Allergy/Immunization

***We are pleased to announce that COVID-19 vaccine appointments have resumed. To schedule your appointment, please call:
                •             DSN: 314-590-LRMC (5762)
                •             Commercial: 06371-9464-LRMC (5762)
 
Additionally, a walk-in opportunity for the COVID-19 vaccination will be held on Friday, Nov. 22, during the following hours:
                •             8:30 a.m. to 11:30 a.m.
                •             1:30 p.m. to 3:30 p.m.
 
Location: LRMC 6D, Immunizations Clinic
 
For updates, please continue to follow our Facebook page and tricare.mil website.
 
We would like to thank everyone for their patience and understanding as we worked to resume scheduling appointments for the COVID-19 vaccine.***

Initial Allergy Consult: All initial allergy consultations should be made through a referral by your provider (physician, physician's assistant, or nurse practitioner). Please allow 48-72 hours for consult review, and then call the main TRICARE appointment line (DSN 590-6502; Comm 06371-9464-6502).
 

Current referral guidelines are listed below:

1. Allergic Rhinitis - Minimum 2 week trial of antihistamines and nasal steroids (suggested although not required). If patient is already on immunotherapy (or has been previously), please have patient bring allergy shot serum, shot prescription(s), prior skin testing results, and prior allergy notes to appointment. Patients deploying or leaving military service within the year of evaluation are not usually put on allergy shots. If you are currently receiving allergy shots from a Civilian Allergist, we will not be able to continue with those outside extracts, but we can convert to our extract system.

2. Asthma - Mild asthma should be managed via National Heart Lung Blood Institute guidelines by PCM. For patients with persistent asthma, allergy evaluation (either via RAST or skin testing) is recommended to screen for environmental/aeroallergen triggers.

3. Food Allergy -Food allergy reactions usually include symptoms such as hives/swelling, respiratory symptoms (upper and/or lower), nausea/vomiting/diarrhea, abdominal cramping, syncope/pre-syncope, and/or changes in blood pressure w/in min-2 hours of ingestion. If patient has been evaluated previously, patient should bring all prior testing results to first appointment.

4. Urticaria/Angioedema - Acute (duration<6 wks), unless there is specific trigger (ie food, animal exposure, medication), can be managed by PCM. Chronic (duration>6 wks) should have minimum 2 week trial on daily antihistamine; if fail, then send for evaluation; allergy testing not usually performed unless there is a patient-identified trigger.

5. Drug Allergy - If evaluation is for peri-operative drug reaction, please send operative report/list of medications used/timing of meds given.

6. Rash - Suspected aeroallergen/food triggers can be evaluated for atopic dermatitis/eczema. If exact diagnosis of rash is not clear, send to Dermatology before referring to Allergy.

7. Stinging Insect Allergy - Large local reactions and patient<16 y/o with hives/swelling only are not skin tested or put on allergy shots.

8. Latex Allergy - Latex IgE (RAST) prior to Allergy referral

9. Anaphylaxis - Acute symptoms should be managed in ED/PCM clinic. Further evaluation can be via ROUTINE allergy consultation.

10. All Other Suspected - Send consult for further review by Allergy Clinic staff.

Traveling outside the United States or Europe? Travel vaccines can be administered in our clinic but require a written prescription from a provider. There are four clinic sources to fulfill your travel medicine requirements:

1. Travel Medicine (Infectious Disease, LRMC) Clinic: Please call 06371-9464-5827 or visit the Infectious Disease Clinic in 3A to make an appointment.

2. Travel Health (Occupational Health, LRMC) Clinic: Call 06371 9464 6040 to make an appointment.

3. Deployment Medicine/Travel Medicine (Ramstein) Clinic: Call 06371-46-2525 to make an appointment (preferred), or walk-in to Building 2114, Room 126.

4. Your PCM

   **If you are an active duty member or a DoD civilian traveling on government orders for 30 days or more, please visit your local deployment center**

Items to bring: Valid ID card and immunization records (if available).