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Thats because the antibody response from that one-dose vaccine isnt as high as for the two-dose mRNA vaccines from Pfizer and Moderna, and it is waning

1 2 3 "Vitamin B12 in health and disease"

Since its absorbed B12, not the supplemental dose, that reaches skin bacteria, and since oral supplementation produces far lower serum levels than injectable B12, the risk of acne from oral supplementation is considerably lower than from injections

There are a few options for supplementation, including tablets, sublingual (under the tongue) liquids, and injections

Approximately one year later, he experienced a severe worsening of his previously very mild neuropathy, and lab evaluation yielded a serum B12 of 220 pmol/l (which is normal, remember!?), but an elevated serum MMA of 1300 nmol/l, supporting the existence of true B12 deficiency