I woud not prescribe a vaccine or medication to be self administered if the patient must have epinephrine "readily available" to use it. Nevertheless I would make a judgement of risk benefit in some cases, provided the real effectitivity of the product
FDA Advisers Recommend New Grass Allergy Treatments — Physician’s First Watch
FDA Advisers Recommend New Grass Allergy Treatments
By Amy Orciari Herman
FDA advisers voted on two new allergy immunotherapies last week, Reuters reports.
Grastek, a sublingual tablet, received a 9 to 0 vote in favor of its efficacy for treating Timothy grass pollen allergy in those aged 5 years and older. The advisers also agreed that Grastek is safe — as long as epinephrine is readily available to patients. Postapproval safety studies were recommended for its use in those aged 5 to 11 years, as side effects such as lip swelling and oral blistering have been noted.
A second sublingual tablet, Oralair, earned a 9 to 1 vote for its efficacy in those 5 years and up. It includes extracts from five grass pollens: Kentucky bluegrass, orchardgrass, perennial ryegrass, sweet vernal, and Timothy. Concerns were raised about its use in pregnant women and patients with asthma, and side effects in those under age 10 were discussed.