<div>Risk of adverse effects and exacerbation in autoimmune neurological
conditions(ANC)are frequently cited reasons for COVID-19 vaccine
hesitancy. This study evaluates the ANC safety of COVID-19 vaccines in
the real world. We selected studies that provided data on the occurrence
of adverse effects and exacerbation of conditions related to ANC after
vaccination. The pooled incidence rates for various adverse effects,
stratified for the disease category, dosage, and type of vaccine were
estimated. Twenty-eight studies (31 vaccination cohorts) were included.
The pooled incidence rate of general adverse events was 0.35 (95%CI,
0.27–0.43, I <sup>2</sup>= 100%). The pooled incidence rate of
exacerbation adverse events was 0.05(95%CI, 0.04-0.07, I
<sup>2</sup> = 84%). The pooled incidence rates of local
injection reaction, fatigue, weakness, myalgia, fever, headache, and
chills were 0.27 (0.18–0.36, I <sup>2</sup> = 98%),
0.16(0.11-0.21, I <sup>2</sup> = 93%), 0.15(0.00-0.31, I
<sup>2</sup> = 97%), 0.13(0.08-0.19, I <sup>2</sup> =
97%), 0.11(0.07-0.15, I <sup>2</sup> = 95%), 0.11(0.07-0.16, I
<sup>2</sup> = 97%), and0.09(0.03-0.16, I <sup>2</sup> =
96%), respectively. According to available evidence, the administration
of COVID-19 vaccines in individuals with ANC seems to be well-tolerated,
with few reports of adverse events. Furthermore, exacerbation of ANC
following vaccination appears to be infrequent.</div>