Allergy & Dermatology

ALK-Abello Immunotherapy Injection Vaccines (SCIT)

 







For Australian & New Zealand medical professionals,
the latest information (as of 14/4/2010) on the availability and products of
ALK-Abello Injection Immunotherapy Vaccines
can be obtained by viewing the relevant Restricted Access section of this website. 
To enter the Restricted Access section on ALK-Abello Injection Immunotherapy Vaccines, click here.
To obtain your password for this restricted Access Section, contact AMS.

ALK-Abello Injection Immunotherapy Vaccines

More than 20% of the world’s population suffers from allergy or allergic asthma and the numbers are rising. Allergic reactions in the eyes and respiratory system are most frequently due to grass or tree or weed pollens, house dust mites or animal danders. In addition, foods may be allergens, as well as various Stinging Insect venoms and Drugs and Occupational allergens such as latex.

For many of these types of Inhalant Allergens, treatment with allergy Vaccines is not only possible but is highly effective. Immunotherapy is also the only means by which the underlying disease mechanism can be modified, rather than just smothering the symptoms of the body’s immune reaction to the allergen.

Traditionally, allergy vaccination has been achieved through the use of a program of Injections administered according to a standard Protocol (or Regime or Scheme). This is known as Sub-Cutaneous Immunotherapy; SCIT. The usual standard SCIT Protocol utilises a series of approximately 15 weekly doses of increasing strength and/or volume of the allergen solution; called the Initial Phase. Once the highest tolerated strength/potency has been achieved, then this becomes the Maintenance Dose and is repeated every 4 to 6 weeks for approx. 3 years. After this three year course of therapy, the course is then either stopped or tailed off, or may be continued for certain highly-sensitised patients.

Most usually the clinical benefit against the targeted allergens (and probably also other potential allergens) persists for several or many years and possibly the patient's lifetime.

Other treatment protocols exist for different Vaccine products and Patient clinical cases, such as “Rush” or “Ultra Rush” or “Cluster”. However, these are most usually reserved for use by an Allergy Specialist in the hospital setting.

Experimental vaccines to treat food allergy, such as peanut allergy, do exist but they are for use only by Allergy Specialists on special clinical cases, and done in the hospital setting.

There are today available other forms of Immunotherapy Vaccines than Injection Vaccines, and these are stated further below.

Depot Injection Vaccines
Most immunotherapy vaccines used in Australia are of the type called "Depot Vaccines" meaning that the allergenic substances (most usually proteins) are adsorbed to a matrix of (most usually) aluminium hydroxide (sometimes calcium phosphate). Therefore when the allergenic material is injected into the patient there is a slow release of the allergen off the matrix and into the patients immune system.

Most commercially manufactured vaccines used in Australia, and by most Allergists, are of this type. These types of Vaccines are manufactured in Europe and used worldwide except the Americas, or where there is strong influence o fthe American style of Immunotherapy Vaccines.

There is most usually an Initial Treatment Set of 3 or 4 vials of increasing potency, and when that is used up after weekly injections over 3-4 months then the patient goes onto the Maintenance Treatment Set which provides one injection per month for several months. Further Maintenance Treatment Sets are used up to a total of three years of maintenance treatment.

For bona fide medical professionals, further information on Sub-Cutaneous Immunotherapy Vaccines is available at www.amsl.com.au/SCIT .
A password is required to access that information. Contact AMS for that password.

Aqueous or Glycerinated Injection Vaccines
The other two types of vaccine are known as "Aqueous" or "Glycerinated" Vaccines, whereby the allergenic material is suspended in either water or a 50% glycerin solution with water.

When injected, the allergenic material is much more rapidly released and becomes immunologically reactive in one large dose.

This type of vaccine is commonly used in the United States of America and by some Australian Allergists who were trained in USA. 

