Fever, headache, fatigue and pain at the injection site were the most commonly reported side effects, and overall, most side effects were mild to moderate. However, as with the two-dose or single-dose primary series, serious side effects are rare, but may occur.
This is because in the "U.S.A.", people in all the regions in the U.S.A. historically migrated throughout an "entire land mass" (essentially) ; and this "land mass" tends to be more "homogeneous" (as opposed to "British English" speakers; who speak with different dialects, accents). Note that the United Kingdom, including Great Britain, is further isolated from the U.S.A.—by a huge ocean— than the "relatively more homogeneous physical region"/ and thus the "relatively more linguistic region".
It’s use is now limited to tropical regions where it helps control malaria
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