NEUROMYELITIS OPTICA; UPPER BACK PAIN/BACK OF SHARP PAIN; This spontaneous report received from a patient concerned a 62 year old female. The patient's height, and weight were not reported. The patient's past medical history included: trouble with breathing, and concurrent conditions included: asthma, and other pre-existing medical conditions included: no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808978, expiry: unknown) 1 total, dose was not reported, administered on left arm on 04-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 04-APR-2021, within 24 to 48 hours of vaccination, the patient complained of upper back pain which she thought was related to her lungs. Patient called her pulmonologist (treated for asthma), who prescribed a new inhaler. Consumer stated she went through 3 inhalers a month and still had the pain. Inhaler would alleviate the pain momentarily. On an unspecified date in AUG-2021 (12-AUG-2021 or 13-AUG-2021), patient had an attack in back of sharp pain and she told her lung doctor about it, and they did a Computerized tomogram (CT) scan and thought to change inhaler. On an unspecified date in OCT-2021, patient tried to get out of bed and could not move her left leg, when she finally stood up, her right leg was numb. Patient stated she had no pain and went to get an ice pack, but when she placed it on the numb leg she could not feel the cold. Patient went to emergency room (ER) and was admitted. Patient got an Magnetic resonance imaging (MRI) of spine which showed inflammation on C3-C4-C5 and stayed in hospital for a week. Patient had multiple tests done including spinal tap. On the 5th day, patient was diagnosed with neuromyelitis optica (NMO). Patient was told it was like her immune system attacking her spine. Patient stated that according to doctors it was the IgG antibody and aquaporin-4 (AQP4) that showed she had NMO. Patient received steroids and medication to lower her immune system (Rituximab IV 500mg and then 1000mg after a week) and was treated for the last 3 months. Patient stated that after her immune system was lowered, she started having spasms every 3 min left-right side, that according to MD were related to lowered immune system and fluid in spine. On an unspecified date in DEC-2021, a week before Christmas, patient was hospitalized for plasma treatment for 7 days. Doctors ruled out cancer and other causes for NMO. Patient had gone through CT scans, MRIs, contrast scans and radiation (to see if she had cancer). As per patient, doctors said that the next thing affected could be her eyesight and stated that her immune system bracket was 0. On an unspecified date in JAN-2022, patient was transferred to another hospital which specialized in NMO. The patient visited physician office. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from neuromyelitis optica, and the outcome of upper back pain/back of sharp pain was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender's Comments: V0: 20220341139-COVID-19 Vaccine Ad26.CoV2.S- Neuromyelitis optica. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s). Therefore, this event(s) is considered unassessable.