WASHINGTON (AP) — More than two years into the COVID-19 pandemic, U.S. health officials are beginning to grapple with how to keep the vaccines updated to best protect Americans from the ever-changing coronavirus.

On Wednesday, a panel of vaccine advisers to the Food and Drug Administration spent hours debating key questions for revamping the shots and conducting future booster campaigns. They didn’t reach any firm conclusions.

The questions facing the experts included: How often to update the vaccines against new strains, how effective they should be to warrant approval and whether updates should be coordinated with global health authorities.

Last week, the FDA authorized a fourth dose of the Pfizer or Moderna vaccines for anyone 50 or older and for some younger people with severely weakened immune systems. It’s an effort to get ahead of another possible surge.

But the FDA’s vaccine chief Dr. Peter Marks acknowledged at the meeting “we simply can’t be boosting people as frequently as we are.” He called the latest booster update a “stopgap” measure to protect vulnerable Americans while regulators decide whether and how to tweak the current vaccines.

Marks cautioned that waning vaccine protection, new variants and colder weather in the fall could raise the risk of more surges.

“Our goal here is to stay ahead of future variants and outbreaks and ensure we do our best to reduce the toll of disease and death due to COVID-19,” said Marks, adding that he expects more meetings of the vaccine panel in coming months.

Some of the key questions the panel discussed:

HOW SHOULD THE U.S. DECIDE WHEN TO LAUNCH FUTURE ROUNDS OF BOOSTER SHOTS?

One area where experts appeared to agree is that vaccines should be judged on their ability to prevent severe disease that leads to hospitalization and death.

“We need to focus on the worst case, which is severe disease, and we need to change strains when we’re losing that battle,” said Dr. Mark Sawyer of the University of California San Diego.

By that measure, the current vaccines have held up remarkably well.

During the last omicron-driven surge, two vaccine doses were nearly 80% effective against needing a breathing machine or death — and a booster pushed that protection to 94%, federal scientists recently reported.

But only about half of Americans eligible for a third shot have gotten one. And many experts said it was unsustainable to continue asking Americans to get boosted every few months.

A panelist from the Centers for Disease Control and Prevention suggested that the 80% protection from severe disease could become the standard for evaluating the vaccines.

“I think we may have to accept that level of protection and then use other alternative ways to protect individuals with therapeutics and other measures,” said Dr. Amanda Cohn, CDC’s chief medical officer.

Presentations at the meeting by government health officials and independent researchers underscored the challenges of predicting when the next major COVID-19 variant might appear.

Trevor Bedford, a disease modeler with the Fred Hutchinson Cancer Research Center, said a major new strain like omicron could emerge anywhere from every 1.5 years to once a decade, based on currently available data. Given that unpredictability, researchers will need methods to quickly determine whether current vaccines work against emerging variants.

WHAT’S THE PROCESS FOR UPDATING VACCINES TO ADDRESS NEW VARIANTS?

All three COVID-19 vaccines now used in the U.S. are based on the original coronavirus version that emerged in late 2019. Updating the vaccines will be a complex task, likely requiring coordination between the FDA, manufacturers and global health authorities.

To speed the vaccines to market, the FDA relied on research shortcuts to judge effectiveness, mainly looking at their early impact on the immune system’s antibody levels. A number of panelists said Wednesday they wanted more rigorous data from studies that track patients over time to see who gets sick or dies.

But that approach would likely be too time consuming.

“We’re looking at a conundrum here in that it’s going to hard to generate all the data we want in short order when a new variant emergences,” said Dr. Ofer Levy of Harvard Medical School.

A representative for the U.S. Biomedical Advanced Research and Development Authority laid out the narrow window that manufacturers could face to reformulate, study and mass produce an updated vaccine by September.

“If you’re not on your way to a clinical trial by the beginning of May, I think it’s going to be very difficult to have enough product across manufacturers to meet demand,” said Robert Johnson, deputy assistant secretary of BARDA.

