Allergy Immunotherapy: Shots, Tablets, and Long-Term Relief
Allergy immunotherapy teaches the immune system to quit overreacting to pollen, mold, and other triggers. It is the only treatment that changes the underlying allergy instead of masking symptoms, and it can stop new allergies and asthma from developing (per ACAAI).
The therapy comes in two forms: allergy shots, the most common and most effective, and sublingual tablets. A full course lasts 3 to 5 years. Around 80% of users gain marked relief, and about 60% hold onto that benefit after therapy ends.
How well immunotherapy works
Allergy shots are the only disease-modifying treatment — they retrain the immune system rather than masking symptoms.
How allergy shots work
Allergy shots, called SCIT, feed the body rising, measured doses of the exact allergens that bother you. During the build-up phase you receive one to three injections a week for roughly 6 to 10 months, then move to maintenance shots about once a month for a total of 3 to 5 years. Because a serious reaction is possible, every injection is given in an allergist's office followed by a 30-minute observation period.
Sublingual tablets
Sublingual immunotherapy, or SLIT, is a tablet held under the tongue for a minute or two before swallowing. Only FDA-approved tablets in the US cover ragweed, northern pasture grasses such as timothy, and dust mites. Allergy drops are a separate product that is not FDA-approved, is off-label in the US, and is usually not covered by insurance (per ACAAI).
Who is a candidate
Immunotherapy suits people whose symptoms stay poorly controlled despite medication and avoidance, those carrying a heavy pill load or side effects, or anyone who wants to quit daily medication. The AAO‐HNSF 2015 guideline advises offering or referring for immunotherapy when allergic rhinitis fails to respond to drugs. An allergy test first pinpoints what to target. Children can begin therapy too, which may stop years of worsening symptoms before they settle in.
What to expect
Immunotherapy is measured in years, not weeks, and gains appear step by step. The reward is durable: around 80% improve markedly and about 60% keep lasting benefit after completing a 3-to-5-year course. Because it can block new sensitivities and blunt progression toward asthma, it is the one allergy treatment that actually changes the disease.
Shots and FDA-approved tablets are generally covered by insurance, unlike off-label allergy drops, so they remain the standard route. Missing doses slows progress, so the people who benefit most are those who can stick to the full schedule. For them, a few years of therapy can replace decades of daily medication.
What a course involves
typical full treatment course
ACAAI
build-up phase before maintenance
ACAAI
in-office wait after each shot
Cleveland Clinic
Check your local pollen forecast
Pollen seasons vary sharply by region. These metros see some of the worst pollen pressure — check the current forecast for each, or look up any US city on the pollen count hub:
- Scranton, PA pollen count — A high-burden allergy metro where long seasons make immunotherapy worth considering.
- Wichita, KS pollen count — Stacked grass and ragweed seasons are strong candidates for allergy shots.
- Richmond, VA pollen count — Long Mid-Atlantic seasons mean many residents outgrow what medication can manage.
- Oklahoma City, OK pollen count — Heavy grass and weed pollen make this prime immunotherapy territory.
- Memphis, TN pollen count — A long Mid-South allergy season where disease-modifying treatment pays off.
- Louisville, KY pollen count — Ohio Valley pollen and mold make immunotherapy a common next step.
Frequently asked
- What is allergy immunotherapy?
- A treatment that gradually exposes you to your allergens so the immune system stops overreacting. It is the only option that changes the underlying allergy and can prevent new allergies and asthma.
- How long do allergy shots take?
- A build-up phase of one to three shots a week lasts about 6 to 10 months, then monthly maintenance continues for a total of 3 to 5 years.
- How well do allergy shots work?
- About 80% of people see significant symptom improvement, and roughly 60% keep lasting benefit after completing a 3-to-5-year course.
- What is the difference between shots and tablets?
- Shots (SCIT) are given in the office and treat many allergens. Sublingual tablets (SLIT) are taken at home but are FDA-approved only for ragweed, grasses, and dust mites.
- Are allergy shots safe?
- They carry a small risk of a serious reaction, so they are given in an allergist's office with a 30-minute observation period afterward. Serious reactions are uncommon.
- Who should consider immunotherapy?
- People whose allergies are not controlled by medication and avoidance, who have a heavy medication burden, or who want to stop relying on daily pills. An allergy test confirms what to target.
More pollen & allergy guides
- Ragweed Allergy: Season, Symptoms, and Where It's Worst
- Hay Fever (Allergic Rhinitis): Causes, Seasons, and Relief
- Pollen Allergy Relief: What Actually Works
- Grass Pollen Allergy: Season, Triggers, and Relief
- Tree Pollen Allergy: Season by Region and the Worst Trees
- Pollen Count Scale: What Low, Moderate, High, and Very High Mean
- Allergy Season Calendar: When Each Pollen Peaks by Region
- Cedar Fever: Texas Mountain Cedar Season, Symptoms, and Relief
- Thunderstorm Asthma: How Storms Trigger Sudden Allergy Attacks
- Oral Allergy Syndrome: Why Pollen Makes Certain Foods Itch
- Mold Allergy: Outdoor Spore Season, Symptoms, and Relief
- Allergies vs. a Cold: How to Tell the Difference
- Allergy Testing: Skin Prick, Blood Tests, and What Results Mean
- Kids' Allergies: When They Start, Symptoms, and Safe Relief
- Winter Allergies: Indoor Triggers, Symptoms, and Relief
- Fall Allergies: What Triggers Them and When They Peak
- Dust Mite Allergy: Symptoms, Triggers, and How to Reduce Exposure
- Pine Pollen: Why the Yellow Dust Isn't Your Real Allergy Trigger
- Pollen Calendar: When Tree, Grass, Weed, and Mold Seasons Start and End
- Pollen count by city