While vaccine acceptance changes over time, and factors determining vaccine acceptance differ depending on disease and region, limited studies have evaluated vaccine acceptance in Nepal. We conducted an online, cross-sectional study to assess COVID-19 vaccine acceptance among Nepalese. Data were collected before and after the vaccine approval in Nepal, during which 576 and 241 responses were obtained, respectively. We found that vaccine acceptance was generally high among Nepalese (93%) and increased after the safety of vaccine was examined by the regulatory bodies (98%). This indicated the role of the national drug regulatory authority to convey drug safety. In addition, we analyzed the predictor(s) of vaccine acceptance. We found that the people who believe that vaccine is an effective measure in preventing and controlling the disease were highly likely to accept vaccination. Given that Nepal had just passed the most devastating wave of COVID-19 during our post-approval data collection, we assume that this might have also played a role in the belief that vaccination is an appropriate approach to combat the pandemic. Likewise, the number of people willing to vaccinate as soon as possible increased from 43% to 86% after approval. Therefore, our results indicate that the government needs to focus on assuring the safety and effectiveness of a vaccine to enhance acceptance. Although fewer responses obtained after vaccine approval might have affected our results, overall, our findings indicate vaccine acceptance is likely to be affected by socio-demographic factors and the attitudes of respondents. This should be carefully considered in the rollout of the vaccination plans in Nepal and countries alike in future.
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