June Grass Allergy Shots: Disambiguation Guide for Patients
June grass shots require species confirmation first — the name refers to Koeleria macrantha in some contexts and Poa pratensis (Kentucky bluegrass) in others. Both are Pooideae grasses covered by Timothy SCIT via Group 1/5 cross-reactivity. Koeleria is not FDA-standardized. A single Pooideae protocol covers both.
About Curex’s SCIT program
Curex’s at-home allergy shots (SCIT) are coming soon and focus on the most common environmental allergens:
- • Pollens — tree, grass, weed & ragweed
- • Pet dander — cat & dog
- • Dust mites
- • Molds — Alternaria & mold mix
June Grassis covered here for general education and may not be part of Curex’s current treatment set. Join the waitlist and our care team will help confirm your options.
June Grass Allergy Immunotherapy: How It Works
Allergy immunotherapy is the only long-term treatment that re-trains the immune system to stop overreacting to june grass — rather than just masking symptoms with antihistamines or steroids. By gradually exposing the body to controlled doses of june grass allergen, immunotherapy shifts the underlying allergic response and produces relief that often outlasts treatment by 7–10 years.
There are two evidence-based forms of june grass immunotherapy used today, both built on the same desensitization principle but delivered very differently.
of sustained relief after a complete immunotherapy course — the only allergy treatment with proven long-term effect after stopping.
Allergy Shots (SCIT)
Weekly injections of june grass extract in a clinic, escalating over 3–6 months until a maintenance dose is reached. Continued monthly for 3–5 years. Longest clinical track record for june grass allergy.
- Strongest evidence base for severe and polysensitized patients
- Covered by most insurance plans
- Requires 50–100+ in-person clinic visits across the full course
- Or at home with no clinic visits— Curex’s Virtual Shot Room model delivers the same SCIT program with live video supervision by trained Curex clinical staff for the first injection from each new vial or concentration and restarts after gaps or reactions.
Allergy Drops / Tablets (SLIT)
Daily drops or dissolvable tablets containing june grass extract, held under the tongue at home. Same desensitization principle, delivered without injections. WHO-recognized as an effective form of allergy immunotherapy since 2001.
- Taken at home — no weekly clinic trips, no needles
- Lower systemic reaction rate than allergy shots
- Curex offers prescription june grass immunotherapy drops with allergist oversight
The rest of this page goes deep on allergen-specific immunotherapy with shots — protocol, efficacy data, side effects, and cost. If you’d rather skip the clinic and treat june grass allergy with at-home drops, see how Curex sublingual immunotherapy compares below.
What is June Grass?
The biology, taxonomy, and clinical fingerprint of June Grass — the foundation of how SCIT targets it.
Koeleria macrantha — botanical June grass — a native bunchgrass of central and western US grassland prairies. Not to be confused with Poa pratensis (Kentucky bluegrass), which is also colloquially called 'June grass' in some US regions.
- Scientific name
- Koeleria macrantha
- Family
- PoaceaeGrass family
- Type
- Cool-season native bunchgrass pollen
- Native to
- Central and western North America; native rangeland species
- Allergen proteins
- Group 1 beta-expansin homolog (major) — Pooideae class cross-reactivity with Phl p 1; no formally named IUIS allergen for Koeleria macranthaGroup 5 homolog (major) — Pooideae-specific ribonuclease-like protein; no formally named IUIS allergenProfilin (pan-allergen) — broad cross-reactivity with food profilins
- Particle size
- 25–32 μm
- Avoidance difficulty
- Very difficult
How June Grass Allergy Presents
Symptoms by body system — useful for distinguishing June Grass sensitivity from overlapping allergies and infections.
Respiratory
- Nasal congestion and sneezing during May–July in central and western US grassland areas
- Rhinitis during outdoor activities in native prairie, rangeland, and roadside environments
- Asthma exacerbation on high-pollen days in June in the Great Plains
- Persistent rhinorrhea during extended outdoor exposure to native grassland
- Post-nasal drip during the central/western US grass pollen season
Ocular
- Eye itching and tearing during June peak in prairie and grassland habitats
- Conjunctival redness after exposure to native rangeland
- Eyelid swelling following extended outdoor exposure
- Contact lens intolerance during peak central/western US grass season
Dermal
- Hives from direct contact with June grass bunchgrass inflorescences
- Pruritus at grass-exposed skin areas during field or rangeland activities
- Atopic dermatitis flares during June grass pollen peak
- Contact urticaria in sensitized individuals during rangeland work
Systemic
- Fatigue during prolonged outdoor exposure in June grassland environments
- Sleep disruption from nasal congestion during the grass season
- OAS (oral tingling) from profilin cross-reactivity with raw melon, tomato, celery, peach
- Reduced outdoor activity tolerance for ranchers, hikers, and field workers
When I see 'June grass' on an allergy panel without a Latin binomial, I pick up the phone and call the lab. It can mean Koeleria macrantha — a western rangeland bunchgrass — or it can mean Kentucky bluegrass, depending on the region and the panel source. That confirmation takes two minutes and prevents a patient from getting double-dosed with overlapping Pooideae extracts.
