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Generally, B12 shots are designed to provide a sustained boost in B12 levels, but the exact timeframe can depend on factors such as your metabolism, lifestyle, and any underlying health conditions

According to the Mayo Clinic, most people consume adequate amounts of B vitamins through their diet, though the elderly, particularly those with pernicious anemia, athletes, strict vegetarians, and people who consume a lot of alcohol may be deficient in the B vitamins and may require injections or oral supplementation of B vitamins or vitamin B-12, in particular

Those with Poor Diets: Individuals who dont consume a balanced diet may be at risk of vitamin B12 deficiency

So, for example, your 2021 IRMAA is based on your MAGI from 2019