The European Medicines Agency (EMA) has recommended adding a warning about the risk of a rare form of spinal inflammation — transverse myelitis — to the list of adverse events associated with AstraZeneca’s COVID-19 vaccine.

The EMA’s safety committee conducted a review of globally reported cases, including those in its adverse events database, EudraVigilance, and concluded that “a causal relationship” between the shot and side effect is “at least a reasonable possibility.”

The EMA previously recommended adding transverse myelitis to the list of possible side effects linked with Johnson & Johnson’s (J&J) COVID-19 vaccine.