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Methylcobalamin is the active form of vitamin B12 that can be directly utilized by the body, bypassing the need for conversion

Hills et al., 2019

The answer comes down to what "sterile" and "0.9%" actually require at a pharmaceutical level and why falling short of either standard creates contamination risk that is invisible until something goes wrong

For adults, a common dosage is weekly injections of 1000 mcg (1 mg) of vitamin B12

Researchers do this to equalise pressure, but it introduces airborne contaminants and creates a positive pressure differential that forces solution back through the needle tract on every subsequent draw, accelerating bacterial contamination