• People with narcolepsy may be eligible for additional doses of the Pfizer and Moderna COVID-19 vaccines depending on their age and other 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.

People with narcolepsy may be eligible to receive a third dose of the Pfizer or Moderna COVID-19 vaccine shot depending on their age and health status. All adults who received the Johnson & Johnson single-shot vaccine are eligible to receive a booster shot two months following their shot.

Additionally, the Centers for Disease for Control and Prevention (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.

The CDC released eligibility guidelines for the Moderna and Johnson & Johnson vaccines on Oct. 21. The agency released Pfizer guidelines on Sept. 24.

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.

Moderna and Pfizer Eligibility

The following groups are now eligible for a Moderna or Pfizer booster shot at least six months after their second dose of the 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 CDC’s list of underlying medical conditions includes “dementia or other neurological conditions.”

“Even though narcolepsy is a neurological condition, [the CDC] is referring to more serious neurodegenerative disorders,” Dr. Michael Grandner told MyNarcolepsyTeam. Dr. Grandner is the director of the Sleep and Health Research Program and Behavioral Sleep Medicine Clinic at the University of Arizona College of Medicine.

While narcolepsy is not defined as an underlying medical condition, people with narcolepsy may have other conditions that make them eligible for a Pfizer or Moderna booster shot. Having a chronic lung condition, diabetes, heart disease, certain mental health conditions, or being overweight can also make someone eligible for a booster shot.

Johnson & Johnson Eligibility

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.

Mix and Match Doses

The FDA and CDC have authorized mix and match booster doses for the three COVID-19 vaccines available in the United States. This means 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 vaccines and are eligible for a booster can receive it from any of the three companies six months after their second dose.

Additional Doses for People Who Are Immunocompromised

An additional dose of the Pfizer or Moderna vaccine at least 28 days following the second dose 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 COVID-19 vaccines’ emergency use authorizations on Aug. 12 to allow a third vaccine dose 28 days after the second dose for certain immunocompromised individuals.

Individuals defined as immunocompromised include:

• 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
• People taking high-dose steroids or other immunosuppressive drugs
• Those with certain other health conditions

People with narcolepsy are not generally considered immunocompromised, unless they have another health condition that affects the immune system. “Even though narcolepsy involves an immune response, the type of immune compromise that this recommendation is referring to is much more extreme,” Dr. Grandner explained.

Talk to Your Doctor

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

“There is very little evidence that people with narcolepsy should be concerned with the [COVID-19] vaccine,” Dr. Grander commented. “The very small risks associated with the vaccine seem to be minuscule in comparison with the risks associated with COVID-19 itself.”