Background:The Coronavirus disease pandemic disrupted the normal social and economic activities of the people resulting in over 3 million deaths worldwide.  Piece of literature depicted that predictors of vaccine acceptance are complex, multiple, and vary depending on the type of vaccine involved.

Objectives: The study aimed at assessing the COVID-19 acceptance and its predictors among College students in Addis Ababa, Ethiopia, 2021.

Methods: A multi-center-institutional-based cross-sectional study was conducted among 407participants from three institutions in Addis Ababa selected based on a simple random sampling method from May 01 to July 30, 2021. A self-administered structured questionnaire was used for the collection of data, after which informed consent was obtained from all the included study participants. Descriptive statistics was used for the summarization of the data. Binary(Bivariate and multivariate) logistics regression was applied for the identification predictors of vaccine acceptance with their respective 95% confidence interval and less than 5% p-value for the ascertainment of presence of association.

Results:The level of vaccine acceptance was 39.8% (95%CI: 35.0%-44.7%). Being male (AOR=0.463, 95% CI: 0.284 – 0.755, P<0.001), living with children under the age of five (AOR: 2.295; 95CI:1.416-3.721, P<0.05), living with an elderly (AOR=1.609, 95%CI: 1.016 – 2.548, P<0.05) and having had poor knowledge (AOR=2.187, 95%CI: 1.391-3.438, P<0.001) were predictors significantly associated with an increased level of vaccine acceptance.

Conclusion and Recommendation: The level of vaccine acceptance among College students in Ethiopia was lower than necessary to achieve herd immunity. Sex, living with under-five children, and elderly, and knowledge were predictors of COVID-19 acceptance.  Concerned bodies were suggested to work over the identified predictors of vaccine acceptance in the study settings.

Keywords: COVID-19, Vaccine acceptance, Predictors, College students