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[9] The most frequently observed adverse reactions are mild injection-site pain, transient erythema, and localized warmth, typically resolving within minutes

Additionally, all people have "good days" and "bad days." People are also influenced by their environment (i.e., a disrupted schedule due to the holidays, less sunlight in the wintertime, a new teacher, etc.)

Others may be contaminated with heavy metals or made in facilities that do not follow good manufacturing practices, which can increase safety risks

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Wahibah et al., 2018)