Background: A considerable proportion of the population remain unvaccinated due to multiple reasons including vaccine hesitancy. To study the factors responsible for the incomplete immunization of under-5 children from the perspectives of the communities, a vaccine hesitancy survey was done in two districts of Odisha. In addition, the survey aimed to elucidate the reasons for differential vaccine hesitancy. Methods: This community-based cross-sectional study was conducted in the rural areas of Balangir and Nuapada districts in Odisha. We adapted the vaccine hesitancy survey questionnaire (core closed questions) developed by SAGE working group. We used this questionnaire in a sample of 260 households, selected from 30 clusters. The questions were categorized into three main dimensions, namely, awareness about vaccine efficacy, accessibility to obtain vaccine, and acceptability of the vaccines at the individual and community level. We used bivariate and multivariate regression analysis to determine the predictors for refusal or hesitancy of the vaccine. Results: Long distances and time are the two prime factors of accessibility linked with the refusal or hesitancy of the vaccine. We found that there is a high level of acceptance of vaccines at the level of parents and more than three-fourths took their children for vaccination despite hearing negative information about them. Pentavalent and measles were more commonly refused or hesitated vaccines by the parents compared to BCG or polio. Conclusion: In the current scenario of increasing immunization coverage in India, vaccine hesitancy acts as a missing link in action for the policymakers to achieve cent percent target.