King County likes to think of itself as more urbane and better-run than Pierce County, but our neighbors to the south sure seem to be doing a superior job administering the H1N1 (commonly referred to as swine flu) vaccine.

Locally, it’s been madness with little method. Public Health–Seattle & King County has been distributing vaccinations to health clinics and pharmacies without any guidelines about which of the various high-risk groups—kids, pregnant women, health-care workers, people with other illnesses—should be vaccinated first. Consequently, health-care providers have set up their own rules. Some of the 44 pharmacies which got vaccines earlier this month gave them to anyone aged 3 and up, while others set the bar at age 9 or 14. And most set up vaccination times during school hours, creating an obvious conflict for younger clients.

Both clinics and pharmacies have been inundated. At Virginia Mason’s Sand Point Way clinic on Nov. 7, parents and kids started lining up at 4 a.m. By 8:40—40 minutes after the clinic opened—it was turning people away. Meanwhile, the Tacoma–Pierce County Health Department set a clear priority for who would be vaccinated first—kids—and opened vaccination clinics in the most obvious place: schools. Clinics at two Tacoma high schools vaccinated 3,800 students free of charge on successive Saturdays. And on Nov. 7, health-care workers vaccinated everyone who came to Clover Park High School, bringing back 1,000 unadministered doses. Now Pierce County’s health department is making pregnant women and health-care workers a priority.

“There’s no perfect way to get vaccine out, and each county has its own,” says James Apa, spokesperson for King County’s health department.

Originally the department had planned to open school clinics, but scrapped the plan when vaccine shortages arose. Apa says the plan may be resurrected as supplies increase.