treatment.

Allergy shots do carry a risk of anaphylaxis, a life-threatening allergic reaction. Serious reactions, however, are quite rare, as long as you are working with a qualified allergist who is accustomed to treating children with allergies.

Benefits of Allergy Shots for Children

As noted earlier, in addition to reducing your child's symptoms, allergy shots may reduce the risk of developing allergic asthma. Allergy shots may also reduce the risk of developing the most severe consequence of allergies: anaphylaxis.

Bottom Line on Allergy Shots (Immunotherapy) in Children

There are clear benefits and risks for allergy shots in children, but these will be different for every child. It's important to note that the age of a child alone is not a good indicator of when shots should be started. Some children may receive great benefits with shots beginning in early childhood, whereas others would be better off waiting until their teens, or later. Symptom control is important for children as symptoms can have many consequences during their physical, emotional, and social development. In addition, allergy shots may help prevent allergic asthma from developing in some children. These factors need to be weighed individually against the small but real risks of reactions and even anaphylaxis.

Sources:

Abrams, E., Szefler, S., and A. Becker. Effect of Asthma Therapies on the Natural Course of Asthma. Annals of Allergy, Asthma ad Immunology. 2016. 117(6):627-633.

Kliegman, Robert M., Bonita Stanton, St Geme III Joseph W., Nina Felice. Schor, Richard E. Behrman, and Waldo E. Nelson. Nelson Textbook of Pediatrics. 20th Edition. Philadelphia, PA: Elsevier, 2015. Print.

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