When a patient with a known venom allergy reports a sting during immunotherapy but before reaching maintenance dose, do you accelerate the build-up schedule or restart from the beginning?

When a patient with a known venom allergy reports a sting during immunotherapy but before reaching maintenance dose, do you accelerate the build-up schedule or restart from the beginning?

• Continue the build-up schedule as planned, the sting does not change my approach
• Accelerate to maintenance more quickly given the natural antigen exposure
• Restart from a lower dose out of caution
• Check venom-specific IgE and IgG4 levels before deciding
• It depends on whether the patient had a reaction to the field sting
• Other