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Rare side effects of B12 shots (require medical attention) Serious reactions to B-12 shots are uncommon, but it’s important to be aware of them: Allergic reaction, including rash, hives, dizziness, or trouble breathing Significant swelling, pain, or warmth that worsens at the injection site Palpitations or chest discomfort Signs of drug interactions, especially if you take multiple prescription medications If you experience symptoms that feel intense, progressive, or unusual, you should contact your provider right away