Ghana was the first country globally to receive about 600,000 Oxford-AstraZeneca vaccine doses from the WHO-backed Covax program in February 2021. Ghana’s initial plan was to vaccinate about two-thirds of its adult population by the end of October 2021. This necessitated the selection of vaccination centers across the country. This study analyzed vaccination centers location against other factors, including COVID-19 cases, population density, and poverty level to assess the efficiency of each center's location in Greater Accra Metropolitan Area (GAMA). Our study applied spatial-analytical techniques to access the spatial coterminous distribution of COVID-19 cases with vaccination centers within GAMA. Hotspot analysis of cases was performed using kernel density tool and compared to hotspots of vaccination centers. Nearest neighbor analysis and error differential ellipse were performed to access the spatial pattern of the distribution of COVID-19 vaccination centers within the GAMA. This study revealed three local clusters of COVID-19 cases in Tema East municipality, Ayawaso Central, and Ablekuma West; three vaccination hotspots, found in Ashaiman, Madina, and AyawasoCentral localities. COVID-19 case clusters are not coterminous with vaccination centers. The top three vaccination clusters were found in Ashiaman, Madina-La Nkwantanan, and Kpone-Katamanso which are inhabited by indigenous populations and also recorded the lowest COVID-19 cases. Tema East and Ayawaso East, which have the highest number of COVID-19 cases, recorded the lowest number of vaccination centers. We conclude that need-based allocation is lacking in the distribution of vaccination centers, which partly affects the equitable access and spatial distribution of COVID-19 vaccines.