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Contrastive learning (CL) has become a cornerstone of self-supervised pretraining (SSP) in foundation models; however, extending CL to pixel-wise representation--crucial for medical vision--remains an open problem. Standard CL formulates SSP as a binary optimization problem (binary CL) where the excessive pursuit of feature dispersion leads to an "over-dispersion" problem, breaking pixel-wise feature correlation thus disrupting the intra-class distribution. Our vector CL reformulates CL as a vector regression problem, enabling dispersion quantification in pixel-wise pretraining via modeling feature distances in regressing displacement vectors. To implement this novel paradigm, we propose the COntrast in VEctor Regression (COVER) framework. COVER establishes an extendable vector-based self-learning, enforces a consistent optimization flow from vector regression to distance modeling, and leverages a vector pyramid architecture for granularity adaptation, thus preserving pixel-wise feature correlations in SSP. Extensive experiments across 8 tasks, spanning 2 dimensions and 4 modalities, show that COVER significantly improves pixel-wise SSP, advancing generalizable medical visual foundation models. Codes will be publicly available at https://github.com/YutingHe-list/COVER.