The COVID-19 vaccine is a cost-effective and reliable public health intervention to combat the emerging COVID-19 pandemic. The vaccination is considered safe and effective at any stage of pregnancy; however, pregnant women show more vaccine hesitation than the general population. This study aims to assess pregnant women's awareness, perception, and acceptability of the COVID-19 vaccine attending antenatal clinics. An institutional-based cross-sectional analytical study design was used to assess the acceptance of the COVID-19 vaccine and associated factors among pregnant women between Feb-1 to March-30 -2022 at antenatal clinics of Bharatpur Chitwan using systematic random sampling. A semi-structured interview schedule was used to collect data from 644 respondents. Collected data were analyzed using descriptive and inferential statistics like the Pearson chi-square test and logistic regression analysis. The COVID-19 vaccine acceptance was found to be 22 % and ethnicity (AOR =1.826; 95% CI = 1.215-2.745) , education level (AOR=1.773; 95%CI= 1.025-3,068; ), history of COVID-19 infection (AOR =3.63 ;95% CI=1.323-9.956;) ,number of child (AOR= 5.021; 95% CI 1.989-12.677; ), trimester (week of pregnancy) (AOR=2.437; 95% CI 1.107-5.366 ) and level of perception (AOR= 2.152; 95% CI 1.109-4.178) were found to be statistically significant for acceptance of COVID-19 vaccine among pregnant mother. In this study, low levels of vaccine acceptance were found. Several influential factors like occupation, history of COVID-19 infection, number of pregnancies, week of gestation, and level of attitude were found to be significant for acceptance of the COVID-19 vaccine among pregnant women. Everyone needs vaccine acceptance to get herd immunity and reduce the COVID-19 infection. But Vaccine hesitancy is one of the significant threats to the COVID-19 rollout and successful pandemic mitigation. Therefore, properly disseminating information and removing misperceptions about the COVID-19 vaccine is necessary to raise the acceptance.

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