As acute and infectious disease neurologists, we are often asked if a vaccine is safe. Pfizer’s announcement Monday that its Covid-19 vaccine is 90% effective makes the question even more pertinent. Earlier this year, two late-stage clinical trials, from Johnson & Johnson and AstraZeneca, were briefly paused after reports of neurological concerns in individual study participants. Each of these rare instances was carefully scrutinized as an adverse event—a serious clinical observation that requires review by the Data and Safety Monitoring Board.

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