• People with epilepsy may be eligible for additional doses of the Pfizer and Moderna COVID-19 vaccines, depending on personal health factors.
• All adults who received the Johnson & Johnson vaccine are eligible for a booster shot regardless of health status
• Health agencies have also approved “mix and match” boosters, meaning a person may receive initial doses of one type of COVID-19 vaccine and a booster of another.

The Centers for Disease for Control and Prevention (CDC) released recommendations for Moderna and Johnson & Johnson COVID-19 vaccination boosters on Oct. 21. Based on the new recommendations, adults with epilepsy who received the Moderna vaccine may be eligible for a booster depending on personal factors, and all adults who received the Johnson & Johnson vaccine are eligible regardless of health status or other factors. Additionally, the CDC and U.S. Food and Drug Administration (FDA) have approved mix and match boosters, which allow people to receive initial doses of one type of COVID-19 vaccine and a booster of another.

Booster Shot Eligibility

A COVID-19 vaccine booster is administered when someone developed adequate immunity after the initial vaccine dose or doses, but that immunity has decreased over time.

The following groups are now eligible for a booster shot at least six months after their second dose of the Moderna COVID-19 vaccine:

• People over 65
• People over 18 who have underlying medical conditions
• People over 18 who live in long-term care facilities
• People over 18 who live or work in high-risk settings (such as front-line workers or people who are incarcerated)

The FDA and CDC approved booster shots in September for the same groups of people who received the Pfizer vaccine.

All adults over 18 who received the single-dose Johnson & Johnson COVID-19 vaccine are eligible for a booster shot at least two months after receiving their shot.

The CDC recommendations were released after the FDA amended the emergency use authorizations for the Moderna and Johnson & Johnson COVID-19 vaccines to allow for booster doses.

Mix and Match Doses

The FDA authorized mix and match booster doses for the three COVID-19 vaccines available in the United States. This means that you can receive a booster dose of a different vaccine from your original vaccine. For example, any adult over 18 who received the Johnson & Johnson vaccine can receive a booster dose of the Pfizer, Moderna, or Johnson & Johnson vaccines at least two months after receiving their shot. Those who have received the Pfizer or Moderna COVID-19 vaccines and are eligible for a booster may receive it from any of the three companies six months after their second dose.

Additional Doses for People With Epilepsy

People with epilepsy who are considered immunocompromised may be eligible for a third dose of the Pfizer or Moderna vaccines at least 28 days following their second dose. Additional doses may be recommended for those who did not develop an adequate immune response after the two-dose vaccination series.

The FDA amended the Pfizer and Moderna vaccines’ emergency use authorizations on Aug. 12 to allow a third vaccine dose for certain immunocompromised individuals.

Individuals defined as immunocompromised include:

• People taking high-dose steroids or other immunosuppressive drugs
• People in cancer treatment
• People who received a stem cell transplant in the past two years
• People who are organ donor recipients and taking immunosuppressive drugs
• Those with certain other health conditions

According to the Epilepsy Foundation, “There is no evidence that people with epilepsy alone have a weakened immune system. They should not be considered ‘immunocompromised’ and would not have an ‘immune deficiency’ from having seizures.”

The Epilepsy Foundation does note that some people with epilepsy may take medications, such as steroids, that could affect the immune system. However, most seizure medicines do not affect the immune system.

If someone with epilepsy is not considered immunocompromised based on their medications or other health factors, they may be eligible for a Pfizer or Moderna booster six months after the second dose of their COVID-19 vaccine — depending on their age and other health conditions.

The CDC’s list of underlying medical conditions that would make someone eligible for a Moderna or Pfizer booster doesn’t explicitly list epilepsy as a condition that may qualify them for the shot. The list includes several underlying medical conditions, such as:

• Chronic lung disease
• Diabetes
• Heart conditions
• Obesity
• Smoking or smoking history
• HIV infection

Talk to your doctor if you have questions about your eligibility for an additional COVID-19 vaccine dose.