Social media platforms like Twitter (now X) have been pivotal in information dissemination and public engagement, especially during COVID-19. A key goal for public health experts was to encourage prosocial behavior that could impact local outcomes such as masking and social distancing. Given the importance of local news and guidance during COVID-19, the objective of our research is to analyze the effect of localized engagement, on social media conversations. This study examines the impact of geographic co-location, as a proxy for localized engagement between public health experts (PHEs) and the public, on social media. We analyze a Twitter conversation dataset from January 2020 to November 2021, comprising over 19 K tweets from nearly five hundred PHEs, along with approximately 800 K replies from 350 K participants. Our findings reveal that geo-co-location is associated with higher engagement rates, especially in conversations on topics including masking, lockdowns, and education, and in conversations with academic and medical professionals. Lexical features associated with emotion and personal experiences were more common in geo-co-located contexts. This research provides insights into how geographic co-location influences social media engagement and can inform strategies to improve public health messaging.