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Deficiency in vitamin B12 is also associated with disproportionate fetal growth (low muscle mass and excess fat mass), increased insulin resistance, intrauterine growth restriction, and lifelong susceptibility to certain chronic diseases

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[244] [245] The Kennedy-led ACIP also voted to "recommend that when evaluating the need for a subsequent hepatitis B vaccine dose in children, parents should consult with health care providers to decide whether to test antibody levels to hepatitis surface antigen to evaluate adequacy of protection through serology results." [244] [245] This vote came "despite no evidence suggesting fewer doses than the standard series of three offer lifelong protection"