Adult allergy · London
Insect venom immunotherapy (VIT) - London.
The only treatment that dramatically reduces the risk of a future systemic reaction after a bee or wasp sting - a 3 to 5 year injection course, delivered by a specialist adult allergy consultant, in a clinic equipped for anaphylaxis.
Why patients choose us
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A specialist adult allergy consultant, in a UKAS-accredited clinic
Not a general immunology clinic. A named allergist with a high VIT case volume, in a unit equipped for anaphylaxis resuscitation and prolonged supervised injections.
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The right venom, or both
Species identification is the whole game. We test to bee, wasp/yellow-jacket, and (where relevant) both, using skin prick, specific IgE and component-resolved diagnostics.
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Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private VIT course costs in London.
Indicative ranges across our partner clinics. Send the sting history and prior tests and we come back with firm figures across two or three options.
In short
A full 3-year VIT course in our London network: £4,500 to £8,500, all-inclusive.
| Item | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Consultant allergy assessment and workup | £450-£850 | 60-90 min | Same visit |
| Component-resolved venom testing (rApi m 1, rVes v 5) | £220-£380 | 15 min | 7 days |
| Conventional VIT, 3-year course, all-inclusive | £4,500-£8,500 | 3 years | Ongoing |
| Conventional VIT, 5-year course, all-inclusive | £6,500-£12,000 | 5 years | Ongoing |
| Rush up-dosing (2-3 day inpatient) | £1,800-£3,200 | 2-3 days | Same admission |
| Adrenaline auto-injector training and review | £120-£240 | 30 min | Same visit |
Prices vary by clinic, by which venom (bee courses are typically longer and more complex than wasp), by rush versus conventional up-dosing, and by whether you need dual bee-wasp VIT. We come back with a firm quote within one working day.
What VIT is
Small, rising doses of the venom that nearly killed you.
Venom immunotherapy is the only treatment that dramatically reduces the risk of a future systemic reaction after a bee or wasp sting. Auto-injectors buy time. VIT changes the biology.
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Subcutaneous purified venom extract
A purified extract of bee (Apis mellifera) or wasp (Vespula) venom is injected under the skin of the upper arm, in slowly rising doses over weeks or days.
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Up-dosing then maintenance
Up-dosing builds tolerance to 100 micrograms of venom - roughly the dose of two stings. Maintenance keeps that tolerance alive with monthly injections.
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A 3 to 5 year commitment
Once at maintenance, you continue injections every 4 to 6 weeks for 3 to 5 years. Beekeepers and mastocytosis patients often stay on longer, sometimes for life.
The journey
From referral to end-of-course review - what happens, in order.
One team from your first message through years of maintenance injections and the end-of-course review.
Phase 1 · Before your course
Concierge, off-stage for you
Phase 2 · On the day
A few hours at the clinic, each visit
Phase 3 · After
Concierge, back on
- 01
Before
You send us the sting history
A short, confidential form. What stung you, where, when, how quickly the reaction came on, and what treatment you needed (adrenaline, hospital, ITU).
- 02
Before
We come back with a recommendation
Within one working day: whether VIT fits, which venom to test to, indicative price and centre options. An honest read either way.
- 03
Before
Workup at the allergy clinic
Skin prick and specific IgE to bee (Api m 1, Api m 10) and wasp (Ves v 5, Ves v 1). Baseline serum tryptase. Basophil activation if unclear.
- 04
On the day
Up-dosing phase begins
Rush (2-3 days inpatient) or conventional weekly injections for 6-12 weeks to reach a maintenance dose of 100 micrograms of venom extract.
- 05
On the day
Each injection, 60 minutes observation
Subcutaneous injection into the upper arm, then 60 minutes observation with adrenaline, hydrocortisone and antihistamine at the bedside.
- 06
On the day
Monthly maintenance for 3-5 years
Once at 100 micrograms, injections drop to every 4-6 weeks. A trained clinician gives every dose. You still carry your auto-injector.
- 07
After
End-of-course review and lifelong AAI
At 3 or 5 years we review with skin prick, specific IgE and tryptase. Most people stop VIT. Adrenaline auto-injector and MedicAlert stay for life.
Up-dosing: 2-3 days rush or 6-12 weeks conventional. Maintenance: every 4-6 weeks. Total course: 3-5 years.
Who is eligible
Who VIT is for - and who it is not.
The eligibility rule is simple: an adult with a moderate-severe systemic reaction after a bee or wasp sting, plus a positive skin prick or specific IgE to that venom. Recheck IgE at 1-2 months as it can be low immediately after a reaction.
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Anaphylaxis after a wasp or bee sting
Airway swelling, wheeze, hypotension or collapse after a sting - the classic indication for VIT once the culprit venom is confirmed.
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Generalised urticaria plus systemic features
Widespread hives with wheeze, GI symptoms or dizziness after a sting counts as moderate-severe systemic and warrants VIT assessment.
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Beekeeper with multiple exposures
Occupational and hobby beekeepers have a high re-sting risk and often need VIT even after single moderate reactions.
