General Allergy Injection Protocol Information for Patients

by Dr. Christopher Chang, last modified on 5/21/21.

Please note that we do NOT treat patients with symptomatic asthma (daily inhaler use). We are an ENT allergy practice and as such, deal only with problems above the shoulders which excludes the lungs and asthma.

General Policy:
Sign in on the allergy sheet when you arrive. Injections are given in the order of arrival. You must have TWO up-to-date Epi-Pens immediately available should you have an anaphylactic reaction and demonstrate knowledge in its use before you receive injections. Your provider will review your progress on an yearly basis. This follow-up appointment will be scheduled when you come for your first allergy injection.

If you are interested in learning how allergy vials are made for allergy shots, watch this video.

General Injections:
You will be given a schedule of times available for you to come for injections in this office (NO appointment is required). We cannot give you an injection if you come less than 5 days from your last injection, nor can we advance you if you allow more than 10 days to elapse between injections. In order for you to receive maximum benefit from immunotherapy, it is important for you to come on a regular, weekly basis. Allergy injections will not be given if you arrive earlier or later than the times stated on our schedule.

Read more about how allergy shots are given here!

Missed Injections:

By 10-14 days: Repeat last dose
By 14-21 days: Decrease by one dose
By >21 days: Decrease by 2 doses
By >40 days: Restart at first dose for that vial with vial testing
By >60 days: Retest and create new vials

Increasing Time Interval Between Injections When at Maintenance:
AFTER one year of weekly injections at maintenance AND without allergy symptoms off medications, than injection interval increases by one week (if weekly, than 2 weeks; if at 2 weeks, than 3 weeks, etc).

If symptoms appear, than injections are continued at that point and maintained at that frequency for at least 6 months before consideration of increasing time between injections.
Once injections are at every 4 weeks for at least 6 months and no allergy symptoms, then injections may be stopped. Keep in mind that if your symptoms come back, you may need to be retested and receive shots again.

Injection Alterations:
Dose may be adjusted based on reaction after injection. Dose may be reduced or postponed if you are sick. If you are pregnant, testing will be by RAST or immunoCAP only; if currently receiving injections, your OB/GYN must approve and your vial strength will not be increased until after delivery.

Reactions:
If after receiving your injection, you experience a reaction such as throat or chest tightness, hives, or shortness of breath, administer Epi-Pen and call our office immediately. If it is after hours, call 911 or go immediately to the nearest emergency room. Please tell them that you have had an allergy injection.

If at the injection site, you get a swelling and redness the size of a quarter, the same dose will be repeated. If it is the size of a half-dollar and present for 2-3 days after the injection, your dose will be decreased to the dose last used without a reaction. This dose will be used for 2 weeks before increasing again.

Charge for injections: $22 per 1 injection
We will submit to your insurance, as long as it is one we are participating with. If it is not, we ask that you pay promptly for the injections and we will supply you with an itemized statement for you to receive reimbursement. Please be aware that it is our policy that a patient’s account be kept current in order for new vaccine to be made and the allergy injections to continue. It is also our policy to charge your insurance company for the allergy vials when they are made and then an administration charge for the injections when they are given.

To check on the potential copay amounts for allergy shots as well as allergy vials, call your insurance company and provide them with these CPT codes:

95165 (Allergy Vial)
95115 (1 shot)
95117 (2+ shots)

Click here to read more about the hidden costs of allergy shots.

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General Allergy Injection Protocol Information for Patients

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