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Another commenter expressed concern that less publicized extraordinary circumstances will not prompt CMS to issue an ECE without request, and that the process to submit an ECE request via the HQR portal, email, or secure fax may be unavailable if an emergency event severely disrupts operations for months

[3] The speed of response depends on multiple factors including the severity and duration of deficiency, the presence of neurological complications, and individual metabolic differences

Benefits of B12 Skinny Shots: Boosts metabolism to help the body burn fat more efficiently

Potent methyl-free B12 and folate

Then, weekly injections for a month follow

So if you are getting injections and not getting improvement why are the b12 shots not working