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Hepatic effects that are considered adverse include death, abnormal clinical chemistry parameters, obvious functional organ impairment, DNA and mitochondrial alteration, glutathione depletion, hepatocyte necrosis, enhanced replicative DNA synthesis, generation of reactive oxygen species, and increased peroxisome proliferation (in rodents) (Williams and Iatropoulos 2002)

One example of this is Shoulder Injury Related to Vaccine Administration (SIRVA) a rare but recognized condition that can occur when a vaccine is placed too high, too deep, or into the shoulder structures instead of the deltoid muscle

We are fighting an uphill battle to convince them to say, 'Here, these are your options,' Mandeville said

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10.1002/(sici)1097-4547(19990415)56:2 3.0.co;2-k J

Who Should Consider Adenosylcobalamin