Hepatitis B vaccination coverage and associated factors among adults in Somalia: a cross-sectional study.

BACKGROUND

Hepatitis B virus (HBV) remains a significant global health concern with substantial morbidity and mortality. Although effective vaccines exist, vaccination coverage remains suboptimal in many low- and middle-income countries, including Somalia. This descriptive cross-sectional study aimed to assess Coverage of the complete hepatitis B vaccination series and identify associated demographic, occupational, and health-related factors among Somali adults.

METHODS

This cross-sectional study was conducted in Somalia from April 2024 to November 2024. Data were collected through structured face-to-face interviews and validated with hospital records at multiple healthcare institutions, universities, and community settings. Hepatitis B coverage was defined as completion of the full three-dose series. Binary logistic regression was used to identify factors associated with adherence.

RESULTS

Among 10,300 recruited participants, 9,975 had complete data for analysis. Hepatitis B vaccination adherence was high (81.91%). Females constituted the majority (55.05%), with most being single (56.65%), students (62.50%), and urban residents (89.37%). Significant factors associated with adherence included gender, education level, occupation, residence, and prior health conditions. Females, university graduates, healthcare workers, and hospital staff had notably lower adherence rates. Logistic regression identified male gender (OR = 4.91), student status (OR = 3.64), and urban residence (OR = 3.27) as strong positive predictors of vaccine completion. In contrast, hospital staff (OR = 0.37) and university students (OR = 0.17) had significantly lower odds of adherence. These results highlight the need for targeted interventions among specific subgroups to improve vaccination uptake.

CONCLUSION

This study reveals a promising hepatitis B coverage rate in Somalia, with key disparities linked to gender, occupation, education, and residence. Addressing these disparities will require context-specific, multi-pronged strategies that combine expanded access, targeted communication, and flexible delivery methods to reach underserved and high-risk populations.