DISTRICT-LEVEL VARIATION IN COVID-19 VACCINATION RATES AND AVAILABILITY OF VACCINATION SERVICES IN BULGARIA

Abstract

Purpose: Since early 2022, the COVID-19 vaccination rate in Bulgaria has remained low, with large regional differences. This study examines the association between the availability of vaccination sites and the number of administered doses, and the extent to which district-level variation is attributable to differences in vaccination services provision. Materials and Methods: Data on COVID-19 vaccine doses administered by districts were used. This data set was combined with district-level information on available vaccination sites, such as general practitioners and temporary vaccination points. The district-level differences in vaccination coverage and service provision were illustrated through country heat maps, and the association between the variables was explored using two linear regression models. Results: According to the first regression model, the number of general practitioners and temporary vaccination points accounted for only 3.8% of the district-level variation in administrated doses. As covariates in the second model, sociodemographic and economic data were included. The combined influence of these factors explained 42.2% of the variance across districts. According to the findings, the average annual gross wage is a significant determinant of the district-level differences in the number of administrated doses. Conclusion: There is no statistically significant association between administered doses and vaccination sites by districts, which does not correspond to the findings of other international studies. District-level variation in vaccination rates is associated with some sociodemographic and economic differences. The paucity of district-level data impedes further analyses of the vaccine coverage differences and their underlying determinants.