Are Allergy Shots or Sublingual Drops Right for You?

If you suffer from seasonal or year-round allergies, you may be considering immunotherapy—treatments designed to reduce your sensitivity to allergens over time. The two most effective types of immunotherapy are allergy shots (subcutaneous immunotherapy, or SCIT) and sublingual drops (sublingual immunotherapy, or SLIT). But how do you know which one is right for you?

Understanding the Options

Allergy shots have been used for over a century and are FDA-approved in the United States. They involve injecting small, gradually increasing amounts of allergens under the skin, typically in a medical office. Sublingual drops, on the other hand, are placed under the tongue and can often be taken at home. Both approaches train your immune system to become less reactive over time.

Factors That Determine the Best Fit

1. Type and Severity of Allergies
Allergy shots treat a wide range of environmental allergens including pollen, dust mites, mold, and pet dander. They are especially beneficial for patients with multiple severe allergies. SLIT is generally more appropriate for patients with mild to moderate symptoms or those allergic to a smaller number of triggers.

2. Age and Tolerance
Children as young as 5 can receive allergy shots, but they must be able to cooperate with regular injections. SLIT may be a better option for younger children or needle-averse adults because it’s non-invasive and pain-free. However, SLIT is not yet FDA-approved for custom formulations in the U.S., although it is commonly prescribed off-label.

3. Time Commitment
Allergy shots require frequent office visits—typically once or twice a week during the buildup phase, followed by monthly maintenance shots for 3–5 years. If your schedule doesn’t allow for this kind of regular commitment, SLIT may be more convenient since it can be administered at home.

4. Medical History and Risk Profile
People with uncontrolled asthma or a history of severe allergic reactions may not be ideal candidates for allergy shots due to the risk of systemic reactions. SLIT has a lower risk of anaphylaxis and may be safer in these cases, though all immunotherapy should be started under the supervision of an allergy specialist.

5. Insurance and Cost
Allergy shots are generally covered by insurance. SLIT, especially custom-mixed formulations, is often not covered and may require out-of-pocket payment. However, the convenience and reduced travel may offset the cost for some patients.

Making the Right Choice

The decision between shots and drops should be made in partnership with a board-certified allergist. They’ll conduct skin or blood testing to identify your allergens, assess your overall health, and recommend a personalized treatment plan. Whichever method you choose, the goal is the same: to reduce your symptoms, decrease medication use, and improve your quality of life.

Final Thoughts

Both allergy shots and sublingual drops are highly effective tools for long-term allergy relief. By understanding the pros and cons of each and consulting with your allergist, you can take the first step toward breathing easier, sneezing less, and enjoying life more—season after season.