Innovative Strategies to Boost Hepatitis B Vaccine Uptake in Nigeria

Purpose: This study aims to identify barriers and enablers to hepatitis B birth dose vaccine (HBV-BD) uptake in Nigeria and propose community-informed solutions using a Participatory Action Research (PAR) approach. Hepatitis B, a major public health issue and the leading cause of liver cancer affects 8.1% of Nigerian adults. Timely administration of the HBV-BD within 24 hours of birth, followed by three doses, reduces the risk of infection and liver cancer by up to 100%. However, despite its inclusion in Nigeria’s Immunization Schedule, only 20–33% of newborns receive the vaccine within 24 hours. Methods: Using PAR, an open call was launched to crowdsource ideas from Nigerian youth on improving HBV-BD uptake. Five teams advanced to a Bootcamp, where they received training in research ethics, community engagement, and intervention design. Over five weeks, participants developed study proposals and piloted projects in their communities using the PEN-3 model to identify barriers and design culturally appropriate strategies to improve vaccine uptake. Results: Quantitatively, the 15 participants (14 females, 1 male; mean age 25) demonstrated a 21.66% increase in HBV knowledge and a 36.37% improvement in research skills post-Bootcamp. Qualitatively, teams identified key barriers to HBV-BD uptake, including limited knowledge of hepatitis B, low vaccine awareness, cultural myths, mistrust of foreign medical interventions, healthcare worker attitudes, vaccine inaccessibility, and preference for home births. Proposed strategies included (a) culturally tailored health education through workshops, (b) outreach campaigns to raise awareness, (c) media-based information dissemination, and (d) community engagement with leaders, healthcare workers, and traditional birth attendants. These strategies leveraged perceptions, enablers, and relationships within communities to address gaps. Conclusion: Despite existing HBV-BD policies, uptake in Nigeria remains low, emphasizing the need for community-driven interventions. Crowdsourcing through the Mega-Designathon empowered communities to co-develop innovative, cost-effective strategies that address sustainability and implementation challenges. Scaling HBV-BD coverage to 90% by 2030 could prevent 32% of averted deaths in Africa. These findings could inform vaccination programs in other low- and middle-income countries. Citation Format: Maria Augustina Afadapa, Olufunto Olusanya, Peter Kalulu, Nkiruka Obodoechina, Priscilla A. Kabutey, Caven N. Ngoe, Sonam Shah, Temitope Ojo, Abideen Salako, Joseph Ogbeh, Folahanmi T. Akinsolu, Ucheoma Nwaozuru, Dawit Alemu, Olaitan H. Olayiwola, Idris A. Oladosu, Collins Airhihenbuwa, Joseph Tucker, Oliver Ezechi, Juliet Iwelunmor. Improving Training on Hepatitis B in Nigeria: Findings from an Innovation Bootcamp to Strengthen Capacity [abstract]. In: Proceedings of the 13th Annual Symposium on Global Cancer Research; 2025 Sep 16. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(12_Suppl):Abstract nr 28.