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Bee / Wasp Venom Immunotherapy Information for Parents and Carers

We have written this leaflet to answer questions you may have about your child starting wasp or bee venom immunotherapy. It explains the benefits, risks and alternatives, as well as what you can expect when your child comes to hospital. If you are considering this treatment for your child please read this leaflet and discuss its contents with your child. If you have any further questions, please ask the allergy team.

What is immunotherapy?

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Immunotherapy or ‘desensitisation’ is a well-established treatment for certain severe allergies. It involves the administration of increasing doses of allergen, the substance you are allergic to, over a prolonged period of time, to help teach your immune system to tolerate it and not ‘fight’ it.

Wasp and bee venom immunotherapy has been shown to lower the risk of severe reactions to wasp and bee stings.
It is given as a course of regular injections under the skin over 3-5 years.

Bee Sting

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How is the treatment course given?

  • The first part of treatment consists of an ‘up-dosing’ phase, when you and your child will visit our day ward on a weekly basis for approximately 15 weeks. It may take longer if your child is having difficulty tolerating the doses.
  • After this your child will enter the ‘maintenance’ phase of treatment. Their injections will be gradually spaced out to:
    • every 4 weeks for the first year,
    • and 4 to 6 weeks in the second and subsequent years.
  • It is important that these appointments are kept.
  • This schedule can be quite time consuming for children and their family as the five-year treatment involves many hospital visits for their immunotherapy injections. You should take this into consideration deciding if your child should begin venom immunotherapy.

What are the risks?

As with any medicine, there is a risk of side effects with wasp or bee venom immunotherapy.

  • It is quite common to get some mild pain, itching and swelling at the site of the injection.
  • It is also quite common to experience headaches and tiredness.
  • If your child experiences any other effects which you believe may be due to the therapy, it is important that you let us know.
  • There is a risk of an allergic reaction after each injection, which can range from mild (skin rash) to severe (anaphylaxis).
    For this reason we must monitor your child in our Day Ward for 60-90 minutes after their injection.

What happens during the treatment?

  1. When you arrive on the Medical Day Ward, you will be asked about any changes in your child’s health or medications since they were last seen.
  2. Your child will be examined and have some basic observations recorded.
  3. Your child may be asked to do a simple blowing test to check if they are fit for their treatment.
  4. The injection will be given in your child’s arm like a vaccination.
  5. A small number of children have allergic reactions to the venom — usually within an hour of getting the injection. Your child will be monitored for 60-90 minutes.
  6. Before going home we will teach you how to record details of any local reactions using a measuring tape and your phone to take a photo.
  7. We will advise you on how to treat these reactions.

Is the injection painful?

Your child might feel some discomfort when they get the injections. We can give topical anaesthetic cream to numb the injection site to make it more comfortable.

Can my child take other medicines whilst having immunotherapy?

  • Some medicines cannot be taken during immunotherapy treatment; for example some medicines that may be prescribed for heart conditions or depression.
  • It is important that you let us know about any medicines that your child is currently taking, including over the counter and herbal medicines.
  • Please check with us before they start taking new medication.
  • Vaccines must not be given within seven days before or after an injection of immunotherapy. Let us know if your child is scheduled for a vaccine.

Can I stop carrying my child’s adrenaline pen while they are receiving immunotherapy?

No — your child must continue to have their emergency medication with them at all times in case of a sting.

Any precautions after going home?

After the injection:

  1. Your child should avoid heavy exercise such as sports / training that evening.
  2. Avoid hot baths / saunas on the day of the immunotherapy.
  3. Some children find their eczema or hay fever becomes briefly worse after each immunotherapy injection. This normally settles down with time and usually responds to an antihistamine.
  4. If your child feels unwell or has a large local skin reaction at the injection they may benefit from antihistamine, paracetamol and using an ice-pack.
  5. Tiredness on the day of the injection may occur. This rarely lasts longer than 24 hours.

Contact Details

Important

In the extremely unlikely event that after going home you notice your child is having any signs of an allergic reaction, such as:

  • rash
  • itching
  • hives on their skin
  • swelling of the face, lips
  • shortness of breath
  • trouble breathing

Give adrenaline pen and call 999 or 112.

Authors: Mairead Sheehan Version: 1 Approval Date: March 2025 Review Date: March 2028 Copyright © Children’s Health Ireland The information contained in this leaflet is correct at time of approval.

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