Abstract
BACKGROUND: Without vaccine, attaining herd immunity remains a global challenge. While medical personnel have been a focus of vaccine promotion and immunization improvement, non-medical personnel (NMPs) working in hospital settings remain understudied in Tanzania. Given their routine interaction with patients and healthcare workers, NMPs can play a crucial role in the transmission of infections. This study aimed to assess vaccine acceptance level in this vulnerable, predisposed population using the health belief model (HBM) as a guiding frame to obtain insights from the COVID-19 vaccine in Tanzania. METHODS: A total of 203 purposively selected NMPs from three randomly selected health facilities in Mwanza City were involved in a cross-sectional study. A validated self-administered questionnaire was used to collect data. Descriptive statistics were presented using counts and percentages. Multivariate logistic regression was used to determine the association between sociodemographic, lifestyle behaviors, and health belief constructs with vaccine acceptance. Associations were reported using odds ratios with 95% confidence intervals at p < 0.05. RESULTS: The overall COVID-19 vaccine acceptance was 16.75% despite 62.07% of NMPs indicating willingness to vaccinate. Hesitancy was 65% primarily due to lack of information (19.21%), fear of side effects (17.73%), and concerns about vaccine safety (16.25%). Perceived threats (aOR: 9.89, p = 0.01), perceived barriers (aOR: 8.83, p = 0.02), and cues to action (aOR: 1.45, p = 0.05) were significantly associated factors of vaccine acceptance among NMPs. CONCLUSION: Vaccine acceptance among NMPs in Mwanza remains low due to fear, doubts and limited information. HBM provides a robust framework for understanding vaccine-related behavior. Policymakers should implement structured risk communication, workplace vaccination initiatives and engage NMPs as “vaccine champions”, using HBM strategies to improve uptake and public health advocacy. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-026-26319-2.