Citation: Gaire, A.; Panthee, B.; Basyal, D.; Paudel, A.; Panthee, S. COVID-19 Vaccine Acceptance: A Case Study from Nepal. COVID 2022, 2, 1014–1025. https://doi.org/ 10.3390/covid2080075 Academic Editor: Manuela Tamburro Received: 17 June 2022 Accepted: 18 July 2022 Published: 23 July 2022 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations. Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). Article COVID-19 Vaccine Acceptance: A Case Study from Nepal Amrit Gaire 1 , Bimala Panthee 2,3 , Deepak Basyal 1 , Atmika Paudel 2 and Suresh Panthee 2, * 1 Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal; amritgaire16@gmail.com (A.G.); deepakbasyal2005@gmail.com (D.B.) 2 Sustainable Study and Research Institute, Kathmandu, Nepal; bimupanthee@gmail.com (B.P.); atmikapd@gmail.com (A.P.) 3 School of Nursing and Midwifery, Patan Academy of Health Sciences, Lalitpur, Nepal * Correspondence: supanthee@gmail.com Abstract: While vaccine acceptance changes over time, and factors determining vaccine accep- tance 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. Keywords: COVID-19; vaccine; acceptance; Nepal; regulatory approval 1. Introduction COVID-19 is an infectious disease caused by severe acute respiratory syndrome coro- navirus 2 (SARS-CoV-2) [1]. The infection, declared by the World Health Organization to be a global pandemic, can be asymptomatic or range from moderate to severe respi- ratory sickness, pneumonia, and death [1]. Within a month of the first official global COVID-19 case recorded in China on 31 December 2019, Nepal reported its first case on 23 January 2020 [2–4]. Despite several efforts to combat the spread, the disease is a major problem in Nepal, with several waves of infection and the spread of mutant variants [5]. As of 1 July 2022, more than 6 million deaths have been registered globally, with almost 12,000 in Nepal alone [6]. In the absence of successful treatment options, prevention with disinfection approaches and social distancing is considered the most effective approach to control the spread of infection. However, successful eradication of the disease requires high immunization coverage with an efficient vaccine [7]. Unfortunately, vaccine development is a challenging and time-consuming process, usually taking years to develop. The previous quickest vaccine to be developed, from virus sample to licensure, was four years for mumps in the 1960s [8]. As the availability of any effective vaccine would enormously facilitate our attempts to overcome the disease, the U.S. Food and Drug Administration (FDA) first COVID 2022, 2, 1014–1025. https://doi.org/10.3390/covid2080075 https://www.mdpi.com/journal/covid