Useful to know about VACCINATION AGAINST ALLERGY (allergivaksinasjon)

VACCINATIONS AGAINST ALLERGIES ( allergivaksinasjon )

Useful information about allergy vaccination – Information sheet from the Norwegian Asthma and Allergy Association

Vaccination is an alternative form of treatment for long-term and acute allergies when the use of conventional medications does not provide a satisfactory effect. Treatment is also called hyposensitization or special immunotherapy. The principle of treatment is to reduce allergy symptoms by injecting the substance that causes the allergy.

This should not be confused with cortisone injections for allergies. Cortisone injections should only be used when a quick response to serious symptoms is needed and other treatments have not been effective.

Antiallergic vaccination is performed by injecting small doses of an extract of the allergen to which the body reacts under the skin. Initial doses should be small enough not to cause an allergic reaction. Doses are gradually increased until a level of tolerance is reached. This optimal dose is usually administered at intervals of 6-8 weeks for 3-5 years. Thus, it is possible to achieve the development in the body of tolerance to the allergen used in the course of treatment.

In what cases is this treatment used?

Vaccination can be used for most types of pollen allergies (birch, hazel, grass). Antiallergy vaccination is also used to reduce the risk of life-threatening reactions in people suffering from acute allergies to bee and wasp stings. In some cases, vaccination is used for allergies to animals and house ticks. Studies have shown that allergy vaccinations may prevent the development of asthma later or provide greater control of allergic asthma. However, people suffering from acute asthma should not receive allergy vaccinations.

Pollen allergy vaccination with Grazax tablets is an approved treatment for adults and children over five years of age who suffer from pollen allergies. The medicine is a lozenge containing extracts of timothy pollen allergens.

Who is the vaccine for?

Before considering vaccination, treatment with conventional allergy medications, antihistamines, and topical medications for eye and nasal symptoms is necessary. If symptoms persist after such treatment, vaccination may be a good alternative.

Allergy vaccination is not recommended for children under 5 years of age, or for individuals with uncontrolled asthma, serious cardiovascular disease, or cancer. Vaccination should not be started during pregnancy.

Allergy vaccination should not begin during pollen season and dose increases should be completed before pollen season begins. For example, increasing the dose of birch allergen should be completed between July and February, grass - between September and April, and wormwood - between October and April.

Allergy vaccination requires a proven allergy using a skin test or blood test. Pulmonary function testing should also be performed before starting treatment.

The costs of allergy vaccinations are covered by the state insurance fund or by a “blue prescription”. Other vaccines may be covered solely on an individual basis.

For allergy vaccinations using Grazax tablets, a lozenge is taken every day for three years, and treatment should begin four months before the start of pollen season.

Grazax entitles you to reimbursement for moderate to severe seasonal pollen allergies for at least two years, in cases where other treatments have failed to achieve sufficient control of the disease or have resulted in side effects. Reimbursement also provides that the patient does not receive vaccines containing extracts of other allergens. The right to reimbursement of expenses applies to children over five years of age, as well as to adults.

Where is vaccination carried out?

Vaccination against allergies should only be carried out by a lung specialist, otolaryngologist or pediatrician with allergy specialization.

Danger of side effects

Allergy vaccinations carry a certain risk of side effects. These may include mild symptoms such as a runny nose, itchy eyes and larynx, or serious, sometimes life-threatening symptoms such as difficulty breathing or anaphylactic shock. This is especially true for the initial phase of vaccination and the moment immediately after the injection. Therefore, vaccination must be carried out in specially designated places where there are means of providing assistance in case of possible serious complications. This is also why you should not leave the vaccination site for 30 minutes after taking the last dose of the drug. During the first 24 hours after the injection, local reactions may occur, such as swelling of the skin, so physical activity should be avoided for the first 24 hours after vaccination.

The most common side effects of vaccination using Grazax tablets are local allergic reactions in the mouth in the form of burning or swelling of the sublingual area. In most cases, these reactions subside within a few weeks from the start of vaccination.

What is the effect of the treatment?

There is documentation that vaccination is an effective form of treatment that can reduce allergic symptoms, improve the allergy sufferer's quality of life, and thereby significantly reduce the use of other medications. For most patients, the effect will be permanent. However, some patients may not experience significant improvement. It is impossible to determine in advance whether vaccination will have an effect for a particular patient.

Allergy vaccination itself is a form of treatment that requires a lot of time and money. The risk of side effects and the fact that not everyone will feel better after treatment makes it necessary to weigh the pros and cons before starting vaccination.

The development of new and more effective forms of immunotherapy provides hope for more reliable treatments and improved outcomes in the future.

The facts about allergy vaccination have been developed jointly with the medical council of the Norwegian Asthma and Allergy Association.

Treat not the symptoms of allergies, but their causes!

Allergen-specific immunotherapy (ASIT) is the only method of treating allergic diseases that affects all parts of the allergic process.