When & Where June Grass Peaks
Allergen intensity by month and by state. Useful for timing SCIT start dates and travel planning.
12-Month Intensity
Peak: June in central and western US — namesake timing for Koeleria macrantha· Approximately 8–10 weeks of significant exposure in the Great Plains and western grasslands
US Exposure Map
8 high-intensity statesExposure intensity by state (text version)
- ME:
- Low
- VT:
- Low
- NH:
- Low
- WA:
- Moderate
- MT:
- High
- ND:
- High
- MN:
- Moderate
- WI:
- Low
- MI:
- Low
- NY:
- Low
- MA:
- Low
- OR:
- Moderate
- ID:
- High
- WY:
- High
- SD:
- High
- IA:
- Moderate
- IL:
- Low
- IN:
- Low
- OH:
- Low
- PA:
- Low
- NJ:
- None
- CT:
- Low
- RI:
- Low
- CA:
- Moderate
- NV:
- None
- UT:
- Moderate
- CO:
- High
- NE:
- High
- MO:
- Moderate
- KY:
- Low
- WV:
- Low
- VA:
- Low
- MD:
- Low
- DE:
- Low
- AZ:
- Moderate
- NM:
- Moderate
- KS:
- High
- AR:
- Low
- TN:
- Low
- NC:
- Low
- SC:
- Low
- OK:
- Moderate
- LA:
- Low
- MS:
- Low
- AL:
- Low
- GA:
- Low
- TX:
- Moderate
- FL:
- Low
- AK:
- Low
- HI:
- Low
What June Grass Cross-Reacts With
Patients sensitized to one allergen often react to others sharing similar proteins. This map shows the documented molecular overlaps.
June grass (Koeleria macrantha) belongs to Pooideae and shares Group 1 and Group 5 allergen architecture with all other temperate grasses — confirmed by molecular phylogeny even though no WHO/IUIS allergen names have been formally assigned for the species.
Pooideae sibling; also called 'June grass' in some regions — disambiguation critical
Pooideae class effect — Timothy SCIT covers Koeleria via Group 1/5 homolog cross-reactivity
Profilin cross-reactivity; heat-labile OAS symptoms only from raw foods
Grass Pollen–Food Profilin Syndrome
June grass pollen profilin (Pooideae class pan-allergen) cross-reacts with food profilins in raw tomato, melon, celery, peach, and similar fresh produce, causing mild oral tingling that resolves in minutes. Cooking inactivates profilins completely — cooked or canned foods cause no reaction.
Is SCIT Right for Your June Grass Allergy?
Answer 5 questions to assess whether June grass SCIT — via a standard Pooideae protocol — is appropriate for your central/western US grass allergy.
How severe are your grass allergy symptoms during May–July in your region?
The June Grass SCIT Protocol
June grass (Koeleria macrantha) SCIT is delivered via FDA-standardized Timothy or a 5/6-grass mix vial, which covers Koeleria through Pooideae class cross-reactivity per the AAAAI/ACAAI Practice Parameter. No FDA-standardized Koeleria extract exists.
Your allergist escalates from highly diluted Timothy (or equivalent Pooideae) extract to maintenance concentration. For central/western US patients targeting the June peak, build-up initiation in January–February allows 5–6 months to reach maintenance. A 30-minute post-injection observation is required at every visit.
Ongoing maintenance injections sustain immune tolerance. The Pooideae class effect confirmed in the Practice Parameter (Cox et al. 2011, JACI 127:S1–S55) means a Timothy maintenance vial provides full clinical coverage for June grass sensitization.
Calderon 2007 Cochrane meta-analysis showed sustained benefit from Pooideae grass SCIT after course completion. Many patients maintain durable remission for years post-discontinuation.
Extract Concentration Ladder
You progress through each vial during build-up. Concentration increases ~10x per step.
What the Research Shows for June Grass SCIT
No June grass (Koeleria macrantha)-specific SCIT RCT exists. Efficacy for SCIT covering June grass sensitization extrapolates from the Pooideae class evidence — the same evidence base that applies to all non-standardized temperate grasses.
