Hepatitis B Vaccination Coverage Among Healthcare Workers in Kenyan Hospitals
Abstract
Background: Healthcare workers (HCWs) are at increased risk of hepatitis B virus (HBV) infection due to occupational exposure. Despite the availability of safe and effective vaccines, HBV vaccination coverage among HCWs in many African countries remains suboptimal. This study assessed coverage and identified barriers among HCWs in Kenyan hospitals.
Methods: Cross-sectional survey across 24 hospitals (March–Nov 2021). A total of 1,485 HCWs were recruited via stratified random sampling. Questionnaires, vaccination record verification, and anti-HBs testing in a subset were performed. Multivariable logistic regression identified factors associated with vaccination status.
Results: Complete vaccination (≥3 doses) was 52.8% (95% CI: 50.2–55.4%). Coverage was highest in physicians (71.3%) and lowest in support staff (26.4%). Only 35.2% of vaccinated HCWs had post-vaccination anti-HBs measured. Independent predictors of full vaccination included awareness of occupational risk (aOR 3.28), longer employment duration (aOR 1.89), and working in referral hospitals (aOR 2.15). Main barriers: vaccine unavailability (38.7%), cost (27.5%), time constraints (18.3%), and safety concerns (15.5%). Among 487 tested, 83.6% of fully vaccinated had protective anti-HBs (≥10 mIU/mL).
Conclusion: HBV vaccination coverage among Kenyan HCWs remains suboptimal with disparities across cadres. Institutions should implement clear vaccination policies, improve vaccine access, expand education on occupational risk, and adopt routine post-vaccination serology with boosters as needed.
Keywords
Publication Details
Citation
Mwangi A, Githinji G, Wanjiku C, Nganga L, Kariuki S, et al. (2022). Hepatitis B Vaccination Coverage Among Healthcare Workers in Kenyan Hospitals. Journal of Viral Hepatitis, 29(4), 321–330.
Funding
Gastroenterology Society of Kenya and Kenya Medical Research Institute (KEMRI) with additional support from the World Health Organization (WHO) Kenya Country Office.
Key Findings
HBV Vaccination Coverage by Professional Category
Figure 1: Complete vaccination (≥3 doses) across healthcare worker categories.
Reported Barriers to HBV Vaccination
Figure 2: Reported barriers among HCWs in Kenya.
Policy Recommendations
Mandatory Vaccination Programs
Implement mandatory HBV vaccination for all HCWs at the institutional level, with focused outreach to non-clinical support staff who have the lowest coverage.
Cost Reduction Strategies
Subsidize vaccination via institutional or government programs and explore public–private partnerships, as cost is a major barrier.
Post-Vaccination Serological Testing
Adopt routine anti-HBs testing to confirm immunity and provide boosters to non-responders or those with waning titers.
Education and Awareness
Strengthen education on HBV occupational risk and vaccination benefits, prioritizing cadres with lower knowledge levels.