Indications for allergen-specific immunotherapy

Patients with allergic rhinitis (rhinoconjunctivitis);
Seasonal allergies (hay fever);
Year-round rhinitis of allergic origin;
Bronchial asthma.
Patients with mild and moderate forms of bronchial asthma, with FEV1 values more than 70% of the required values after adequate pharmacotherapy.
Patients whose symptoms are not adequately controlled after allergen elimination or where complete allergen elimination is not possible;
Patients who have both bronchial and rhinoconjunctival symptoms or dermatitis.
Patients who refuse long-term (continuous) use of pharmacological drugs, including for religious reasons.
Patients in whom pharmacotherapy causes severe side effects.

What is allergen-specific immunotherapy?

The treatment regimen involves gradually introducing a person with a provoking serum of a specific allergen. A gradual increase in dosage causes the body to become addicted, thus relieving the problem. The ASIT method is a derivative of vaccination and homeopathy; it was created on a similar principle, taking as a basis the following main points:

from the field of homeopathy - the principle of treating like with like: or relief lies in microdoses of an allergen that causes allergies in large quantities;
from vaccination - preparing the immune system to accept a foreign element: a low concentration of the allergen before introducing large dosages is the key to successfully overcoming the problem.

The mechanism of action of the technique is a sequence of multicomponent reactions to normalize the immune response. The course of treatment sometimes lasts for months and even years, but after its completion a long respite is guaranteed, which can provide immunity to a given allergen, in some cases forever.

Specific immunotherapy for allergies has proven effective in the treatment of rhinitis and conjunctivitis, asthma and dermatitis, reactions to insect bites if they are caused by allergic reactions.

Make sure the vaccine is safe

Before vaccinating a child, you need not only to make sure that the vaccine is of good quality, but also to clarify its composition, since it may be unsuitable for an allergy sufferer. Some vaccination preparations (for example, live measles-rubella-mumps vaccine) are prepared on chicken embryos and are contraindicated if you are allergic to chicken egg white. If you are allergic to baker's yeast, you should not receive the hepatitis B vaccine, and if you are allergic to gelatin, you should not receive the chickenpox vaccine. Sensitive children often react poorly to the pertussis component of the DTP vaccine, and doctors recommend vaccinating them against diphtheria and tetanus with the ADSM vaccine, which is considered to have a milder effect. If a child is allergic to antibiotics, live and multi-component vaccines are dangerous for him. In general, when vaccinating allergy sufferers, it is better to avoid live and multicomponent vaccines as much as possible. The vaccination schedule is extended over time, but it will be better for the child’s body.

Double benefit

There are vaccinations that are especially... useful for allergy sufferers. For example, in case of virus-induced bronchial asthma (allergy to viral infections), such a vaccination can protect against an allergic reaction to a viral disease. It is also recommended that all children with allergies be promptly vaccinated against diphtheria and tetanus, because the risk of acute allergic reactions to treatment - the administration of anti-tetanus and anti-diphtheria serums - is much higher than to the toxoids that are used in vaccines against these diseases.

Choose your time

Although an allergic disease in a child is not a contraindication to vaccination, it requires an individual vaccination schedule. Children with allergies should not be vaccinated during an exacerbation, that is, during severe manifestations of atopic dermatitis, asthma or hay fever. In case of hay fever, vaccination should be avoided throughout the flowering season, even if there are no strong manifestations of allergies at the moment. It is best to wait for a period of complete “calm” to avoid unnecessary stress on the immune system.

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The Mantoux reaction is not formally a vaccination, but nevertheless it is the introduction of a foreign substance into the body, which often causes allergies. The disadvantage of this procedure is that it too often gives a false positive reaction. Almost all allergy sufferers react this way to the component of the drug – tuberculin. Therefore, children with allergies or a tendency to it need to do Mantoux under the guise of antihistamines or use other methods of testing for tuberculosis. For example, there is a diagnostic developed in Russia called Diaskintest: not tuberculin is injected under the skin, but a recombinant protein that causes an immune reaction only to Mycobacterium tuberculosis. But although this drug is considered less allergenic, it is still better to administer it while taking antihistamines.

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You can also resort to an alternative option for diagnosing tuberculosis - taking blood from a vein for analysis. This is a more complex and lengthy procedure, but it is also more gentle on the immune system of an allergic child.

Prevention measures

When planning to vaccinate even a healthy child, it is good to do tests of his blood and urine shortly before vaccination to make sure that there is no hidden incubation period of the disease in the body. As for allergy sufferers, it is advisable for them to also take antihistamines three days before vaccination, on the day of vaccination and three days after it. Just in case, this should also be done for children with a possible predisposition to allergies (when there are allergy sufferers among close relatives), in whom vaccination can act as a “trigger” for the onset of the disease.

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Rarely, an acute allergic reaction known as serum sickness or anaphylactic shock occurs immediately after vaccination, and children with allergies are at greater risk than others. No matter how low the likelihood of this happening, it is better not to leave the clinic for at least half an hour after vaccination - the treatment room has everything necessary for urgent assistance in such cases. If your child becomes ill after you return home, you need to call an ambulance.