There’s an old saying in politics that the perfect is the enemy of the good.

It’s a phrase that aptly describes the vaccine rollout in Colorado at this stage. We appear to have out-thunk ourselves. The whole system of distribution is too nuanced, too complex, too opaque to be called efficient. In trying to be equitable, the state has given up speed and simplicity. In order to give communities say over how the vaccines are handed out, we’ve created weird disparities.

Like a 75-year-old with a heart condition I know who is still waiting for a shot even though Gov. Jared Polis said the state will start vaccinating people in their late 60s Monday.

And the essential workers like bus drivers, mail carriers, grocery store employees and public health workers who have been bumped down in priority twice since the vaccinations started. They were promised the vaccine in January; now they will have to wait until at least March.

Colorado Springs homeless shelters, soup kitchens prepare for vaccinating clients, front-line staff

Or the people who have good internet access who are getting the vaccine before those folks without computers who have serious illnesses and are the most at risk.

“The reality is that when something is in scarce supply, people with more resources, more time and more opportunity for digging around looking online, they’re gonna end up having an advantage,” observes Dr. Matthew Wynia, director of the Center for Bioethics and Humanities at the Anschutz Medical Campus.

Less than 40% of the 70-and-up population had gotten the first shot when Polis announced the state would move to the next category.

Intentions have been honorable, but this may be a case of smart people being too smart for their own good, making things more complicated than they need to be.

It’s happening everywhere. Many states have delegated the distribution to dozens of county health departments which have each devised their own system and rules for who gets the vaccine.

Colorado has distributed through a variety of providers, including county health departments, hospitals, private practices and pharmacies.

Seth Klamann, our health reporter for the Denver Gazette, says there’s even some variation within systems — there are three different places to register for Banner Health, for example, depending on where you live.

“I think the overarching rules of distribution are pretty standardized, and the different protocols for signing up are starting to align,” said Klamann. “But it’s being handled by a bunch of different providers.”

The states with the highest vaccination rates — Alaska, South Dakota, West Virginia — have tried to bring some measure of simplicity to the process. West Virginia, for example, created a uniform statewide process.

With its more complicated approach, Colorado is running in the middle of the pack.

“We’ve created really nuanced vaccination and allocation strategies, when the main problems turn out to just be logistics,” said Wynia. “And the more and more complex and nuanced your allocation strategy is, the more it adds to those logistical challenges of just getting the vaccine to where it needs to be.”

Britain had a much simpler approach. After immunizing its hospital workers, “They basically said we’re just gonna do it by age,” recounts Wynia. “So if you’re over 85 now is your time. Come on in. Then 80, then 75, then 70.”

In Colorado, we relied on individuals to figure out when they were eligible themselves, and then we kept changing the priorities. And that, of course, leaves people who don’t have a son or a daughter or a neighbor or someone who’s willing to spend time to help them with three or four different health systems flailing in the dark.

“Well, that’s kind of nuts,” said Wynia. “There could have been a statewide system. But that, of course, that would have required a lot of resources to set that up. And the state public health department is completely strapped. They’re swamped with with existing work. They’re chronically underfunded. And the federal government did not give them any resources to manage this kind of thing, which means state health departments couldn’t do it.”

At this stage, Wynia believes the most effective use of the vaccine is to get it to those communities that are particularly hard hit, but it takes time and the energy and resources to reach out to people in those communities.

“If you want to get the vaccine into those communities, you have to think about communication strategies that are specific to those communities. You have to think about outreach. You have to go directly to people, you can’t just put up a website.” 

As the state begins to do that, “I think we’re gonna start to see more of a balancing out of the disparities,” Wynia said.

I recently visited the Matthews-Vu Medical Group to see for myself how the vaccinations were going. The clinic was a madhouse of worried senior citizens getting their shots and trying to get their shots, with harried medical staff doing all they could to accommodate everyone. Most of the seniors were just walking in the door without appointments; the practice had set up a daylong clinic for anyone who wanted a shot, whether they were patients or not. And they have been proactively calling and scheduling minority patients to get their shots.

And then I saw some of the newly vaccinated emerge from the back while I was there, 11 months of anxiety and dread lifting off their shoulders as they came into the lobby, mile-wide smiles returning to their faces.  

It really lifts a psychological burden when you get the shot, said Wynia. “It really does. People cry. It’s emotional. It’s amazing.”

The clinic wasn’t perfect — many folks were sent home and told to come back another day — but it sure was good. 

Said Wynia of the mood at such clinics right now: “It is the happiest place on Earth.”