At a glance
Allergen immunotherapy, commonly called allergy shots, is a long-term treatment that gradually trains your immune system to tolerate the substances that trigger your allergic reactions. A doctor injects tiny, carefully measured amounts of an allergen (the substance you are allergic to) under the skin of your upper arm on a regular schedule.
Over months and years, the dose is slowly increased. The immune system learns to recognise the allergen as harmless instead of something to attack. As a result, your body stops producing the large chain of reactions that causes sneezing, itching, swelling, or breathing difficulty when you encounter the allergen in everyday life.
Medical Condition
Allergy shots are prescribed when allergic symptoms are frequent, severe, or poorly controlled by antihistamines and other medicines, or when those medicines cause side effects that interfere with daily life. They target the root cause of the allergy rather than just masking symptoms.
- Allergic rhinitis (hay fever): sneezing, runny nose, and itchy eyes triggered by pollen, dust mites, mould, or animal dander
- Allergic asthma where airway inflammation is driven by a known allergen
- Allergic conjunctivitis (eye inflammation) linked to environmental allergens
- Insect venom allergy: severe reactions to bee, wasp, or fire-ant stings
- Some cases of allergic eczema (skin inflammation) where a specific trigger has been confirmed by testing
Allergy shots are not suitable for everyone. Doctors usually avoid them in certain situations.
- Severe or unstable asthma that is not well controlled with medicines, because the risk of a serious reaction during the shot is higher
- Certain heart conditions or use of beta-blocker medicines that make treating a severe allergic reaction difficult
- Pregnancy, as starting a new course is generally avoided, though continuing an existing one may be discussed with the doctor
- Children under five years old, because they may not reliably communicate early warning symptoms
- Food allergies: shots are not used for foods; other approaches are evaluated for those cases
Risks & Complications
Allergy shots carry a low overall risk when given in a medical setting with trained staff, but reactions can occur because the treatment intentionally introduces the substance your immune system reacts against.
- Local reactions at the injection site: redness, swelling, and itching that usually settle within a few hours and are the most common side effect
- Delayed local swelling: a larger lump at the injection site appearing several hours after the shot, generally harmless
- Systemic reaction: sneezing, hives (raised itchy welts on the skin), or nasal congestion affecting the whole body, appearing within 30 minutes
- Asthma flare: coughing, wheezing, or chest tightness, more likely in patients whose asthma is not well controlled at the time of the shot
- Anaphylaxis (a rare but serious whole-body allergic reaction): can include throat swelling, a sudden drop in blood pressure, and difficulty breathing, requiring immediate treatment with adrenaline (epinephrine)
- Because of the anaphylaxis risk, clinics require patients to wait at least 20 to 30 minutes after each injection before leaving
Preparation & Procedure
Before the first injection, an allergist (a doctor specialising in allergy and immune conditions) will review your full medical history, including all medicines you take. Blood thinners, beta-blockers, and some other medicines may affect safety and will be discussed.
Unlike many procedures, allergy shots do not require fasting. However, a few steps help make each visit safer. Vigorous exercise raises blood flow and can speed up how quickly an allergen is absorbed, so most clinics ask patients to avoid hard exercise for two hours before and two hours after each shot. Alcohol is usually avoided on injection days for the same reason.
On days when you have a fever, an asthma flare, or a significant illness, the injection is typically postponed. Tell the nurse before every shot about any new symptoms, new medicines, or reactions from the previous injection.
Testing done before starting the course usually includes:
- Skin-prick tests or intradermal (just under the skin) tests to identify exactly which allergens trigger your reactions and how strongly
- A specific IgE blood test (a blood test that measures allergy antibodies) as an alternative or complement to skin testing
- Lung-function tests for patients with asthma, to confirm asthma is stable enough to begin
- A brief physical check on the day of every injection to confirm you are well enough to receive the dose
The injection process itself follows a standard sequence, though the number of visits and how quickly doses are increased varies between protocols and clinics.
- 1. The allergist prepares a custom extract containing the allergens identified in your tests, mixed to a precise concentration.
- 2. The nurse or doctor confirms your identity, reviews your symptom diary and any reactions from previous shots, and checks your peak flow (a quick breath test) if you have asthma.
- 3. A small amount of the extract is injected just under the skin of your upper arm, usually with a very fine needle.
- 4. You wait in the clinic for at least 20 to 30 minutes while staff monitor you for any signs of a reaction.
- 5. The injection site is checked before you leave. Any local swelling is noted so the dose can be adjusted next time if needed.
