Allergy shots - do I really need retesting after 6 months?
March 24, 2019 10:30 AM Subscribe
I started allergy shots 6 months ago, and just hit maintenance dose. Sales pitchy doctor (who I increasingly trust less) now says I'm due for retesting again before they reorder - is that standard?
I started allergy shots this fall, and got a full range of allergy skin/blood tests at that time. My allergist talked me into them and I'm not sure he should have - they are pretty mild and occasional (seasonal spring + mild pet), and I've previously been pretty happy with prescription solutions. Because that cost would run $90 month out of pocket and my employer health insurance was ending, he pressed that if I had the testing & new vials made then, the overall costs would be minimal since they would last a year (when I expect to have employer health insurance again).
This was a very direct conversation with a big sales pitch and lot of assurance from his end about the exact cost and schedule, so I'm unhappy that they are now saying something very different: that I need new vials and new testing again after just 6 months (which together will run an unexpected $2K at minimum given my current minimal marketplace plan). The testing schedule is a general office recommendation for everyone, and they have also pressed for other additional costs previously that don't seem to have much purpose to my specific situation, like check-in appointments "on how things are going" ( I pushed back here successfully since I had no side effects, and since I wouldn't know the effectiveness until spring anyway).
I don't want to try switching doctors at this time, especially since my insurance situation is going to change again within a few months. But I do feel like they are eager to charge whatever they can and not sensitive to my insurance situation, and that retesting so quickly may not actually be necessary (this article recommends every 2 years, though is unclear about whether that is the case during immunotherapy). I would love to hear accounts of what others have encountered during the testing process, thanks!
I started allergy shots this fall, and got a full range of allergy skin/blood tests at that time. My allergist talked me into them and I'm not sure he should have - they are pretty mild and occasional (seasonal spring + mild pet), and I've previously been pretty happy with prescription solutions. Because that cost would run $90 month out of pocket and my employer health insurance was ending, he pressed that if I had the testing & new vials made then, the overall costs would be minimal since they would last a year (when I expect to have employer health insurance again).
This was a very direct conversation with a big sales pitch and lot of assurance from his end about the exact cost and schedule, so I'm unhappy that they are now saying something very different: that I need new vials and new testing again after just 6 months (which together will run an unexpected $2K at minimum given my current minimal marketplace plan). The testing schedule is a general office recommendation for everyone, and they have also pressed for other additional costs previously that don't seem to have much purpose to my specific situation, like check-in appointments "on how things are going" ( I pushed back here successfully since I had no side effects, and since I wouldn't know the effectiveness until spring anyway).
I don't want to try switching doctors at this time, especially since my insurance situation is going to change again within a few months. But I do feel like they are eager to charge whatever they can and not sensitive to my insurance situation, and that retesting so quickly may not actually be necessary (this article recommends every 2 years, though is unclear about whether that is the case during immunotherapy). I would love to hear accounts of what others have encountered during the testing process, thanks!
Best answer: I have had allergy shot series twice twenty years apart, both with plenty of vial reorders and was never asked to retest. During my last 3 plus years of allergy shots I changed doctors (because my dear original Dr. retired). The new Dr required retesting because they used a different allergy formulation. Could the dr be changing the formulation he is using as is just not being upfront with you?
I cannot imagine any other reason to retest. The dr gets information each time you get a shot — either you react or you don't. If you react they give you less allergen next time, if you don't, they give you more. There is nothing else they need. I am super allergic and so had a number of reactions, the dr would just give me less of the allergen in my next shot each time, even starting over once. No retesting, though they did consider stopping the shots altogether.
I would ask the Dr what would happen if you were not retested. I find this behavior very suspicious.
posted by djinn dandy at 11:00 AM on March 24, 2019 [1 favorite]
I cannot imagine any other reason to retest. The dr gets information each time you get a shot — either you react or you don't. If you react they give you less allergen next time, if you don't, they give you more. There is nothing else they need. I am super allergic and so had a number of reactions, the dr would just give me less of the allergen in my next shot each time, even starting over once. No retesting, though they did consider stopping the shots altogether.
I would ask the Dr what would happen if you were not retested. I find this behavior very suspicious.
posted by djinn dandy at 11:00 AM on March 24, 2019 [1 favorite]
Best answer: My allergist never did that in 3.5 years of shots.
posted by umbú at 11:13 AM on March 24, 2019 [1 favorite]
posted by umbú at 11:13 AM on March 24, 2019 [1 favorite]
Best answer: Hi, that sounds super weird to me. I've been on allergy shots on and off for 24 years. Here are the times I've been tested:
- at age 8 to start getting shots (I went for about ~7 years)
- at age 20 when I was getting allergy shots from a new doctor in a different part of the country (from this point on I've basically gotten shots continuously)
- at age 27 when I was experiencing a lot of symptoms despite my shots, so they wanted to check and see if I'd developed new allergies (spoiler alert: yes)
In between 2 and 3 I switched allergists, and the new doctor was happy to just take my old test results. My current allergist is amazing and highly regarded, fwiw.
So yes: it sounds weird to me that you have to re-test so soon. It is also weird that your doctor told you that shots could replace prescription meds?? Like yes maybe, in the long run, but over the course of a year?! I think that's very weird too.
posted by goodbyewaffles at 11:19 AM on March 24, 2019
- at age 8 to start getting shots (I went for about ~7 years)
- at age 20 when I was getting allergy shots from a new doctor in a different part of the country (from this point on I've basically gotten shots continuously)
- at age 27 when I was experiencing a lot of symptoms despite my shots, so they wanted to check and see if I'd developed new allergies (spoiler alert: yes)
In between 2 and 3 I switched allergists, and the new doctor was happy to just take my old test results. My current allergist is amazing and highly regarded, fwiw.