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Elevated baseline tryptase or mastocytosis
Raised tryptase or systemic mastocytosis alongside venom allergy means a longer VIT course, sometimes lifelong, with lifelong auto-injector.
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Loss of consciousness after previous sting
Any prior sting causing collapse or requiring adrenaline is a strong indication - the next sting can be worse without protection.
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Positive test but only large local reaction
A big swollen arm alone is not an indication for VIT in most adults - risk of future systemic reaction is low. We say so honestly.
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Child with cutaneous-only reaction
Paediatric skin-only reactions rarely need VIT - risk of future anaphylaxis is under 10% and the auto-injector is often enough.
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Red flag: reaction to unknown insect
If the culprit was not seen, both bee and wasp testing is needed. Do not start VIT until species is confirmed by history plus IgE.
Species identification
Bee or wasp? The most important question of the workup.
The whole treatment turns on which venom to test - and to inject. History (was the insect seen?), sting location, situation (garden, hive, picnic, indoors), and whether a sting was left behind (bees leave stingers, wasps do not) all matter.
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History and photograph
A clear description or photograph of the insect, whether a sting was left in the skin, and the setting (near a hive, near food, indoors) narrows it down. In practice, dual sensitisation on testing is common.
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Skin prick and specific IgE
Skin prick to whole bee and whole wasp venom, plus serum specific IgE to Apis mellifera and Vespula. Both are frequently positive after a reaction - which is where components come in.
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Component-resolved diagnostics
rApi m 1 and rApi m 10 are markers of true bee sensitisation; rVes v 5 and rVes v 1 are markers of true wasp sensitisation. Positive to only one side = clear culprit. Positive to both = genuine dual allergy or cross-reactive CCD.
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Basophil activation test (BAT)
When skin prick and IgE do not agree, or in mastocytosis, a functional test measuring basophil activation on exposure to venom clarifies which venom is really driving the reaction.
Course options
Up-dosing schedules and diagnostic add-ons.
What each option involves - and which venom, protocol and diagnostic combination fits which patient. Efficacy is over 95% for wasp VIT and 85-90% for bee VIT, and benefit persists after course completion for the majority.
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Wasp (Vespula) venom immunotherapy
The commonest indication in the UK. Purified Vespula venom extract, weekly up-dosing to 100 micrograms, then monthly for 3-5 years. Over 95% protection.
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Honey bee (Apis mellifera) VIT
Slightly harder course - more systemic reactions during up-dosing, 85-90% protection. Essential for beekeepers and their families.
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Dual bee and wasp VIT
When both venoms are clinically relevant (positive test plus history), both are given on the same schedule. Two separate injections at each visit.
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Rush up-dosing
Reach maintenance in 2-3 inpatient days rather than 12 weeks. Higher rate of systemic reactions during up-dosing, but faster protection - useful before summer.
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Conventional weekly up-dosing
Six to 12 weekly injections in the outpatient clinic to reach 100 micrograms. Safer up-dosing profile, longer wait to full protection.
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Component-resolved venom diagnostics
rApi m 1, rApi m 10, rVes v 5 and rVes v 1 separate genuine sensitisation from cross-reactive CCD, and clarify true dual bee-wasp allergy.
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Basophil activation test (BAT)
A functional blood test that flags basophils reacting to venom - useful when skin prick and IgE disagree, or in mastocytosis workup.
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Second-opinion review
A specialist review of your sting history, prior test results and A&E notes - sometimes the answer is testing first, not immunotherapy.
Our vetted London network
A small panel of specialist adult allergy consultants, we picked them.
Named centres include The Portland Hospital Adult Allergy, HCA The Wellington, London Allergy Clinic, Guy's and St Thomas' Private, and Chelsea and Westminster Private. Introductions are made once we understand your case.
Selection criteria
How we choose every allergy consultant in our network.
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Consultant allergists with high adult VIT case volumes, not general immunology clinics
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Facilities equipped for anaphylaxis resuscitation and 60-minute post-injection observation
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Component-resolved diagnostics (ImmunoCAP ISAC or ALEX) available in-house
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Rush and conventional up-dosing protocols, with mastocytosis pathways when needed
Safety and high-risk groups
What to expect - and who needs extra care.
VIT is well established and safe when delivered properly. The main planning points are the up-dosing reaction rate, beta-blocker and ACE-inhibitor review, mastocytosis, and the lifelong role of the adrenaline auto-injector.
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Local reactions are common
Redness, itching and swelling at the injection site in the first hours. Antihistamines help. It is not a reason to stop - the course continues.
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Systemic reactions during up-dosing
Urticaria, wheeze or hypotension in up to 10-20% of bee VIT and 5% of wasp VIT patients during up-dosing. Managed on the spot with adrenaline.
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Adrenaline auto-injector always at hand
You carry two auto-injectors during and after the course. Annual training review. MedicAlert bracelet. VIT lowers risk but does not remove it.
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60 minutes observation after each dose
Standard post-injection observation. Adrenaline, hydrocortisone, chlorphenamine and IV access ready. Do not drive straight home after early doses.