The process for updating annual flu vaccines offers one possible model, as laid out by a representative from the World Health Organization.

Twice a year, WHO experts recommend updates to flu vaccines to target emerging strains. The FDA then brings those recommendations to its own vaccine panel, which votes on whether they make sense for the U.S., setting the stage for manufacturers to tweak their shots and begin mass production.

But COVID-19 hasn’t yet fallen into a predictable pattern like the flu. And as the coronavirus evolves, different strains may become dominant in different regions of the world.

Several experts said they would need more meetings with more data and proposals from the FDA to decide on a strategy.

“We’ve never been here before. We’re all working together to do the best we can and it’s very complex,” said Oveta Fuller of the University of Michigan’s Medical School.

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Jeremiah Jacobs went missing Sunday evening from the 8400 block of Holly Lane, according to the Riverside Police Department.Officers canvassed the area with a bloodhound search team after receiving several calls that Jacobs was spotted in the area of Garfield and Monroe Street but have not found him as of Monday morning.

The department says Jacobs has a speech impediment but should answer to his name.Jacobs is described as 5 feet tall with black hair, brown eyes with black-framed glasses. He was last seen wearing a blue hoodie, blue jeans and black and white shoes.Anyone who has information about the boy‘s whereabouts are urged to contact the Public Safety Communications Center at (951) 354-2007 and reference his name or report number: 200032118.

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On September 21, 2020, at 1:00 p.m.,  the third suspect in this investigation, Joseph Goldsmith, turned himself in at the Moreno Valley Sheriff Station. Goldsmith was arrested for his outstanding warrant for Murder, and booked at the Robert Presley Detention Center.

The investigation is currently on-going and no further information will be released at this time. If anyone has information regarding this investigation, they are encouraged to call Investigator Alfaro with the Central Homicide Unit at 951-955-2777.

Citizens may also submit a tip using the Sheriff’s Homicide Tipline form.

Update:

During the course of this investigation, multiple witness interviews were conducted, surveillance camera footage was reviewed, and evidence was collected, leading to the identification of three suspects. Members from the Special Enforcement Bureau,  Moreno Valley Station Burglary and Robbery Suppression Teams, and Problem Oriented Policing Team, served multiple search warrants in the cities of Moreno Valley and Hemet, on September 9, 2020. Two suspects, Andre Richee (27 years of Moreno Valley) and Lee Mooring (32 years of Moreno Valley), were detained at locations in Moreno Valley and Hemet. The suspect vehicle, a white Chevrolet Cruze, and the third suspect, Joseph Goldsmith (28 years of Riverside) were identified.  Both Richee and Mooring were arrested and booked for Murder at the Robert Presley Detention Center on September 10, 2020. An arrest warrant for Goldsmith has been issued, and the Sheriff’s Department is requesting the public’s help regarding Goldsmith’s whereabouts.

The investigation is currently on-going and no further information will be released at this time. If anyone has information regarding this investigation, they are encouraged to call Investigator Alfaro with the Central Homicide Unit at 951-955-2777.

Details:

On September 7, 2020, at 9:08 p.m., deputies from the Moreno Valley Sheriff Station responded to the 22900 block of Allies Pl., Moreno Valley, regarding a report of an assault with a deadly weapon. Deputies arrived within minutes and located three male victims with gunshot wounds. One adult male succumbed to his injuries at the scene, and two minors were transported to a local hospital with non-life threatening injuries. Deputies secured the area as a crime scene and investigators from Moreno Valley Sheriff Station responded. The Central Homicide Unit also responded and assumed the investigation. 

The victim was identified as Daniel Gonzalez, 22 years of Moreno Valley. The investigation is currently on-going and no further information will be released at this time. If anyone has information regarding this investigation, they are encouraged to call Investigator Alfaro with the Central Homicide Unit at 951-955-2777.

For media inquiries regarding this incident please contact the Media Information Bureau.

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