Cox News Service

Doctors have been sticking patients with allergy shots for more than 80 years, but they've just gotten around to asking them, in a scientific way, whether the shots actually work.

Do they lessen your runny nose, your sneezing fits, your general ``I'm so miserable'' hay fever when spring, summer and fall pollens waft through the air? Are you missing less work or school, making fewer trips to the doctor?

The answer, it would seem, from Connecticut to California, is a resounding ``yes.'' Of 175 patients surveyed in three cities (Bridgeport, Conn.; Fresno, Calif.; and Colorado Springs, Colo.), 81 percent said allergy shots keep them healthier, according to a recent article in the Annals of Allergy, Asthma & Immunology, the journal of the American College of Allergy, Asthma and Immunology. The patients also reported dramatic declines in sick days, emergency-room visits and antibiotic use.

``Almost everyone in the study found a significant reduction in their allergy symptoms,'' said allergist Dr. John Santilli of Bridgeport, who led the study. ``And the reduction was pretty much the same in all three sites. To me, that was absolutely unbelievable, because you never expect the same results at three sites. It says that with standardized care across the country, people with allergies are getting significant relief.''

It's the first survey to measure patient outcomes. Two additional new studies show that the therapy remains effective long-term. That's what allergists have seen in their practices, but this is the first proof, Santilli said.

Allergy shots - more technically, allergy vaccinations or immunotherapy - are given to people who find little relief from nasal sprays and antihistamines and who suffer year-round secondary complications, such as sinusitis or asthma. The injections are given in stages extending over about a year, starting with an extremely diluted quantity of the allergen that makes people sick. Gradually, as the dose increases, they develop resistance as antibodies build against the substance.

``People call them allergy shots, but they are really a vaccine. We are giving them protection against pollen, pet dander or dust,'' said Dr. Jon Stahlman of the Allergy and Asthma Center, with offices in metro Atlanta. ``You're inoculated against what's bugging you.''

Treatment must be continual; generally, if shots are missed for more than six weeks, doses will be lowered instead of increased. Because of the regular routine required for the shots, some people find the treatment inconvenient. On average, patients start to see relief of symptoms after six months, but some don't see any improvement and choose to discontinue the therapy.

Monthly maintenance shots continue for about three to five years. After that, most patients become immune to their allergens, a phenomenon that can last at least three years, as another recent study shows.

Thirty-two grass-pollen allergy sufferers were followed after their injection treatment ended, and they continued to get relief for three years afterward.

That research ``provides the best evidence to date that allergen immunotherapy has long-term, perhaps permanent, benefits,'' Dr. N. Franklin Adkinson Jr. of the Johns Hopkins School of Medicine wrote in The New England Journal of Medicine in 1999.

Dr. Kathleen Sheerin of the Atlanta Allergy & Asthma Clinic said 70 percent of patients who undergo shots can remain symptom-free for years, or a lifetime. ``If they have to go back on shots, we'll usually know within the first three years of stopping,'' she said.

As much as 30 percent of the U.S. population suffers hay fever, or allergic rhinitis, caused by triggers such as tree, grass or weed pollen, cats, dogs, molds and dust. For many people, allergies can be a mild annoyance, but others suffer chronic upper respiratory infections or other conditions that leave them continually tired.

An estimated $6 billion a year is spent treating allergic rhinitis and its complications, such as sinusitis, which calls for expensive antibiotics to treat the bacterial infection. Allergic rhinitis also accounts for about 3.5 million lost workdays and 2 million missed school days every year, the ACAAI says.

Those costs could be decreased and quality of life increased if more people took advantage of allergy shots, allergists say. Currently, about one in every 10 allergy sufferers gets shots.

``If you live in Atlanta and are allergic to every grass, weed and tree and cannot enjoy our beautiful spring and fall weather because of pollen allergy, you need to see your doctor,'' Sheerin said. ``Shots are a way of actually changing how you react to pollen. ... Medicines may work well for many people. However, when you stop the medicines, the symptoms come back. Medicines treat the symptoms, not the cause.''

Pat Quinn says the shots have provided much relief in her Conyers household since 5-year-old Stephen started getting them two years ago. He's highly allergic to dust, mold, feathers, eggs, strawberries and other foods.

``He couldn't live without the shots,'' Quinn says. ``It's very stressful to have a child with severe allergies. The shots make it manageable. He can still have a runny nose and sneeze a lot, but before he was sick all of the time.''

Children can start receiving allergy shots as young as 3. Quinn said Stephen initially kicked and screamed at his weekly injections. But now he's down to one shot a month, and ``he doesn't cry or scream, but he does want to be left alone afterward to be mad.''

Because patients could have a reaction to a shot, doctors monitor them for 20 to 30 minutes afterward. The most common reaction is swelling and redness at the injection site. More severe reactions, requiring antihistamines or other medical care, are uncommon, occurring less than 5 percent of the time, allergists estimate.

Shanna Johnson, 21, of Dahlonega says the shots help her get through college without the added stress of asthma attacks brought on by allergies.

``I probably had two to three asthma attacks per week before getting the shots,'' she said. ``I notice a huge difference between getting the shots and not getting the shots.''

Health insurance companies cover immunotherapy, but many patients, including Johnson, must pay a co-payment for every shot.

``It was $10, but that price has just gone up,'' she said. ``It does add up, but my parents are helping pay for that cost, because they know if I don't get the shots, I could die.''

Copyright 2001 Cox News Service. All rights reserved.