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Reactions at the site of the injection are possible (redness, swelling) but are rare and short lived

10.1016/j.rvsc.2010.10.012 43 ClarkA

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casei CRL 431 was due to the preservation of the barrier function and attenuation of inflammation

Based on UK guidelines and common practice, a GP surgery may refuse to give a B12 injection a day earlier than scheduled for a patient with Pernicious Anemia for a few key reasons: Clinical Guidelines and Protocols Standard Treatment Schedules: The NHS and professional bodies like the British Society of Haematology have established guidelines for B12 injections for Pernicious Anemia