beginning legislative work at 2:00 p.m. eastern. house members will gavel back at that time. we are expecting another recess to allow the house rules committee to complete its work. when they do get back to business, members will begin work on a pair of issues, elech changes, and police reform. the first votes on those mish measures on debate rules is set for 6:30 p.m. eastern today. more live house coverage when members return here on c-span. h, kentucky is what you are seeing. this is the distribution. the mike hanna distribution land where the johnson & johnson vaccine is being boxed up and the starting shipment today after winning fda approval. today we are on our covid watch segment and we will talk about supply chains when it comes to the vaccine, what effects it and how it is impacted by certain things.

joining us is kaiser health news correspondent rachana pradhan. we appreciate your time. rachana: thank you for having me. host: when we talk about supply chain, what is specifically involved particularly when it comes to this vaccine? rachana: for any vaccine i would say this applies broadly not just for the johnson & johnson vaccine. we are talking about the process of securing the raw materials and having the necessary equipment and factories and everything it takes from sourcing all the ingredients you need, to making the vaccine and putting it in your vials and packaging it and doing all the inspections and distributing it. you just saw the johnson & johnson vaccine, there are a few million doses that have begun to go out the door since we had authorization from the fda less than 48 hours ago. host: because this is a

brand-new vaccine, what does this mean for creation of supply chains? what were the challenges? rachana: when it comes to vaccine manufacturing there are challenges that have existed in the past that are relevant today. what people who i have spoken to who were involved in the trump administration's operation warp speed effort which funded vaccine research, development, and manufacturing. we did not have excess capacity a year ago to make these vaccines for covid-19. it required a lot of resources to figure out how to get the equipment, how to build the lines where the vaccine needs to be produced and the raw materials. that is especially true for the

earlier vaccines from moderna and pfizer and biontech. those vaccines are a brand-new technology. it required a lot of first time development and manufacturing development to make millions of doses. i think anthony was quoted in a pro public a story. he said something to the effect of making vaccines is not the same as making a shoe. these things are incredibly difficult and require a lot of precision. even with billions of dollars invested you are still going to run into bumps along the way as we have seen. host: rachana pradhan, last week there was a hearing taking a look at methods of distribution and the issues. one people they heard from was the coo of operation warp speed,

general gustave perna talking about the rate of distribut distribution in front of that hearing. here's what he had to say. gen. perna: because of our whole of america approach and the collective efforts of the federal, state, and local governments, private industry, and the health care community, today i can report that we have developed to safe and effective vaccines, and three safe and effective for therapeutics authorized for use. there will be more soon. we steadily increased our manufacturing capacity that will result in enough doses available to all americans by this summer. we have delivered more than 90 million doses of vaccine across 50 states and date territories to the right locations in the right conditions in near flawless execution. those are our nation's accomplishments and all americans can be proud of how far we have come in a short amount of time.

host: rachana pradhan, if that is the talk about what they can promise as far as the end result, how much of that depends on distribution chains and supply chains, do supply chains have the ability to keep up with those promises? rachana: that's a good question. i should start by saying when it comes to supply chain challenges we can figure out a certain amount based on johnson & johnson's vaccine and for pfizer and moderna and a lot of these things remain proprietary. it is hard to know with exact precision i will say that i think we have seen the manufacturing increase the rate at which companies are increasing -- has gone up over the past few weeks and the companies are anticipating that it will continue to go up.

in order to achieve the levels they say they will be able to a lot of things have to go right. nothing can go wrong. you can't have contamination, you can have all sorts of issues that can muck up the process. i think it's achievable, the targets that the biden administration has outlined for vaccine administration for the first half of this year. it's definitely going to be difficult, it's not a given. the second half of it is making the shot is one thing and distributing it in a way that it gets administered quickly is another challenge. that's a whole host of other issues. host: rachana pradhan our guest with kaiser health, talking about the vaccine supply chain. you can ask questions.

