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Individuals at higher risk include older adults with reduced stomach acid production, people with gastrointestinal conditions affecting absorption, strict vegans, and those taking medications like metformin or proton pump inhibitors

Reaction was diagnosed as an extremely rare (Thus far, reported by ~.006% of individuals at our medical hospital) reaction to the vaccine pityriasis rosea which is a rash that sometimes develops after a viral infection

Inactive ingredients: L-histidine, mannitol, polysorbate 20, sucrose, and hydrochloric acid

We appreciate the commenters' insights on these challenges and we agree that the balance between protecting patient privacy and enabling meaningful quality improvement is important