Linking local COVID-19 and population statistics to a U.S.-based survey we recently conducted, we examine the spatial variation in the impact of COVID-19 on Americans’ attitudes toward China. The research strategy capitalizes on differential local COVID-19 incidence rates as varying dosages of COVID-19 impact across local contexts in the United States. Our results reveal negative yet heterogeneous effects of the ongoing COVID-19 pandemic on Americans’ attitudes toward China. We find that greater local exposure to COVID-19 is associated with a lower level of trust in Chinese and a less favorable attitude toward China. These findings lend consistent support to behavioral immune system theory by bridging the literature on contextual variations in public attitudes, with broader implications for U.S.-China relations.