(202) 748-8000 for those of you who are seeking the vaccine or have received the vaccine. (202) 748-8001 if you are not seeking the vaccine. you can text us at (202) 748-8003. how much has the federal government through operation warp speed spent on these vaccines and how much of that money gets applied to supply chain? rachana: the government accountability office in washington which is a nonpartisan research and auditing office has put together a handy resource on showing, manufacturing how much money was poured in to not just develop but build capacity for these vaccines. in our recent story that myself and my colleagues wrote for health news it was roughly $14 billion we saw in that gao report that was given either directly to pharmaceutical

companies, six of them to fund either development and manufacturing capacity for them, and also that figure included money that was given to boost manufacturing in other ways, perhaps for ancillary supplies or for other companies that were helping these drug companies make the vaccine. that funding went to help boost capacity for vials and syringe's and all these things we need to give a shot expeditiously. they ported a lot of money and it's more than we have seen abroad. they made an effort, there are things some experts say should have been funded in addition to the things that largely the trump administration funded for vaccine manufacturing.

we did pour in more money than other nations and the other thing is that even with all of that funding we are still going to run into some bottlenecks that can't totally be escaped. host: before we take calls you right in your most recent article about supply chains "there are three bottlenecks." can you highlight them and then we will take calls? rachana: one of the big ones is, for the pfizer and moderna vaccine's in particular, this won't exist for the johnson & johnson jab because it's a different kind of vaccine. one big issue is the sourcing of nanoparticles -- these are

nessus larry for the mrna vaccines to function. these have never been made at a capacity where you would need them for millions of vaccine doses. sourcing that is a challenge. another thing is towards the end of the process when it comes to vaccine manufacturing is called still finished. it happens at the tail emd when you're finishing your doses and getting ready to put them in the vials and do all the packaging. that is a constraint and has been a constraint historically for other vaccines. people we talked to set the same when we had the h1n1, much smaller scale, but that pandemic about a decade ago, that was an issue for vaccines being developed at that time. another one is infections and capacity for filling lines. all of these vaccines are very -- produced under extremely tightly regulated conditions and need a

lot of inspections before they go out the door. those are some of the big picture challenges that are involved. host: this is rachana pradhan of kaiser health news. she is a correspondent for that publication. our first respondent comes to temple -- comes from temple, texas seeking a vaccine speaking about the supply chain. you're on the air. caller: good morning. good morning, ma'am. i'm a 70-year-old, one hundred percent disabled, vietnam vet. a weekend a half ago the v.a. called me and told me because of my status i was eligible to take my shot now. but because of three people i really loved hank aaron, sicily tyson, and mary wilson of the

supremes. they took those shots and within a few weeks they were dead. i don't know why and i don't care why. i'm waiting for the one shot. the johnson & johnson shot. i do not trust those other shots because they came out so early. nobody has given me a reasonable explanation for what happened to hank aaron, sicily tyson, and mary wilson. host: thank you very much. go ahead. rachana: i want to just flag, there are numerous concerns about the development of these covid-19 vaccines, some of which our color highlighted. they were developed in record time compared to how long vaccine development and manufacturing takes historically.

all three vaccines available in the u.s. are highly effective, all the research notes that they have -- they are extremely good at preventing systematic disease or moderate to severe covid that would keep you out of the hospital or potentially worse. they are effective and i think all of the medical experts including our top government officials say that if a vaccine is available you should take it. host: when it comes to supply chain what determines where the vaccines end up? rachana: that's a good question. i want to amend one thing i said earlier which is that when we were talking about big picture challenges i failed to mention one of these things which is that assembly lines, we need sterile assembly lines to manufacture vaccines. if there is a contamination that can really come up the process. to get to your question.