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Beta-blockers and ACE-inhibitors
These medicines can make anaphylaxis harder to treat. The allergist reviews them carefully and, where safe, switches you to an alternative before VIT.
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Pregnancy
Do not start VIT in pregnancy, but if you are already on maintenance it is generally continued - the risk of a sting reaction outweighs the risk of the injection.
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Re-sting during the course
A re-sting during up-dosing may cause a reaction. Once on maintenance, most people tolerate a re-sting well. Tell the clinic straight away.
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Mastocytosis and raised tryptase
These patients need a minimum 5-year course, often lifelong VIT, and lifelong adrenaline auto-injectors. Specialist input is essential.
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Red flags after any injection
Wheeze, throat tightness, dizziness, generalised rash or vomiting in the hours after leaving the clinic - use the auto-injector and call 999.
Reading your allergy report
Your VIT workup in four parts. Read the last one first.
Whichever venom is the culprit, the report the allergist sends you keeps to the same shape.
A quiet reminder
Allergy language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the report before your review, just ask.
- 01 Header
Sting history and culprit species
What stung you, in what setting, how quickly the reaction came on and what treatment you needed - the single biggest clue to the venom.
- 02 Testing
Skin prick, specific IgE and components
Wheal sizes, kU/L values, and which components (rApi m 1, rApi m 10, rVes v 5, rVes v 1) were positive - the map of true sensitisation.
- 03 Findings
Baseline tryptase and BAT (if done)
A baseline serum tryptase over 11.4 ng/mL suggests mastocytosis and changes the course length. BAT clarifies borderline cases.
- 04 Impression
Plan, course length and AAI advice
Read this first: which venom, rush or conventional up-dosing, 3 or 5 year course, and the auto-injector and MedicAlert advice.
Recognised by major UK insurers
Cover for VIT varies by insurer and by policy - usually funded when medically indicated. We confirm cover before booking.
Frequently asked
Everything we get asked about venom immunotherapy.
Quick answers on auto-injectors, re-stings, insurance, children, dual bee-wasp allergy and lifelong VIT.
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Do I still need to carry my EpiPen during VIT?
Yes. Two adrenaline auto-injectors go with you at all times during and after the course - VIT dramatically lowers the risk of a future systemic reaction but does not remove it entirely. Even at 3-5 years of maintenance a small residual risk remains, and re-sting can occasionally provoke a mild reaction. MedicAlert bracelets stay on for life.
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What happens if I am stung during the VIT course?
Once you are on maintenance dosing (100 micrograms), most re-stings are tolerated without a systemic reaction. During up-dosing, protection is only partial - if you are stung, use the auto-injector at the first hint of a systemic symptom and call 999. Tell the allergy clinic the next working day so the schedule can be adjusted.
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Do UK insurers cover venom immunotherapy?
Cover for VIT varies. Most major insurers (Bupa, AXA, Aviva, Vitality, WPA, Cigna, Healix) fund the initial workup and consultation when medically indicated. The 3-5 year injection course is often subject to annual benefit limits and pre-authorisation. We check cover with your insurer before booking.
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Can children have venom immunotherapy?
Yes, but most paediatric sting reactions are cutaneous only (urticaria without systemic features) and the natural risk of future anaphylaxis is under 10% - VIT is usually not needed. Children who have had true anaphylaxis (airway, wheeze, hypotension) after a bee or wasp sting are candidates and are seen at specialist paediatric allergy centres.
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What if I am allergic to both bees and wasps?
True dual sensitisation happens, but is less common than it first looks - many patients are cross-reactive to CCD carbohydrate epitopes rather than genuinely allergic to both. Component-resolved diagnostics (rApi m 1 for bee, rVes v 5 for wasp) separate the two. If genuinely dual, both venoms are given on the same schedule, as two separate injections each visit.
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Will I need VIT for life?
Most adults stop after a 3 or 5-year course, and the majority remain protected long term. Patients with mastocytosis, a very severe index reaction, high baseline tryptase, or beekeepers with ongoing daily exposure often need lifelong maintenance. The decision is made at end-of-course review with repeat skin prick, specific IgE and tryptase.
Related
Related treatments and tests.
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Anaphylaxis management and EpiPen training
Rescue plan, auto-injector technique, MedicAlert and annual review.
Learn more -
House dust mite immunotherapy
SLIT and SCIT for perennial rhinitis and dust-mite-driven asthma.
Learn more -
Pollen-food syndrome
Oral allergy syndrome workup, birch-pollen cross-reactivity, management.
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Component-resolved allergy testing (ISAC/ALEX)
Multiplex molecular allergy diagnostics for complex cases.
Learn more -
Skin prick allergy testing (paediatric)
In-clinic skin prick testing for children with allergic disease.
Learn more -
Drug allergy testing
Skin testing and challenge for antibiotic and anaesthetic allergy.
Learn more
Ready to talk to an allergist?
Get a same-week London allergy consultation and a firm VIT quote.
Send us the sting history and any prior tests. Within one working day we come back with a named consultant, an indicative price across two or three centres, and an honest read on whether venom immunotherapy is the right next step.