• The Centers for Disease Control and Prevention (CDC) has approved a second COVID-19 booster shot of the messenger RNA (mRNA) vaccines for people over 50 years old and those who are immunocompromised.
• Recent studies found that most people who were immunocompromised had a strong immune response to mRNA vaccines for COVID-19.
• The Epilepsy Foundation advises individuals with epilepsy to talk with their health care providers about whether to receive vaccinations that protect against COVID-19.

The CDC and U.S. Food and Drug Administration (FDA) have authorized and recommended a second COVID-19 booster shot for people 50 and over and those with immunocompromising conditions.

The Epilepsy Foundation recommends that people with epilepsy share the decision-making with their doctors about whether to get a second booster shot against COVID-19.

The New Recommendations

Some important details about these recommendations include the following:

• This booster is for people who received their first booster at least four months ago.
• This fourth shot would be of either the Moderna or Pfizer vaccines, not the Johnson & Johnson vaccine.
• Even if you were previously vaccinated with the Johnson & Johnson vaccine, it is now recommended that this next dose be a Moderna or Pfizer vaccine only.
• For those who are immunocompromised and received a three-dose primary vaccination followed by an initial booster, this additional booster counts as a fifth shot.

How Booster Shots Can Protect People With Epilepsy

If you already had your first booster shot, you may be wondering what health experts say about whether additional boosters are effective for people with epilepsy. The Epilepsy Foundation advises individuals with epilepsy to speak with their providers about whether to get a second booster shot. According to the foundation, people with epilepsy are not at a higher risk of side effects following vaccination, based on the most current research. However, the foundation does acknowledge that vaccines may cause fevers, which can prompt seizures.

“Some people with epilepsy have seizures that are triggered by fever,” the Epilepsy Foundation says. “However, the available data about the risks of COVID and the safety of the COVID vaccines still support vaccination.”

Therefore, it’s important to talk with your neurologist about the risks and benefits of vaccination and to discuss a plan of action to prepare for any potential post-vaccine side effects.

The CDC’s list of underlying medical conditions doesn’t explicitly list epilepsy as a condition that may qualify someone for a second booster shot. The list of underlying medical conditions includes, for example, chronic lung disease, diabetes, heart conditions, obesity, smoking or smoking history, and HIV infection, as well as several other conditions.

“I got my COVID booster shot about two hours ago, and I feel fine!” wrote one MyEpilepsyTeam member. Another said, “Got the booster and feeling good — no side effects!”

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

Why Booster Shots Matter

Research indicates that levels of antibodies against coronavirus are likely to decrease over time, so getting booster doses at recommended intervals is necessary — even for vaccinated people who made antibodies after their initial shots.

Simply making antibodies does not always translate to complete immunity from COVID-19 infection. The findings from recent studies, however, are promising. In one study of immunocompromised people with cancer, researchers tested levels of antibodies (the proteins the immune system makes to help destroy a target). In this case, the antibodies were to SARS-CoV-2 (the virus that causes COVID-19), made in response to the Moderna COVID-19 vaccine.

On average, researchers identified antibodies against coronavirus after the second vaccine dose in about 90 percent of the study’s 515 participants. These results are considered a good sign that vaccines using mRNA — which include those by Moderna and Pfizer — for COVID-19 can trigger strong responses, even in people with compromised immune systems. It’s evidence that vaccines can protect people at higher risk of severe infections.

In a study of 178 individuals with epilepsy who’d received first and second COVID-19 vaccine doses, the researchers saw “no significant difference in the number of monthly seizures before the vaccination, the month between the doses, or the month after the vaccination.”

The study authors concluded that the vaccine’s benefits outweighed the negatives in people with epilepsy, but it’s important to speak with your neurologist about whether to schedule a vaccine or a booster shot.

According to the CDC, getting vaccinated is still the best way to protect yourself and slow the spread of the virus. If you are unvaccinated due to immunodeficiency, an autoimmune disease, cancer treatment, or because you are an organ transplant recipient, this new research should give you confidence to speak with your health care provider about when a COVID-19 vaccine would be right for you.

Find Your Team

On MyEpilepsyTeam, the social support network for people with epilepsy and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand.

Are you considering getting a second booster shot? Have you discussed any concerns with your health care provider? Share your insights in the comments below, or start a conversation by posting on your Activities page.