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Background & Aims During the COVID-19 pandemic, vaccination is necessary for pregnant or lactating women which can prevent them from infection to severe case of disease. The present study aims to determine the factors related to the acceptance of COVID-19 vaccination among pregnant or lactating women in Zahedan, Iran using the health belief model (HBM). Materials & Methods This is a cross-sectional study. Participants were 260 pregnant or lactating women referred to comprehensive health service centers in Zahedan city in 2022. Sampling method was done as a convenience sampling method. Data collection was done using a demographic form and a HBM-based questionnaire. The reliability of the questionnaire was confirmed based on Cronbach’s alpha value of 0.7. Moreover, the content validity index value was 0.81 and the content validity ratio was 0.77. The data were analyzed using non-parametric Wilcoxon test, Mann-Whitney U test, Spearman correlation test, and regression analysis in SPSS software, version 22. Results The results of the regression analysis showed that the demographic variables explained 12.6% of the variance in vaccine acceptance behavior, where only the effect of age and educational level was significant, (P<0.05). The BM constructs along with age and educational level predicted 26.3% of the variance in vaccine acceptance behavior, where only age, self-efficacy and perceived benefits had a significant effect (P<0.05). Overall, the mentioned variables predicted 38.9% of the variance in vaccine acceptance behavior. Conclusion The factors of young age, high educational level, and the HBM constructs of self-efficacy and perceived benefits can predict the COVID-19 vaccine acceptance behavior of pregnant or lactating women in the South East of Iran. These findings can help policymakers and health care providers to use this model in designing program for improving vaccination acceptance of these high-risk groups. [ABSTRACT FROM AUTHOR]