Introduction

This guideline relates to allergen desensitisation in paediatric patients. For more information please visit: Allergy and Immunology:Allergy and Immunology

When to refer

• Patients 0-16 years
• Refer to allergy specialist for assessment regarding suitability of specific immunotherapy for:
  • Patients with severe seasonal rhinitis or chronic allergic rhinitis where symptoms are not controlled with optimal medical management over the season or for the last six months
  • Severe allergy (anaphylaxis) to honey bee, wasp or Jack jumper ant

Wait time for appointments 

Specialist Clinic wait times 

Services available closer to home

Alternative paediatric allergy services available in Victoria include:

• Public paediatric allergy services:
  • The Northern Hospital
  • Sunshine Hospital
  • Monash Children’s Hospital
• Consider referral to a private allergist as an alternative to RCH. Options available on ASCIA website: Locate a specialist

Referral criteria/required information

Specific immunotherapy is not recommended for all children. Pre-referral management includes:

• Preventative topical steroid
• Allergen avoidance
• Saline nasal spray
• Antihistamines

Suggestions about managing immunotherapy in the community:

• Do not perform induction or unscheduled up dosing of immunotherapy in doctor’s rooms. This should be performed in a specialist centre
• Maintenance therapy may be provided at doctor’s rooms, provided resuscitation equipment is available
• Asthma management must be optimised in patients receiving immunotherapy
• See the National Asthma Council Managing Asthma resources

Referral criteria/required information

Please include all pre-referral management already tried including:

• Dose
• Length of time used
• Side effects

How to refer 

Specialist Clinics referral

Please complete the above and submit via:

• Facsimile (03) 9345 5034 or
• Email screferrals@rch.org.au
• Urgent referral or clinical query call ED or Registrar on-call (03) 9345 5522

Information for families

• Kids Health Info:Peanut and tree nut allergy
• Kids Health Info:Allergic and anaphylactic reactions

Resources and links

• Department of Allergy and Immunology
• Clinical Services Directory Allergy and Immunology
• Paediatric Handbook (2009) Eighth Edition, Blackwell Publishing. By the staff of the Royal Children's Hospital, Melbourne, Australia.

Acknowledgements

The development of this guideline was coordinated by the Department of Allergy and Immunology (Dr Jo Smart and Dr Paulina Alhucema). Guideline reviewed in February 2025.