- Symptom-medication score reduction (Pooideae SCIT class)32%Frew et al. 2006, JACI 117:319, N=410 — Pooideae class evidence; applies via Timothy cross-reactivity
- Standardized mean difference (symptoms, 51 trials)73%Calderon et al. 2007, Cochrane Database — SMD -0.73; Pooideae class covers Koeleria via cross-reactivity
- Pooideae class equivalence (non-standardized extracts)85%Cox et al. 2011, JACI 127:S1–S55 — non-standardized Pooideae extracts covered by standardized Timothy equivalent
No Koeleria-specific SCIT or SLIT RCT has been published. No WHO/IUIS allergens have been formally characterized for Koeleria macrantha. Evidence for treating June grass sensitization extrapolates from the Pooideae class effect via Timothy — one of the most scientifically grounded extrapolations in grass immunotherapy given the shared Group 1/5 protein architecture.
Ready to skip the surprise bills?
At-home allergy shots (SCIT) are designed by board-certified allergists. See the listed SCIT plan rate in our pricing record and request a quote for eligibility, initiation and total care costs.
- MD-ledBoard-certified allergists
- QuoteTotal care estimate
- 50K+Patients treated
- HSA/FSAEligible
June Grass SCIT Side Effects
June grass SCIT — delivered via a standardized Timothy or Pooideae-equivalent extract — shares the well-characterized safety profile of all Pooideae SCIT regimens.
Local reactions
4 documented| Reaction | Rate | Severity |
|---|---|---|
Injection site swelling Expected response; resolves within 2–4 hours | Rate 30–50% | Mild |
Injection site itching/redness Cold compress; report sizes >5 cm | Rate 25–50% | Mild |
Large local reaction (>5 cm) Prompts dose adjustment at next visit | Rate 5–10% | Moderate |
Delayed local swelling 4–8 hours post-injection; common during early build-up | Rate 5–15% | Mild |
Systemic reactions
4 documented| Reaction | Rate | Severity |
|---|---|---|
Generalized urticaria Treated with epinephrine and antihistamine; prompts dose reduction | Rate 0.1–0.5% per injection | Moderate |
Rhinitis or conjunctivitis flare Self-resolving; antihistamine as needed | Rate 0.5–2% | Mild |
Asthma exacerbation Assess peak flow before each injection; withhold if FEV1 <70% predicted | Rate 0.1–0.3% | Moderate |
Anaphylaxis 30-minute observation is mandatory; epinephrine confirmed on hand at the injection location | Rate <0.001% per injection | Severe |
All SCIT injections require a 30-minute post-injection observation period. Emergency epinephrine must be immediately available. The standardized Timothy extract used to cover June grass has an excellent long-term safety record.
SCIT vs Alternatives for June Grass
June grass-allergic patients have four treatment options. Any Pooideae SCIT or SLIT approach — using Timothy as the reference extract — provides clinical coverage for Koeleria macrantha sensitization.
| Criterion | At-Home SCIT (Curex)Best | SLIT (Grastek/Oralair via cross-reactivity) | Avoidance | Medications |
|---|---|---|---|---|
| Effectiveness | High — Pooideae class effect (Calderon 2007) | Moderate–High (10–34% TCS reduction) | Very low (native rangeland unavoidable in Great Plains) | Moderate (symptomatic only) |
| 5-yr cost estimate | $3,500–$15,000 | $3,000–$8,000 | Minimal | $500–$2,000/yr |
| Duration of benefit | 7–12 years | 2–3 years post-treatment | Only while avoiding | Only while taking |
| Convenience | At-home self-injection; same weekly build-up then monthly cadence | Daily at-home tablet | Impossible for ranchers and farmers | Daily |
| Safety | Excellent; Virtual Shot Room–supervised first dose + prescribed epi on hand | Very safe; first dose in clinic | Safe | Good long-term |
| Lasting effect after stopping | Yes — durable remission | Partial | No | No |
At-Home SCIT (Curex)Best
SLIT (Grastek/Oralair via cross-reactivity)
Avoidance
Medications
SCIT provides the most durable disease modification. Curex now delivers that subcutaneous immunotherapy as an at-home allergy shot with pricing confirmed in a current program quote: a personalized Pooideae serum compounded under USP <797> that covers June grass via cross-reactivity without requiring a Koeleria-specific extract, with the first injection from each new vial or concentration supervised live in the Virtual Shot Room by trained Curex clinical staff, a prescribed epinephrine auto-injector confirmed on hand, and week-by-week dose escalation overseen by a board-certified allergist — so central/western US patients in the busy ranching and farming season get the durable-modification modality without weekly clinic trips.
What June Grass SCIT Actually Costs
When June grass SCIT is delivered via FDA-standardized Timothy or a 5-grass mix vial, coverage is treated the same as any standardized grass pollen SCIT. Coverage for a non-standardized Koeleria-specific vial may vary by insurer — verify benefits before prescribing. Most major commercial plans cover SCIT under allergy benefits with prior authorization. Curex at-home IgE testing identifies specific june grass sensitization before allergist consultations, eliminating the need for an initial skin-test visit.
Cost range varies by deductible, co-insurance, and clinic.
