Allergies: Should I take shots for insect sting allergies?

Get the facts
Compare your options
What matters most to you?
Where are you leaning now?
What else do you need to make your decision?

1. Get the Facts

Your options

Get allergy shots to make you less sensitive to insect stings and reduce the risk of a severe allergic reaction (anaphylaxis).
Do not get allergy shots, and try other things such as avoiding stinging insects and carrying an allergy kit to deal with the risk of a severe allergic reaction.

Key points to remember

Allergy shots usually are recommended only for people who have already had a bad reaction that affects their whole body. If you have been stung in the past and had a whole-body allergic reaction to the sting, you have a high risk of having a similar reaction if you are stung again.
If you had an anaphylactic (life-threatening) reaction in the past, allergy shots greatly reduce your risk of having another severe whole-body reaction.¹
You may not need allergy shots if you had a normal (localized) reaction or a large localized allergic reaction to an insect sting in the past.
If you have taken allergy tests that found one or more sensitivities to insect stings, allergy shots can prevent life-threatening reactions and also make you less worried about insect stings.
Allergy shots may not be safe for you if you have an impaired immune system or certain kinds of heart problems.
Allergy shots can hurt a little, may trigger anaphylaxis in some people, can be costly, and usually take 3 to 5 years to complete.

FAQs

What are allergies to insect stings?

An allergic reaction to a sting occurs when your body's immune system overreacts to substances called allergens in the venom of stinging insects such as bees, wasps, hornets, or fire ants.

What are the different types of allergic reactions?

Minor allergic reactions occur around the site of the sting. This is called a localized reaction, and it can cause redness, swelling, fatigue, nausea, and a low fever.

A more serious allergic reaction can spread throughout your entire body. This is called a systemic reaction. It can cause symptoms such as itching, hives, and swelling of the tongue, throat, or other body parts.

A life-threatening systemic allergic reaction called anaphylaxis can cause severe symptoms such as confusion, trouble breathing, shock, and sometimes death.

How do allergy shots work?

Allergy shots work by putting small amounts of insect venom into your body, making you less sensitive over time to the venom.

Getting a series of allergy shots can prevent a systemic allergic reaction or make it less severe. Allergy shots are not needed if you have mild, local allergic reactions to insect stings. Only about 1 to 10 people in 100 who have localized reactions to insect stings go on to have a more serious, whole-body allergic reaction.² This means that 90 to 99 out of 100 don't ever have a whole-body reaction.

Allergy shots can greatly reduce your risk of having another life-threatening reaction if you've had one before. Imagine a group of 100 people who have had a life-threatening reaction. Without allergy shots, 60 of those 100 people will have another life-threatening reaction in the future. But if those 100 people get allergy shots, only 3 of them will have another life-threatening reaction.¹

After allergy tests have identified the insect(s) you are allergic to, you can begin to get the shots. At first, you will get weekly shots of small doses of venom and allergens from the insect(s) that cause your allergies. After about 4 to 6 months of weekly shots, you will get a regular dose, called a maintenance dose, every 4 weeks for another 4 to 6 months. Finally, you will keep getting monthly shots for 3 to 5 years, depending on the type of stings that cause your allergies. For example, fire ant allergies require longer treatment than other stinging insect allergies.

How can you treat severe allergic reactions?

If you have had severe reactions to insect stings, you may get a series of allergy shots every few hours on the same day or every few days. This helps to rapidly increase your tolerance to an allergen. After the first shot, you must wait to see if you have a reaction to the shot. If you don't have a reaction, you get more shots throughout the day. You (or your child) may feel anxious about receiving the next shot. So it may help to bring a book or something to distract you while you wait.

This treatment usually works in 1 to 8 days instead of the standard treatment, which takes several months. You may have this "rush" treatment if you have severe or life-threatening allergic reactions to insect stings, are a long distance from any type of health care center, have severe allergic asthma, or are about to travel.

What are the risks of allergy shots?

Allergy shots are safe for most people. The most common side effects are redness and warmth at the injection site. Some people may have large local reactions that include itching, hives, or swelling of the skin near the injection site.

But allergy shots can trigger a more serious whole-body reaction, which may include trouble breathing or swelling in the deep layers of the skin. In rare cases, a person may have a life-threatening allergic reaction (anaphylaxis) to the shots. Because of this, the shots are given in a clinic or other health care setting where emergency care can be provided if needed.

Talk with your doctor if you have an autoimmune disease (such as lupus) or are taking medicine for heart problems (such as beta-blockers). Allergy shots may not be safe for you.

Why might your doctor recommend allergy shots?

Your doctor may advise you to have allergy shots for insect stings if:

Allergy tests showed that you are sensitive to allergens from the venom of one or more insects.
You had a life-threatening allergic reaction to an insect sting.
You have whole-body reactions to insect stings but cannot carry an allergy kit with you at all times.
You work outside and have worse reactions each time you are stung.
You have only been stung once but had a moderate to severe reaction.

Why might your doctor NOT recommend allergy shots?

Allergy tests showed that you are not sensitive to allergens from the venom of insects.
You have an autoimmune disease (such as lupus) or are taking heart medicine (such as beta-blockers or ACE inhibitors).
Your allergic reaction to insect stings doesn't affect your whole body.
You are younger than 16 and had a mild skin reaction all over your body (systemic reaction) without any other symptoms.
You tried allergy shots before, but the shots triggered a moderate to severe allergic reaction.