- 6. Visits repeat weekly or twice weekly during the build-up phase, then monthly during the long-term maintenance phase, which typically lasts three to five years.
Aftercare
Allergy shots are an outpatient treatment, so there is no hospital admission and no recovery room stay. The post-injection waiting period in the clinic is the most critical part of aftercare, because most serious reactions occur within the first 30 minutes. Once staff confirm you are well, you go home and resume normal activities.
- Wait the full observation period in the clinic after every injection without exception
- Avoid strenuous exercise for at least two hours after each shot to prevent faster allergen absorption
- Apply a cool compress to the injection site if local redness or swelling develops
- If hives, throat tightness, wheezing, or dizziness appear after leaving the clinic, seek emergency care immediately and use a prescribed adrenaline auto-injector (such as an epi-pen) if one has been given to you
- Keep all scheduled injection appointments; missing multiple visits can require restarting at a lower dose
- Attend follow-up consultations with your allergist, usually every few months, so your response to treatment can be reviewed and the dose adjusted if needed
- Continue any prescribed allergy medicines during the early phase of treatment, as symptom relief from the shots builds gradually over months
- Track your symptoms between visits, as this diary helps the doctor judge whether the programme is working and when maintenance level has been reached
- Treatment typically continues for three to five years; stopping too early reduces the chance of long-lasting benefit
Cost & What Determines It
The cost of allergen immunotherapy varies widely because it is not a single procedure but a multi-year programme with many individual visits. Where you receive treatment, how complex your allergy profile is, and how long you stay in the build-up phase all pull the price in different directions.
- Complexity of the allergen extract: treatment targeting several allergens at once requires a more elaborate custom-mixed extract than a single-allergen course
- Phase of treatment: the build-up phase, with frequent weekly visits, costs more per month than the maintenance phase, where injections are monthly
- Hospital or clinic class: a university hospital with an on-site allergy department charges differently from a private specialist clinic or a general outpatient centre
- Country of treatment: staff wages, regulatory fees, and medicine pricing differ significantly between countries, which is reflected in the total programme cost
- Diagnostic testing before starting: skin-prick panels, blood IgE tests, and lung-function tests are often billed separately from the injections themselves
- Emergency medication: an adrenaline auto-injector prescribed for home use is usually an additional cost
- Consultation fees: allergist visits at the start and during periodic reviews add to the overall programme cost
- Any additional treatment needed to manage flares of asthma or other conditions during the programme
When a hospital offers an immunotherapy package, it typically covers the consultation to design the extract, the extract preparation itself, the injections for a defined number of visits, and the post-injection observation time. Items commonly billed separately include the initial allergy testing panel, imaging or lung-function tests, emergency medications, and follow-up consultations outside the package schedule.
BPJS Kesehatan and most Indonesian private insurance policies do not cover medical treatment received abroad, so patients travelling overseas for this programme generally pay out of pocket or rely on international private health insurance that explicitly includes treatment outside Indonesia. Before travelling, requesting a written cost estimate from the hospital that lists each component of the programme is the clearest way to avoid unexpected bills on arrival.
Frequently Asked Questions
How many shots will I need to complete allergy immunotherapy?
Most people need shots over a period of three to five years in total. Treatment usually has two phases: a build-up phase where you receive shots every week or two, and a maintenance phase where shots are spaced out to once a month. Your doctor will decide the exact schedule based on how your immune system responds.
What does an allergy shot feel like, and does it hurt?
Most people feel a small sting or mild soreness at the injection site, similar to any ordinary shot. Some redness or swelling around the spot is common and usually fades within an hour or two. Rarely, some people have a broader reaction such as hives or sneezing shortly after, which is why clinics typically ask you to wait and be observed for about twenty to thirty minutes after each injection.
How soon will I notice improvement from allergy shots?
Many people begin to notice some relief during the build-up phase, usually after several months of regular shots. More noticeable improvement often comes once you reach the maintenance phase. Because the treatment works by gradually retraining your immune system to tolerate the allergen (the substance that triggers your allergy), results tend to build slowly rather than appearing all at once.
How much does allergen immunotherapy cost?
The cost depends on several factors specific to your situation, including the number and type of allergens being treated, how long your build-up phase takes, and the class of hospital or clinic you choose. Because these variables differ from patient to patient, the most reliable way to get a real number is to request a written treatment estimate from the hospital before you commit.
This page is general information, not a substitute for medical advice. Every case is different. Your doctor decides what is right for you.
