Allergic rhinitis (hay fever) is one of the most common allergies, affecting 1 in 4 young people in Britain. In a small proportion of patients, maximum treatment (with antihistamines, nasal steroids and eye drops) is not effective. Some of these patients may benefit from immunotherapy.
Allergies occur when the body reacts to foreign proteins (allergens). In allergic rhinitis, nose symptoms (runny, itchy or blocked nose) or eye symptoms (itchy watery eyes) occur after contact with these allergens e.g. grass or tree pollen, house dust mite, dogs and cats. In children, grass and tree pollen allergy is an important cause of hay fever.
Immunotherapy is the only treatment that can change the underlying allergic disease. The alternative is to continue with medicines that dampen down the symptoms such as antihistamines and steroids.
Immunotherapy is given by either injection under the skin (subcutaneous immunotherapy [SCIT]), or as a drop under the tongue (sublingual immunotherapy [SLIT]). Giving increasing amounts of the allergen trains the immune system to ignore the allergen (immune tolerance).
Subcutaneous immunotherapy (SCIT) is used by our allergy service, particularly for grass pollen and tree pollen allergies. In a few children it is also used to treat children with bee or wasp venom allergies.
Nose and eye symptoms improve. Patient’s often feel better, are less sleeping and are able to concentrate more on their school work and outside activities.
Allergen immunotherapy may also reduce the likelihood of getting asthma.
Pollinex Quattro SCIT is a grass and tree pollen therapy used for children with very troublesome hay fever. Four injections are given under the skin. They are usually in the upper arm. Injections have to be given each week for one month on three consecutive years.
The vaccine course is usually given in winter, when the pollen count is at its lowest.
SCIT is safe. Over 500,000 doses of Pollinex Quattro have been injected worldwide. The medicine is well tolerated in most patients.
Common side effects are itchiness and swelling in the arm. A dose of antihistamine and/or paracetamol will usually reduce these symptoms.
More serious reactions are uncommon, but include a widespread rash, wheeze, or a drop-in blood pressure (feeling faint), which is why the treatment is always given in hospital. These reactions almost always occur soon after the injection and can be identified and effectively treated while the patient is still in hospital. Therefore we ask you to stay for one hour after the injection.
You will need to be well on the day of injection. The injection should be postponed if you feel unwell with a cold or flu, or you have, or are getting over, an asthma attack.
If you are not able to have one of your injections, it will be given the following week.
If your doctor thinks that SCIT might help you, then you will be offered an appointment in a specialist allergy clinic. During the clinic appointment, a detailed history will be taken and skin prick tests will be performed to a range of pollens and other allergens. We will also ensure that, if you have asthma, it is well controlled so that you can have the treatment.
SCIT will not work for everybody. Pollinex Quattro leads to “very good” or “good” improvement in three out of four pollen allergic patients. It may also reduce the need for hay fever medicines. If it doesn’t work, patients usually have to rely on avoidance strategies and symptomatic treatment. Sometimes there are other allergies e.g. pet allergy or dust mite allergy that need to be sorted.
You will have the opportunity to discuss any issues during your visit to the Allergy clinic.