Effectiveness of Hepatitis B Vaccination Program in Nigeria: A Systematic Review

Abstract

Background: The hepatitis B virus (HBV) infection is a major public health challenge in Nigeria, where the disease is categorised as endemic (8.1% prevalence rate). Although hepatitis B vaccination has been included in the National Programme on Immunisation in Nigeria since 2004, there has not yet been optimal uptake at full-dose populations of the vaccine among target populations. Vulnerable populations like care providers, pregnant women, and infants still have low levels of vaccination coverage, so responding to issues like access to vaccines, low awareness, and poor health infrastructure. Aim: This review explored the Effectiveness of the Hepatitis B vaccination program in Nigeria. Methodology: This systematic review adopted the PRISMA framework to evaluate studies published between January 1, 2016, to May 31, 2025 on HBV vaccination effectiveness in Nigeria. A total of 83 articles were found using the keywords across the different databases, and after screening out 24 articles which were duplicates, this left 59 articles. From their titles, 43 articles which did not meet the inclusion criteria were excluded. In the current review, 10 articles were included. Databases searched included PubMed, Google Scholar, AJOL, and WHO Global Health Library. Studies were included if they focused on vaccination coverage, seroconversion, or prevalence of HBV within Nigeria. Ten eligible cross-sectional studies encompassing a total of 13,442 participants were assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. A thematic narrative synthesis approach was employed to analyse key findings. Results: The review found significant disparities in HBV vaccine uptake, with full-dose coverage ranging from 5.0% to 43.9% across various populations. Healthcare workers had low vaccination completion rates despite high awareness, and only 5% of pregnant women received the full vaccine course. Barriers to vaccination included cost, lack of awareness, fear of side effects, and poor access to vaccination sites. One study reported a 4.3% HBV prevalence in Abuja, while seroconversion was generally higher among individuals who completed the vaccine series. Systemic issues such as inconsistent cold chain logistics and a lack of institutional vaccine mandates contributed to low coverage rates. Conclusion/Recommendation: Although the HBV vaccine has been proven to significantly reduce the infection rates, its usage is inadequate in Nigeria. To fill this gap, a multi-pronged approach is needed to address it, which includes enhancing public education, institutional vaccination policies, the incorporation of HBV vaccination into routine antenatal and occupational health services, and vaccine accessibility. Improving the healthcare system, increasing cold chain coverage, and providing follow-up mechanisms like digital reminders would likely increase the completion rates considerably. To support the WHO elimination targets and mitigate the burden of HBV in Nigeria, a coherent national plan must be implemented.