Gardening, hiking, golfing, picnics, baseball games…. Spring will be here before we know it!
But for people who have bee, wasp, or hornet allergies the change in season can bring feelings of anxiety and fear. The good news is venom immunotherapy (VIT) is a proactive treatment option and if you start now you could be protected before the weather heats up. We had some questions about starting VIT, so we asked Board Certified Allergist Dr. Steven Kernerman, for answers.
Q. Once I’m diagnosed, how quickly can I start venom immunotherapy?
A. After being diagnosed with a bee or wasp allergy, you can pretty much start on venom immunotherapy as soon as can be arranged. If there are no insurance restrictions, this can mean within days of being tested and having the diagnosis confirmed.
Q. How often will I need to come to the office to get allergy shots during the build-up phase?
A. There are two techniques that we use for the build-up phase of venom immunotherapy. The first, often referred to as conventional build-up, involves receiving venom shot(s) every 3-10 days for 15 shot visits. Each venom shot visit take approximately 40 minutes (including the 30 minute wait after the shot is received).
The second, called rush venom immunotherapy, completes the build-up phase over 2 days. The first day’s rush visit lasts approximately 6 hours and the second day is approximately 3 hours in duration.
Q. How long does the build-up phase last?
A. For the conventional build-up it generally takes 3-4 months (range 1 ½ – 5 months) to reach the maintenance level. For rush build-up the maintenance level is reached within 2 days.
Q. What does the maintenance phase entail?
A. Maintenance venom injections are generally given once every six weeks.
Q. How long does it typically last?
A. The maintenance phase of venom immunotherapy typically lasts for 3-5 years. This can vary given specific, individual circumstances.
Q. I want to be protected against bee sting allergies this Spring/Summer. When should I start venom immunotherapy?
A. If you want to be protected and you are going to do conventional venom immunotherapy build-up, you would want to start the process by January or February. For rush venom immunotherapy, ideally you would start no later than March.
Q. Tell us a recent VIT success story.
A. Not too long ago I diagnosed an 8 year old boy with a wasp sting allergy. He was prescribed injectable epinephrine and scheduled to start on venom immunotherapy. That weekend the family was on an outdoor outing and the boy’s father was stung and went into anaphylaxis. The boy, who now had an epinephrine injector, administered this to his father, and prevented further progression of the reaction. I then evaluated the boy’s father in the office and he had similar positive reactions on the venom testing as his son. They subsequently both did rush venom immunotherapy together, and are now protected. They have been stung since being desensitized and have had no significant reactions.
Thanks to Dr. Steven Kernerman of Spokane Allergy & Asthma Clinic for his assistance with this article.
 Ludman & Boyle. Stinging insect allergy: current perspectives on venom immunotherapy. Journal of Asthma and Allergy. 2015:8 Pages 75-86.