the supply chain is sort of right, what it takes to manufacture the vaccine. the distribution on the other hand is a different part of the process. the federal government is responsible for sending each state a certain number of doses and the biden administration takes whatever allotment and distribute a certain number of doses directly to pharmacy and directly to now they are moving to shift doses to community health centers which disproportionately provide health care for low income populations. that is sort of a tiered system. the biden administration will send doses to states and the states will decide where to ship vaccines depending on what tier

of prioritization they are in, who is eligible and the rate at which these facilities are vaccinating people. all providers and anyone administering vaccine has to rip or inventory back to public health authorities. that story of how they figure out where the vaccine is needed. host: nikki from new jersey says he's not seeking a vaccine. caller: during world war ii we were able to win world war ii because we were able to out produce the rest of the world. i always look at the big picture , and it may be god's plan, but i look at the big picture i'm seeing is a worldwide who against the united states and all of its allies. i think they covid relief bills are the biggest theft in history. host: since we are talking about supply chains do you have a

questions specific to that? caller: yeah. why aren't we producing more than the world? that's because we sent dell or production overseas. host: we will let our guests respond. rachana: some amount of production is happening overseas for these vaccines. moderna is an example. they are relying on, they have hired or contracted with certain companies that have facilities here in the u.s. and also abroad to help play a certain role in the manufacturing of their vaccines. i will note that in addition to potentially relying on companies abroad or manufacturing capacity abroad, pfizer has several sites in the u.s. in which they are manufacturing vaccine doses. we are relying on u.s.-based

capacity in addition to relying on some manufacturing capacity in europe to produce for other countries. host: south carolina, mary beth, seeking a vaccine. good morning. caller: good morning, pedro. i have two questions. my first is regarding what vaccine you get when you arrive. my husband and i went and we got it, we did not know until we got there it was mentor now. we were told that, by just asking other friends because we were somewhat reticent about going that there is different strengths of these different vaccines. we were there, we took it, and we've had no problems or anything, but it seemed to be

that the pfizer had a higher strength. i had a second thing i wanted to say. on this one also i wanted to say that are we going to get the same one, the same attorney? are we going to get -- the same mud dharna? are we going to get johnson & johnson -- host: let's let our guest tackle that first part. rachana: appreciate the question. because you received a first dose of the moderna vaccine your second dose will also be from moderna. it's not the case that if you were to receive an initial dose of a vaccine from one company that you would receive a second

dose from another. it's important you receive the dose manufactured from the same manufacturer. host: a quick follow-up? caller: isn't johnson & johnson involved in a lawsuit right now? the one that was just approved by the fda echo -- fda? rachana: i will say that a lot of these pharmaceutical companies in general can be involved in lawsuits either related to, i'm not sure they're involved in one related to vaccine production, but it certainly not on the homily for a large corporation to be embroiled in various legal disputes. i'm not sure i can speak directly to that. the one thing i did want to highlight for your earlier question related to pfizer and moderna, the data from clinical trials that was the basis for the authorization that came from the fda found that the pfizer

and moderna vaccine's are essentially similar as far as levels of effectiveness in preventing symptomatic covid-19 disease. host: the gao tells us operation warp speed has spent 12 billion dollars, close to $13 billion when it comes to the development and manufacturing of vaccines. $2 billion for therapeutic development -- when it comes to companies involved, one billion going to johnson & johnson, 1.2 million for moderna and astrazeneca. pfizer, $1.9 billion. a question from twitter. "can the glass vial that you spoke about be recycled the echo -- recycled?" rachana: i'm not sure if they can, i should look into that. the glass vials are a sort of special type of glass.

a good example is the glass maker corning manufacturers valor glass, a glass brand used for pharmaceutical products. they have an agreement with pfizer, so i think they are manufacturing based on a percentage of the glass vials that pfizer is using. that's a really good question, i'm going to have to look into whether it can be recycled. host: let's hear from someone not seeking a vaccine, vermont, essex junction, this is wrong. caller: i'm very -- with a therapeutics whether it be hydroxychloroquine or remdesivir. if there were two mice and the first mouse asked of the other one if you are going to get the vaccine and he says no i'm not. the other mouse says why not? so the mouse says, i'm waiting

for the human trials to be over. and that kind of is the way i feel in a nutshell. host: anything to that? rachana: i don't know that i have a response to that comment. your concern is you won't be getting the vaccine until clinical trials are over? host: we've let him go. if you want to respond to anything he brought as far as the comment. rachana: i am left speechless which doesn't have -- happen often. host: rachana pradhan joining us from kaiser health news. miguel is next from maryland, received a vaccine. let me push the button. miguel in maryland. caller: hello, good morning. rachana: good morning. caller: i have a question. is this thing supposed to

