Allergy vaccines: types, where to get them, cost, and reimbursement

Spring, with its explosion of life, also brings for many the return of the annoying allergy symptomsSneezing, a runny nose, red eyes, and itching are often caused by pollen released into the air by grasses and trees. Fortunately, in addition to symptomatic therapies, there is a treatment that acts on the very cause of the allergy:Specific Immunotherapy (SIT), commonly known as allergy vaccine.

Index of topics

What is specific immunotherapy?

Specific immunotherapy is the only therapy capable of modify the natural history of allergyIt consists of the gradual and controlled administration of small doses of the specific allergen to which the patient is sensitized.

The goal is to “re-educate” the immune system, inducing one state of tolerance towards that substance that it mistakenly identifies as an enemy. This process leads to a reduction in symptoms, a reduced need for medications, and an overall improvement in the quality of life.

Which allergies can be treated with immunotherapy?

ITS has proven to be effective mainly for respiratory allergies. In particular:

Spring allergies:
- Grass Pollens: one of the most common causes of seasonal rhinitis and conjunctivitis.
- Tree Pollen: like birch, olive, cypress, ash.
- Herb Pollens: like pellitory, which is very common in Italy.
Perennial allergies:
- Dust mites: Responsible for symptoms throughout the year, immunotherapy is also effective in children's allergies and may help prevent the development of asthma in those with dust mite allergic rhinitis.
- Epidermal derivatives of animals: Like the allergies to cats and dogs.
- Mold or Fungi: Like Alternaria.

Immunotherapy is also a lifesaving treatment for severe allergic reactions to hymenoptera (bee, wasp, hornet) venom.

How it works and how it is administered

There are two main methods of administration:

Subcutaneous route (SCIT – SubCutaneous Immunotherapy): It consists of subcutaneous injections of the allergen, administered initially weekly and then monthly, for a total duration of 3-5 years. It must be administered by qualified medical personnel in a controlled environment.
Sublingual route (SLIT – SubLingual Immunotherapy): It involves taking drops or tablets containing the allergen daily, held under the tongue for a few minutes before swallowing. After the initial administration under medical supervision, the patient can continue to take it comfortably at home, again for a period of 3-5 years. It is often preferred for its convenience, especially for allergens such as grasses.

The choice between SCIT and SLIT depends on the type of allergen, the patient's preferences, and the allergy specialist's assessment. Treatment should usually be started a few months before the pollen season for seasonal allergies.

Where to get an allergy vaccine

Specific immunotherapy should always be prescribed and monitored by an allergy specialist, after an accurate allergy diagnosis (skin tests and/or blood tests).

The administration always starts in a doctor's office or in an equipped health facility To manage any adverse reactions, especially for the subcutaneous route (SCIT). The first dose of sublingual therapy (SLIT) is also usually taken under medical supervision.

Subsequently, SLIT can be self-managed by the patient at home, scrupulously following medical indications, while SCIT requires periodic visits to the clinic for injections.

Allergy immunotherapy cost

Il cost of specific immunotherapy It can vary depending on the type of product (SCIT or SLIT), the duration of the therapy, and the manufacturing company. Generally, it is quite a high cost, even 650 euros for perennial allergies, which is at the patient's expenseIn some regions, such as Lombardy, immunotherapy is fully reimbursed by the local health authority.

Allergy vaccine reimbursement

Currently, in Italy, specific immunotherapy (both SCIT and SLIT) for respiratory allergies It is not reimbursed by the National Health Service (NHS) In most cases. Exceptions, in some regions or particular situations, include hymenoptera venom immunotherapy (considered lifesaving) or specific cases assessed by local committees. It is therefore essential to inquire about costs before starting treatment.

Allergy vaccine side effects

Allergen immunotherapy is generally considered safe when performed under medical supervision. However, side effects may occur:

Local Reactions (Municipalities):
- SCIT: Swelling, redness, itching at the injection site.
- SLIT: Itching or mild swelling in the mouth or under the tongue, mild gastrointestinal disturbances. These usually resolve spontaneously or with antihistamines and tend to decrease with continued therapy.
Systemic Reactions (Rare): Hives, rhinitis, asthma, and very rarely, severe anaphylactic reactions. The risk is greater with SCIT, which is why it is performed in a controlled medical setting and requires a period of observation after the injection.

Mite vaccine contraindications

Contraindications to specific immunotherapy, also valid for that against mites, include:

Severe or uncontrolled bronchial asthma.
Presence of some systemic autoimmune diseases.
Current treatments with beta-blockers.
Pregnancy: immunotherapy must not be started During pregnancy. If a patient becomes pregnant while already undergoing treatment, continuation of treatment should be carefully evaluated by a specialist.
Poor patient adherence to therapy.
Presence of acute infections or fever (temporary contraindication).

It is always the allergist who evaluates the patient's suitability for treatment after a careful analysis of his or her medical history.

Allergy vaccine: where to get it, how much it costs, and how to get reimbursed.