I asked our allergist about oral immunotherapy for my daughter and he cited a study that found that avoidance was more effective in preventing severe reactions.
So there’s one factor that doesn’t get discussed much: adherence to a fairly draconian treatment regimen for “forever”. Our allergist screened us for whether they thought that as parents we had the resolve and diligence to figure out a way to get a baby/toddler to eat a full teaspoon of peanut and cashew every single day. And as any parent can tell you getting them to eat a specific thing every single day is non-trivial.
Oral immunotherapy seems to be very effective but sticking with it is nontrivially hard.
Preventing drowning doesn’t require you to check every food item for bodies of water for the rest of your life, nor trusting everybody else in your kid’s school not to bring a swimming pool for lunch.
The same way you avoid exposure to anything. Stay home, don’t go near sick people, etc. The point is that in the event that you are somehow exposed, it’s better to be vaccinated than not.
I wouldn’t tell you to not trust the advice of your doctor. But I would tell you that there is an always argument both ways for something like this. A different doctor may feel differently, and sometimes doctors change their minds when given a bit of pushback. It might be worth asking about the possibility of oral immunotherapy in addition to avoidance, rather than as a substitute for it.