trigger an immune response in people and why is it different than any other vaccine that anyone has had before? i mean generally i think that, i took the vaccine but -- this was through work. they made everybody do it or probably we would lose our jobs. i am kind of -- it worries me they can do something like that and force it on you in that way. i don't trust the politicians or anything like that trying to push it until it needs good for me or someone like bill gates who isn't even a doctor and he's pushing this on everybody. that kind of stuff worries everybody. maybe if you could answer about the immune response and i will take my answer off the air. rachana: could you elaborate on which vaccine you received?

caller: moderna. rachana: the reason why with moderna and pfizer in particular , these vaccines rely on what is called messenger rna or mrna technology. what happens with those is you deliver a bit of some genetic code to your cells and it helps create what is known as a surface protein or a spike protein on the covid-19 virus. it's a new technology -- sars-cov-2 virus. seeing the results from the covid-19 vaccines that we have room pfizer and moderna it seems like mrna technology based on what scientists and researchers are saying could be a very effective technology at developing vaccines across a whole number of conditions, not

just for this. that's why it is so new the way that it works. the johnson & johnson vaccine is known as a viral vector vaccine, it does not have the novelty of the other two companies. that is meant to trigger an immune response because it instructs human cells to make the so-called spike protein that you need to combat the virus. it triggers an immune response. host: one thing we saw from the previous administration and this administration was this -- what does this mean for supply chain? rachana: the defense production act has been used a lot. it's -- the biggest way people think of it is you are mandating a company to make something in the interest of national security or national defense.

the way it has been deployed when it comes to vaccine development and also therapeutics for covid-19, it allows the vaccine manufacturers and other companies like syringe makers and glass file manufacturers to get an enhanced ability to secure the ingredients and the supply of raw materials they need to manufacture their products with the goal that the reason why the government is using this or leveraging this on the private sector is to make it that all these companies can manufacture or components that are needed to distribute the huns of -- hundreds of millions of vaccine doses expected in the u.s. through the end of july. the johnson & johnson through the end of june. all the vaccine manufacturing contracts have what is known as a dpa rating that allows them to

get priority access to raw materials, equipment, supplies they need so they can fulfill contractual obligations for the u.s. government to produce what they are obligated to do. >> here's a perspective from the pfizer chief business officer. he appeared at the house oversight committee and talked about the supply chain. he talked about the use of the defense production act. >> has the dpa been helpful in your efforts to expand manufacturing capacity, and are there additional ways it could aid in scaling up that production? >> thank you for the question. we are in close collaboration with the federal government and some of the recent orders that were released were helpful in ensuring that certain raw materials that initially were constrained in the production of our vaccine --

as i mentioned my testimony we have made decisions in house to manufacture some of those materials. i think dpa is useful, but it's a very targeted piece of legislation and something that should be used to address very specific problems rather than use generally. we certainly found that to be more helpful and grateful for the government's continued support. host: one perspective. do want to elaborate more on that before we go to calls? rachana: what's interesting about pfizer based on the information we got when we were recording our story is that the dpa, these authorities that were referenced were not used until the tail emd of 2020. -- tail end of 2020. some of these manufacturers had dpa ratings for contracts sooner, so they were able to

procure some of the raw materials and equipment -- i think they make a good point which is that as we talked about this has been a sore point in making the mrna vaccines, this is not relevant for the johnson & johnson vaccine. it's definitely a challenge that needs to be addressed. it seems as though they are making headway. host: louisville, kentucky, charles seeking the vaccine. caller: thanks for taking my call. i'm a senior, 70 some years old. cancer survivor, i believe it's moderna, mrna. the university of louisville started something about a year ago or so with this same mrna on

