This one-year follow-up study investigated COVID-19 vaccine acceptance in 23 countries. In June 2021, 75.2% of respondents reported to accept the vaccine, of which 49% had received at least one vaccine dose and 51% were willing to get it once available to them. Factors associated with COVID-19 vaccine acceptance include perceived safety and trust in science, as measured by a novel COVID-VAC score, and personal experience with COVID-19. Males, healthcare workers, well-to-do people, those with university degrees, and those whose physician recommended vaccination were more likely to accept it. Trust in governmental ability to address COVID-19 was weakly associated with vaccine acceptance. Respondents strongly supported vaccination to travel internationally, but weakly supported vaccinating children for school attendance. Hesitancy rates remain high in LMICs. Health policymakers should aggressively communicate vaccination need and inform accurately about efficacy and safety compared to disease risk, and healthcare workers need a greater vaccine communications role.