So yes: it sounds weird to me that you have to re-test so soon. It is also weird that your doctor told you that shots could replace prescription meds?? Like yes maybe, in the long run, but over the course of a year?! I think that's very weird too.
posted by goodbyewaffles at 11:19 AM on March 24, 2019
Best answer: I have had five different allergists providing allergy shots in several different states. Each time I move, I need a new test because allergens can be region specific. After that new test at a new allergist in a new area, I've never had to retest though I imagine I might have to eventually but I always have moved before that eventuality came to pass. At one point I had to get additional testing to figure out the cause of a persistent rash, but that was not related to my shots and therefore the type of additional testing was different and required a dermatologist consult.
My current allergist does mandate office visits when I don't need them just to make money. They used to require once every three months, but I threatened to leave their practice and as a result we negotiated a more reasonable frequency. I actually can't remember if it's once every six months or once a year but it's something I thought was acceptable.
I do need new vials mixed fairly frequently. I don't know how often but I certainly think more than once a year. They run out and/or expire after a certain amount of time and often when you're new to them (or when you travel for lengthy periods of time that reset the allowable dosages) they need to keep raising the strength, too.
posted by vegartanipla at 1:09 PM on March 24, 2019
My current allergist does mandate office visits when I don't need them just to make money. They used to require once every three months, but I threatened to leave their practice and as a result we negotiated a more reasonable frequency. I actually can't remember if it's once every six months or once a year but it's something I thought was acceptable.
I do need new vials mixed fairly frequently. I don't know how often but I certainly think more than once a year. They run out and/or expire after a certain amount of time and often when you're new to them (or when you travel for lengthy periods of time that reset the allowable dosages) they need to keep raising the strength, too.
posted by vegartanipla at 1:09 PM on March 24, 2019
Best answer: I've been getting allergy shots for a year, and I'm on my second set of vials. There's been no mention of re-testing yet.
posted by wryly at 2:58 PM on March 24, 2019
posted by wryly at 2:58 PM on March 24, 2019
Best answer: One more anecdote, I'm on year 4 of allergy shots and haven't been tested since before I started. Every 6 months I meet with the doctor who basically gets a verbal from me that my allergies are still under control before re-ordering my serum. Presumably they'd offer more testing if I told them things had gotten worse, but knock-on-wood it's been very successful.
posted by rouftop at 4:42 PM on March 24, 2019 [1 favorite]
posted by rouftop at 4:42 PM on March 24, 2019 [1 favorite]
Best answer: I've been getting shots for 4 years now, with no suggestion of a re-test. I see the doctor about once every six months.
posted by tuesdayschild at 9:17 AM on March 25, 2019
posted by tuesdayschild at 9:17 AM on March 25, 2019
Best answer: I started shots last May.
My allergist requires an appointment at the start of shots, at the point you go on maintenance dose, and then 6 months after you hit maintenance (and then every 6 or 12 months after, depending on how things are going.) The rest of the time I just see the staff who give the shots.
She said that how long the vials last depends on how frequently I come in for the maintenance shots, which are between 3 and 4 weeks depending on symptoms. If you do 3 weeks, obviously, you use more serum up than at 4 week intervals. (I was doing 3 weeks over most of the winter because I ended up moving and kicking up a lot of dust and related allergens, but I'm working on shifting to 4 week intervals.) I can't remember whether she said the full dose serum expires at 6 months or a year, but whenever that is, they have to remake the serum even if there's still some left.
She's mentioned that retesting might be a thing, especially after a year or two when we have a better sense of what I'm still getting symptoms from, but that it takes a while for benefits to kick in for some people (every piece of paper she's given me says 6-12 months from when you hit maintenance dose, not when you start the shots.) I also started out at least somewhat allergic to approximately everything environmental, so it's not like we'd be adding major new allergens in or something.
posted by jenettsilver at 11:52 AM on March 25, 2019
My allergist requires an appointment at the start of shots, at the point you go on maintenance dose, and then 6 months after you hit maintenance (and then every 6 or 12 months after, depending on how things are going.) The rest of the time I just see the staff who give the shots.
She said that how long the vials last depends on how frequently I come in for the maintenance shots, which are between 3 and 4 weeks depending on symptoms. If you do 3 weeks, obviously, you use more serum up than at 4 week intervals. (I was doing 3 weeks over most of the winter because I ended up moving and kicking up a lot of dust and related allergens, but I'm working on shifting to 4 week intervals.) I can't remember whether she said the full dose serum expires at 6 months or a year, but whenever that is, they have to remake the serum even if there's still some left.
She's mentioned that retesting might be a thing, especially after a year or two when we have a better sense of what I'm still getting symptoms from, but that it takes a while for benefits to kick in for some people (every piece of paper she's given me says 6-12 months from when you hit maintenance dose, not when you start the shots.) I also started out at least somewhat allergic to approximately everything environmental, so it's not like we'd be adding major new allergens in or something.
posted by jenettsilver at 11:52 AM on March 25, 2019
Best answer: I’m allergic to damn near everything and have been getting shots for almost 5 yrs now. In fact last year they told me I could go off them but if I had problems would have to start over w/weekly shots for a year instead of the monthly shots I take now, and considering how bad my allergies are, they recommended I just continue, which I’ve done.
I’ve felt before that my asthma/allergy office pushes things on me, but they’ve never said I needed retesting.
posted by RichardHenryYarbo at 3:31 PM on March 25, 2019 [1 favorite]
I’ve felt before that my asthma/allergy office pushes things on me, but they’ve never said I needed retesting.
posted by RichardHenryYarbo at 3:31 PM on March 25, 2019 [1 favorite]
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posted by cobaltnine at 10:58 AM on March 24, 2019