Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease, and there are some data that link this event with various vaccinations. We report a young female admitted to the hospital with headache, fever, back pain, nausea, vomiting, and urinary retention. Two weeks prior, she received the first dose of SARS‐CoV‐2 mRNA vaccine. Brain and spinal cord magnetic resonance imaging (MRI) showed distinctive for ADEM widespread demyelinating lesions. The patient was successfully treated with methylprednisolone.

We appreciate interest in our case report, 1 however, we cannot agree with the comments in Dr Finsterer's letter. 2 Our article stated that most ADEM events might be due to infections or vaccinations. "Up to three quarters" does not mean only. Other causes of the disease are a rarity. Even letter's author cited case reports as an argument for his concerns. The presented case had no significant medical history, so other conditions have not been an issue.Another doubt was about the test for the SARS COV-2. We feel confused as it is stated in the text that we did RT-PCR to detect the viral infection.The commentary raised the question of the SARS COV-2 vaccine as a cause of ADEM. We want to point out that our article is a case report, so it cannot be about and prove causality of any kind. There is no mention in