cancer, i'm a cancer survivor. it was studied for seven years. i believe in the butternut. i would take the moderna, i'm scheduled for wednesday to take my shot. i inquired, they said call ahead of time. i called and there were three available i don't know which one i want to get. can you tell me which? they tell me you have to go up and take what they have. you mean you can't tell me what i'm going to get before i get there? i waited in line? i can't get the one i one. the needles, the injections, i

hear they are using the same needle for people over and over again. i'm worried about sterilization. host: we will let our guest respond to those issues. rachana: i think if you were told modernity is the vaccine you are scheduled to get that is not likely to change before europe ointment this week. the only reason is because it takes more time, there are quite a number of days required between the federal government getting the vaccines, deciding how to distribute them, and the actual vaccination site receiving the doses. the shots that are likely going to be used in europe ointment are already stored. it's likely to be the case that the vaccine they told you would have is likely going to be the one you receive even though johnson & johnson got authorization it only happened on saturday and they begin to

ship doses but as far as whether they have arrived at any sites that are going to be using it i think it would be a crazy logistical feet to have our eyes on monday morning. there are varying degrees of notification on which vaccine you will be getting. i have heard it varies quite a lot. sometimes you know an advance who you -- what vaccine you will be receiving. it depends on the distribution which vaccines are going out the door. >> in your reporting you use the term coproduction deals. how does this apply to the supply chain? rachana: coproduction deals are a vaccine manufacturer signing an agreement with a competitor pharmaceutical company to get the necessary technology transfer, the know-how and all

the expertise snow might gush going into how you manufacture vaccines in allowing a competitor to do that -- sheets that to produce doses. we started to see these coproduction deals proliferate more in europe because europe has less capacity than the u.s.. towards the tail end of the process what is known as filling and finishing europe has less capacity than america. pfizer in particular has signed some coproduction agreements with competitor pharmaceutical companies to help fulfill that role so that they can manufacture the doses necessary. that's what we are talking about with coproduction deals. in the u.s. we have not seen so much is that exactly. we have seen manufacturers like

moderna and johnson & johnson rely on outside companies may contract with to fill -- fulfill various parts of the vaccine supply chain. host: rachana pradhan our guest from kaiser health news talking to us about supply chains and covid-19 -- caller: thank you for the opportunity to speak to you as well as your guests. the 70 real gentleman that called in with concerns about the vaccine, i have taken the vaccine, boast of -- both the first and second doses and it gives you a sense of hope. we all have to realize, i'm a black male living in milwaukee wisconsin and a lot of people have apprehension about taking the vaccine. i want to assure people we should all take it because this is not just a milwaukee, united states issue this is a worldwide situation we should all be working collectively in supply chains to give everybody in the

world this vaccine. in order to minimize the spread of this disease. i plan on wearing a mask the next two years even though i have been inoculated. i want to encourage people, don't be afraid, let's all work together and we can overcome this fight. we have a lot of work to do. host: go ahead. rachana: they echo what top officials, what are cdc director and dr. fauci have said. this is a global pandemic and you need a global response. to have a hesitancy with taking a vaccine especially in certain minority communities, i think that we are seeing some of that change as in people are open to taking the vaccine and sometimes

it is as simple of a change as they saw a family member, a trusted community member, someone they know and trust receive the vaccine and that sort of because the hesitancy that might have been there initially from seeing more people receive it and that is a convince her to change. host: in your opinion what is important to look out for in the future when it comes to supply chains and how they provide vaccines across the u.s.? rachana: the moderna and pfizer as well as johnson & johnson, -- based on what they have been producing historically or are producing right now. it's not enough to give the u.s.

the doses that president joe biden has said they are obligated to deliver. i'm going to be looking at seeing the math for how that is going along and how that will see the challenges they have identified in the past. host: rachana pradhan is with kaiser health news. you can find the work of her and her other colleagues at khn.org. >> a mandated break before beginning legislative work at 2:00 p.m. eastern. house members will gavel back at that time. we are expecting another recess to allow the house rules committee to complete its work. when they do get back to business members will begin to work on a pair of issues, election changes and police reform. the first votes on those measures on debate rules is set for 6:30 p.m. eastern today. more live house coverage when members return here on c-span.