Hybrid health regimes: Access to primary care physicians and COVID-19 vaccine uptake across municipalities in Romania

This study analyses COVID-19 vaccine uptake at the municipal level in Romania using the global health regimes and vaccine hesitancy perspectives. Our spatial regression (SARAR-het Durbin) shows that the number of primary care physicians is a significant predictor of vaccine uptake, and municipalities with higher access to the labour market have higher vaccination rates. We provide a historical perspective to demonstrate that the current health regime in Romania is a hybrid of internationalist and global health regimes, with socialist investments affecting labour participation, education, poverty, and vaccination rates. Our findings highlight the impact of regional disparities and partial privatization of the health system. •Primary care physicians impact vaccine uptake at municipal level in Romania.•Access to labour market correlates with higher vaccine uptake.•Vaccine uptake lower with primary education, minimum income, and poverty risk.•Socialism's agriculture and industry investments affect vaccination rates.•Vaccine uptake disparities follow regional disparities.