Hepatitis Vaccination Adherence and Associated Factors: Descriptive Cross-sectional Study in Somalia

Background: Hepatitis B virus (HBV) infection remains a global health threat, causing approximately 1.1 million deaths annually(1, 2)Despite the availability of effective vaccines, adherence to the full vaccination regimen remains suboptimal in many low and middle-income countries, including Somalia. This descriptive cross-sectional study aimed to assess adherence to the complete hepatitis B vaccination series and identify associated demographic, occupational, and health-related factors among Somali adults. Methods: This descriptive cross-sectional study included 10,300 participants aged 18 and above, surveyed during HBV screening and vaccination campaigns across hospitals, universities, and communities in Somalia. Data on demographics, vaccination history, and comorbidities were collected via structured interviews and validated with hospital records. Adherence was defined as completion of the three-dose HBV vaccine schedule. Logistic regression was used to identify predictors of adherence. Results: Overall, 86.7% of participants completed the full vaccination series. Adherence was higher among females (89.2%) than males (82.4%) and varied significantly by marital status, education, and occupation (p < 0.001). Healthcare workers (92.5%) and students (90.3%) showed the highest adherence, while unemployed individuals had the lowest (78.1%). Logistic regression identified gender, occupation, education, and urban residency as significant predictors of adherence. Chronic medical conditions were not associated with adherence. Conclusion: Adherence to the Hepatitis B vaccine in Somalia is relatively high, particularly among health workers and students. However, disparities persist by gender, employment, and education. Targeted public health interventions such as improving vaccine access, reducing costs, and enhancing awareness are needed to close these gaps and support national hepatitis elimination goals.