Effective immunotherapy has been shown to be allergen-specific, dose-d
ependent, and duration-dependent. Patients must receive adequate doses
of the relevant allergen to obtain benefit, and most require 3 to 5 y
ears of injections to maintain. prolonged benefit after injections are
stopped. Concurrently, patients must cooperate by modifying their env
ironment and using some medications during difficult seasons. Although
serious reactions to immunotherapy are relatively rare, a physician m
ust be readily available whenever injections are administered, and off
ice staff need to recognize and be ready to respond to systemic reacti
ons.