A deficiency can occur for several reasons, such as pernicious anemia (a condition where the body cannot absorb vitamin B12 from the diet), certain medical conditions (e.g., Crohn's disease, celiac disease), surgical removal of part of the stomach or intestine, or strict vegetarian/vegan diets if not adequately supplemented
The smallest dose of Leukine used for vaccine adjuvant purposes of which the applicant is aware (that is, 70 mcg) would lead to as much as 72 percent of the drug being discarded from a single-dose 250 mcg lyophilized vial, which is the only size available commercially
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