Assessment of hepatitis B and tetanus toxoid vaccination coverage and associated factors among healthcare workers at Kabul University of Medical Sciences affiliated hospitals in Afghanistan.

objectiveHepatitis B and tetanus remain significant public health challenges in Afghanistan, a developing country where vaccination coverage is suboptimal. