The first experimental vaccine against Alzheimer's disease caused encephalitis in some patients, which led to termination of the clinical trial and dealt a serious blow to this therapeutic approach. With second-generation vaccines that are likely to circumvent this side effect, this type of therapy remains promising, although more extensive animal studies are likely to be required before approval of other clinical trials. Another potential side effect, microhemorrhages within the brain vasculature, has been observed in mouse models following passive immunization, but has not been assessed in reports of active vaccination. Together, these serious adverse reactions emphasize the need to test potential Alzheimer's immunotherapy in large cohorts of primate models prior to, or at least concurrently with, human trials, as no effective therapy exists for the disease.