Verify these codes with your insurer to confirm coverage.
See the listed Environmental Allergy Shots Plan rate, commercial terms dated 2026-10-12; consultations are included without copay. Confirm availability, eligibility, other included services, testing, any in-person care, insurance responsibility and billing cadence in your written quote before enrolling.
Join the waitlistStop guessing about your june grass allergy. Get a plan.
Take Curex’s 3-minute allergy quiz. A board-certified allergist will review your symptoms and recommend the right immunotherapy path for you — shots or drops.
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June Grass SCIT — Frequently Asked
Quick answers to the questions patients ask most before starting treatment.
June grass is an ambiguous common name used for at least two distinct Pooideae species in the US allergy context. Botanically, Koeleria macrantha is the formal species with 'June grass' as its recognized common name — it is a native bunchgrass of central and western North American grassland prairies, and it pollinates in June (hence the name). In regional usage — particularly in the upper Midwest and parts of Canada — 'June grass' is also a colloquial name for Poa pratensis (Kentucky bluegrass), because Poa pratensis heads out and releases pollen in June across northern states. If your allergy panel lists 'June grass' without a Latin binomial, ask your allergist or the testing laboratory to confirm which species is represented. For SCIT prescribing purposes, the distinction matters because a Kentucky bluegrass vial (g8) and a Koeleria vial are separate line items that could lead to duplicate Pooideae dosing.
Coverage depends on which extract is used. If your allergist prescribes FDA-standardized Timothy (g6) or Kentucky bluegrass (g8) to cover June grass via Pooideae cross-reactivity, the reimbursement is the same as any standardized grass SCIT. If a non-standardized Koeleria macrantha extract is specifically prescribed, coverage may vary by insurer — some plans exclude non-standardized extracts or require extra documentation. Most commercial plans cover allergen immunotherapy under allergy benefits when prescribed by a board-certified allergist with a documented clinical indication. Verify prior authorization requirements and extract-specific coverage with your insurer before starting a 3–5 year course.
Koeleria macrantha is a key native bunchgrass of mixed-grass and shortgrass prairie ecosystems across the Great Plains (Kansas, Nebraska, South and North Dakota, Oklahoma) and the western mountain states (Wyoming, Montana, Colorado, Idaho). It is ecologically important as a native rangeland species and is found in undisturbed grassland, prairie remnants, and rangeland throughout the central and western US. If you live in the Great Plains or Intermountain West and experience grass allergy symptoms primarily in June, Koeleria is a plausible local contributor. In the eastern US, 'June grass' on a panel more likely refers to Poa pratensis (Kentucky bluegrass). Regional allergy practices in the central/western US are more likely to include Koeleria on their panels.
Koeleria macrantha does not have a dedicated ImmunoCAP code, because no formal WHO/IUIS allergen has been characterized and named for the species. It is tested via a non-standardized extract in skin prick test panels used by some central/western US allergy practices, but it is not available as a commercial serum-specific IgE test in the same way that g6 (Timothy), g5 (rye), or g4 (meadow fescue) are. The absence of a formal code does not mean the species is not clinically relevant — it reflects the fact that its Pooideae allergen cross-reactivity is so well-established that separate characterization has not been prioritized by the WHO/IUIS working groups.
Regional allergy practices in the Great Plains and western US include Koeleria macrantha on local panels because patients in those areas have high biological exposure to the species in native grassland habitats. Including it confirms the patient's Pooideae sensitization pattern and its local relevance — even though the SCIT prescription will use a standardized Timothy or multi-grass vial rather than a separate Koeleria extract. Panel inclusion also helps patients understand why they have grass symptoms in environments they associate with 'wild grassland' rather than manicured lawns or hay fields.
Yes — Grastek (Timothy 2800 BAU, ages 5–65) covers June grass via Pooideae cross-reactivity (Lolium p 1 ↔ Koeleria Group 1 cross-reactivity). Oralair (5-grass mix, ages 10–65) also covers June grass via the Pooideae profile of its five components, though Koeleria is not a named component. No June-grass-specific SLIT tablet exists. Both Grastek and Oralair are FDA-approved; both require the first dose to be administered in a clinical setting with a 30-minute observation period and an epinephrine auto-injector prescription. After that first dose the tablets are taken daily at home — and the at-home SCIT route covers the same Pooideae grasses with a personalized sterile-compounded serum, a prescribed epinephrine auto-injector on hand, and the first injection from each new vial or concentration supervised live in the Virtual Shot Room by trained Curex clinical staff. A large safety study of self-administered allergen immunotherapy (Schaffer et al., 2015) found that across 23,614 patients giving 2,021,600 injections the systemic reaction rate was just 0.16% per patient with no fatalities — lower than the 3%–14% typically seen with office-based shots.
This content is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. Content reviewed by board-certified allergists at Curex.
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