One feature of using the Aqueous or Glycerinated Vaccines is that the individual Allergist will most usually make up their own vaccines tailored to the individual clinical requirements of the patient, so often with a mix of different allergens and different concentrations in the same vaccine; something that is rarely possible with the pre-mixed commercially manufactured Depot Vaccines. The Allergists will have a bank of different stock solutions of different allergens, with which he will make up the individual vaccines for the individual patients and in concentrations appropriate to the stage of their immunotherapy course of treatment.

Treatment Sets (Initial and Maintenance) are also available of the Aqueous or Glycerinated Vaccines.

Whilst each patient’s response to allergy immunotherapy is highly individual, in general most patients will start to experience improvements in symptoms and other medication usage after a few months. After the full 3-year course, remission of symptoms is most usually then complete or at least substantial, and for several years duration or for the lifetime.

It is important to note that vaccination against one particular problem allergen will generally also ameliorate any symptoms from other allergens, and prevent the patient from developing asthma, and will prevent the development of sensitivity against more allergens in the future. This is why there is an increasing trend to identify problem allergens early in the “Allergic March” amongst children, and institute Immunotherapy in order to halt “The Allergic March” towards more severe symptoms, and a greater range of symptoms, and more allergens. 

For bona fide medical professionals, further information on Aqueous & Glycerinated Immunotherapy Vaccines is available at www.amsl.com.au/USA SCIT .
A password is required to access that information. Contact AMS for that password.

Immunotherapy Vaccines Diluents
In addition to the various stock solutions of Aqueous or Glycerinated allergens, the Allergist will also have an appropriate Diluent, either Albumin Saline with Phenol (HSA) or Normal Saline with Phenol (NSP).

For bona fide medical professionals, further information on Immunotherapy Vaccine Diluents is available at www.amsl.com.au/diluents.
A password is required to access that information. Contact AMS for that password.

Venom Immunotherapy Injection Vaccines (VIT)
Immunotherapy Vaccines exist for treatment of severe allergy to Sting Insect Venoms, such as Wasp and Bee and Hornet and Jumper Ant stings.These vaccines are in fact the pure venom, as found in the sting, but that venom is given as a course of injections (only) by the Specialist Allergist (ony), with increases volumes of increasing potency, until the patient becomes fully tolerant of normal natural stings after 3 to 5 years of treatment. This is a very effective and potentially life-saving treatment for sting allergy.

For bona fide medical professionals, further information on Venom Immunotherapy Vaccines is available at www.amsl.com.au/VIT .
A password is required to access that information. Contact AMS for that password.

Sub-Lingual Immunotherapy (SLIT)
Although proven to be very effective in the treatment of Inhalant Allergy or Stinging Insect Venom Allergy, the use of SCIT has been limited by the safety factor. Although rare, and even then usually caused by operator error, serious adverse reactions may occur, and the risk of anaphylaxis must always be considered and catered for. This safety factor has lead to the usage of SCIT only for Rhinitis and Rhino-conjunctivitis patients rather than for cases with a moderate to strong feature of Asthma. In addition, many Paediatric patients would not consider SCIT due to the discomfort from the injections. Also the inconvenience factor of weekly and then monthly doctor’s visits would be a deterrent factor for some patients.

There is however an alternative form of vaccine administration that has been introduced to clinicians in various countries around the world and has become the standard vaccine form in several European countries. In the early 1990s ALK-Abelló was the first manufacturer to introduce Sub-Lingual Immuno-Therapy (SLIT).

In many European countries SLIT is now as popular and if not more popular than SCIT amongst Allergists and patients. There is increasing acceptance amongst Specialist Allergists in Australasia, mirroring the great acceptance and usage in many parts of Europe.

A list of Specialist Allergists in Australia is available at http://www.allergy.org.au 

For further information contact:
Steve Lee                                                
Allergy Division Manager                     
Mob: 0448-022855
Tel: 02-9882 3666
Fax: 02-9882 3999
E-mail: slee@amsl.com.au                

Last updated 27th April 2010