Since 2019, the WHO has included vaccine hesitancy among the top ten threats to global health. Additionally, there is global disparity in vaccine availability and access. As part of a mixed methods study that explored COVID-19 vaccine acceptance and access across Indonesia, Nepal and Vietnam from December 2021 to June 2022, we conducted 67 in-depth interviews with purposively selected community members from both urban and rural settings. We used thematic analysis to analyse and interpret the interviews. Dominant aspects that influenced COVID-19 vaccine acceptance in Indonesia, Nepal, and Vietnam included risk perception, trust, logistics and social norms. These aspects were context-specific and fluid as the pandemic course changed over time. Analysis of COVID-19 vaccination rollout in these settings provide prominent lessons reflecting the importance of embracing contextual norms and building and maintaining trust as early as possible for enhanced acceptance of newly introduced vaccines. Understanding and embracing social norms in specific contexts could also support interventions for specific audiences, with more targeted approaches and methods. Continued discussions to delve deeper into contextual social norms and trust is imperative to support acceptance of newly introduced vaccines.