I know someone whose daughter graduated peanut OIT last year. The risks are very individual and somewhat relative to the protocol the allergist uses and the individual’s tolerance. The risk of anaphylaxis is there, and does happen for many people. Most people are able to adjust and move beyond any reactions, though. But, from the people in my local allergy group, my friend, and her daughter, they felt the risks were worth it.
You will have to ask a lot of questions, and ensure the allergist answers them to your satisfaction. When to skip doses (sickness, typically), how to minimize reactions, how to contact the allergist with questions or urgently if there are any reaction symptoms, what happens if there is a reaction (lower dose, stop, etc.), timing of dosing (and why that time of day!), restrictions you activity or diet during OIT... so many questions.
And the big one: are they using the latest approved OIT ‘drug’ or actual peanut byproducts and peanuts eventually.
I have failed three various attempts at immunotherapy for various allergens. I have had some success with baked/processed milk, but that could be an intolerance and not an allergy (long story). For me, immunotherapy was a really awful journey full of frequent anaphylactic reactions, even on slower lower dosing schedules. So it isn’t for everyone. But for the people who tolerate it, and have kept up with the maintenance, it has been life-changing.
It is a very personal decision. Good luck.