Proximity to COVID-19 vaccination sites and vaccine uptake: the role of gender and vaccine distrust.

Objectives: Despite availability of vaccines proven to prevent severe illness, hospitalization, and death from COVID-19, a significant portion of the population remains hesitant to get vaccinated. This study examined the association between the proximity to vaccination sites and COVID-19 vaccine uptake and the role of gender and vaccine distrust in this relationship. Methods: We used data from the COVID-19 Exposure, Prevention, and Impact Study in Upstate South Carolina of the United States which was a cross-sectional survey conducted from March 2022 to August 2022 using address-based probability sampling for a mail-to-web survey. The analysis included 255 respondents (86 men and 169 women). Results: About 75% of respondents were vaccinated. Men were more likely to be vaccinated than women (84% vs. 71%). Having 1 to 9 pharmacies nearby increased vaccination odds by 4.64 times; having 10 or more increased these odds by 3.46 times (compared to no pharmacies). Each additional kilometer to the nearest pharmacy decreased vaccination odds by 8%. Women showed weaker associations between proximity to vaccination sites and vaccine uptake compared to men. Including vaccine distrust in the model rendered the interaction term of gender and proximity to vaccination sites insignificant, highlighting distrust as a dominant factor. Further analysis showed that the effect of proximity to vaccination sites on reducing COVID-19 vaccine distrust was weaker for women. Conclusion: These findings underscore the complex interplay between access, trust, and demographic factors in determining vaccine uptake. Addressing vaccine hesitancy requires a multifaceted approach. Strategies should focus on improving access, building trust through transparent communication, and tailoring interventions to demographic-specific barriers.