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Accola grew up in Edgewood. Her father, Kevin, is a cardiothoracic surgeon and her mother, Carolyn, was formerly an environmental engineer before becoming a homemaker. Both her parents are active members of the local Republican political party.She has one younger brother.

She is, together with her The Vampire Diaries co-stars Michael Trevino and Ian Somerhalder, one of many supporters of the It Gets Better Project, a project that has made it a goal to prevent suicide among LGBT youth, associated with The Trevor Project.