Do Allergy Shots Hurt?

Getting Your Child (and You) Through the Stress of Shots

Child receiving a free flu shot
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While many people are afraid of allergy shots due to their association with routine vaccinations (such as with tetanus or diphtheria shots), the comparison is largely unfair.

With many routine vaccinations, the injection is delivered intramuscularly (into the muscle) which can cause irritation to not only muscle tissue but to the nearby nerves that service the muscle. Allergy shots, by contrast, are given subcutaneously (beneath the skin) where there are far fewer nerves.

And because the skin is easier to penetrate, the allergy injection needle tends to be far smaller.

Easing the Discomfort of Allergy Injections

Several techniques may be used to minimize the pain of allergy shots both in adults and children. One such technique, known as "pinch anesthesia," involves pinching the skin at the injection site to create a slightly numbing effect.

Other practitioners opt to use topical anesthetic creams or cooling sprays to slightly numb the skin. This may be especially useful in children or people who have a significant fear of needles (at least until such time they become accustomed to the routine injections).

Itching and Swelling After Allergy Injections

As with allergy testing, allergy shots may cause itching and swelling at injection site. These symptoms, which can start minutes or hours after the injection, tend to be more uncomfortable than painful.

There are a number of ways to prevent or alleviate or these symptoms, such as taking an antihistamine several hours before getting a shot.

If swelling does occur at the injection site, ice packs, topical steroids, and non-steroidal pain killers such as Advil (ibuprofen) can usually help relieve the localized swelling or discomfort.

Talking to Your Child About Allergy Shots

It is important to be honest with your children when taking them for allergy shots.

You do not want to either lie or minimize the experience. ("You won't even feel a thing!") All this will likely do is make them more fearful and distrustful the next time around.

Instead, mention that there may be some minor discomfort but that they are not being punished. Remind them that this is a good thing and that you will be with them all of the time. 

On the other hand, don't be too detailed or tell them too far in advance. This may lead to unneeded stress in the days leading up to the doctor visit.

During the injection, some parents will offer to let their child squeeze their hand as hard as possible to make them "more uncomfortable" than the shot itself. This not only makes the experience playful, it may even help distract the child. Other popular distractions include:

  • Letting the child play with your cell phone
  • Putting the child on the phone with a family member
  • Reading to your child or reading together
  • Singing a song together
  • Playing a game like "I Spy"

Other parents will offer a small reward after the injection and not so much as a bribe but as a reward for an accomplishment. This may take the form a bright sticker the child can wear or an activity you and the child will do together.

However, be careful about using the reward as an enticement. In the event the child has a meltdown, you don't want to be seen as withdrawing the reward as "punishment." Always try to focus on the positive, whatever the outcome may be.

Sublingual Immunotherapy as an Alternative to Allergy Shots

Depending on the type of allergy involved, sublingual immunotherapy (allergy drops or dissolvable tablets) may provide a reasonable alternative for those who fear shots.

These types of medication are placed under the tongue, often daily, and can be administered at home rather than in a doctor's office. Much like allergy shots, sublingual immunotherapy gradually helps build the body’s tolerance to an allergen.

Over time, the person may have fewer symptoms and medication needs. The drugs are considered safe and effective, and can even be used in children over two.

There are currently only a limited number of options approved by the U.S. Food and Drug Administration, including:

  • Oralair to treat to five types of northern grass pollen allergies
  • Grastek to treat Timothy grass pollen allergy
  • Ragwitek to treat ragweed pollen allergy
  • Odakta to treat house dust mite allergy

Other sublingual drops and tablets have been used in Europe for years but are not currently approved by the FDA. As for safety, there have thus far been no severe reactions or deaths report in persons receiving sublingual immunotherapy for allergy.

A Word From Verywell

The fear of discomfort is a common concern among parents when it comes to their children. But it is important to separate your fears from those of your child. Any anxiety you may feel may be transferred to the child and, if this happens, no amount of reassurance will completely erase those fears.

If you have any concerns about allergy shots in children—or allergy shots in general—speak with your doctor, allergist, or pediatrician to get all the information you need to make an informed choice.

Source:

Pepper, A.; Calderon, M.; and Casale, T. "Sublingual Immunotherapy for the Polyallergic Patient." The Journal of Allergy and Clinical Immunology. 2017; 5(1):41-45.

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