2. Compare Options

	Have allergy shots	Don't have allergy shots
What is usually involved?	You have a series of allergy shots every week. After 4 to 6 months of weekly shots, you get a shot every 4 weeks. How long you receive monthly shots depends on the type of insect sting you are treating.	You avoid insect stings. You carry an allergy kit in case of a severe allergic reaction. If you get stung, you take medicine, such as antihistamines, for itching and other symptoms.
What are the benefits?	If you have had a severe allergic reaction, allergy shots can prevent symptoms from future insect stings or make your symptoms less severe.	You will avoid having shots. You won't have to spend the money on a long series of shots. You won't have to travel to a clinic for regular shots.
What are the risks and side effects?	You may have: Redness and warmth at the injection site. (This is the most common side effect.) Large local reactions that include itching, hives, or swelling of the skin near the injection site. A serious whole body reaction, which may include having a hard time breathing or swelling in the deep layers of the skin. (This is not common.) A life-threatening allergic reaction (anaphylaxis) to the shots. (This is rare.)	You could have a moderate to severe allergic reaction to an insect sting. You could have a whole-body allergic reaction, especially if you've had one before.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

For more information, see the topics:

Personal stories about allergy shots for insect stings

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

" I have had systemic reactions to insect stings before, although none were life-threatening. I work in the landscaping and grounds maintenance industry, so I am outdoors almost every day mowing lawns, trimming hedges, tending flowerbeds, and similar activities that really put me at risk of getting stung. I carry an allergy kit to my work sites, but I wanted to do something to reduce my sensitivity to stings and cut the risk that I might have a really bad reaction. So I've decided to have immunotherapy. "

— Rudy, age 26

" I have what must be a mild allergy to bee stings. I've been stung three or four times over the past decade, and I always swell up quite a bit—my whole arm or leg or wherever the sting is—and break out in hives around the sting, too. But it never gets any worse than that. For me, allergy shots would just be too much bother and expense for something that only happens once in a great while, and my doctor tells me it's not really necessary. My doctor and I make sure I have an up-to-date allergy kit just in case, but I've never had to use it. "

— Max, age 57

" Our daughter was 14 years old when she had a pretty severe reaction to a yellow jacket sting. She had swelling over most of her body and a bad outbreak of hives. She was very frightened. After talking it over with our doctor and an allergist, we decided to have her take allergy shots. They told us her risk of having another similar reaction was fairly high, and we felt it was worth the cost and the bother of having the allergy shots to reduce the risk. We also make sure she keeps her allergy kit close by. "

— Maureen, age 37

" Our 7-year-old boy was stung on the shoulder by a hornet at a family picnic. He was uncomfortable with a patch of hives across his back, but he got over it without anything worse. After talking things over with our pediatrician, we decided allergy shots wouldn't be needed: The chances he'll have another reaction like that are pretty low. But we do keep an allergy kit at home and with the nurse at school. "

— Kimberly, age 24

3. Your Feelings

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to choose allergy shots for insect stings

Reasons not to choose allergy shots for insect stings

I won't use an allergy kit, because I don't want to give myself a shot.

I feel comfortable giving myself a shot if I need to.

More important

Equally important

More important

I am worried about getting stung and having a bad reaction.

I am more afraid of the allergy shots than of my reaction to the insect stings.

More important

Equally important

More important

I don't mind spending the time and money to have allergy shots if it means I can avoid a bad reaction to an insect sting.

I don't want to spend the time or money to have allergy shots.

More important

Equally important

More important

My other important reasons:

More important

Equally important

More important

4. Your Decision

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having allergy shots

NOT having allergy shots

Leaning toward

Undecided

Leaning toward

5. Quiz Yourself

Check the facts.

1. I had a serious (whole-body) reaction to an insect sting in the past. This means I have a higher chance of having another bad reaction if I get stung again.

True
False
I'm not sure

That's right. If you have been stung in the past and had a bad reaction, you have a high risk of having a similar reaction if you get stung again.

2. With allergy shots, small amounts of insect venom are injected into my body. This may prevent or reduce a bad reaction if I get stung again.

True
False
I'm not sure

That's right. Allergy shots work by putting small amounts of insect venom into your body, making you less sensitive over time to the venom.

3. My chances of having a serious reaction to an insect sting are low. I was stung in the past, but I had only a slight skin reaction.

True
False
I'm not sure

That's right. Only about 1% to 10% of people with localized reactions to insect stings later have a more serious, whole-body allergic reaction.

Decide what's next.

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty.

1. How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2. Check what you need to do before you make this decision.

Nothing. I'm ready to take action.
I want to discuss the options with others.
I want to learn more about my options.

3. Use the following space to list questions, concerns, and next steps.

References

Citations

Moffitt JE, et al. (2004). Stinging insect hypersensitivity: A practice parameter update. Journal of Allergy and Clinical Immunology, 114(4): 869–886.
Golden DB (2003). Stinging insect allergy. In NF Adkinson Jr et al., eds., Middleton's Allergy Principles and Practice, 6th ed., vol. 2, pp. 1475–1486. Philadelphia: Mosby.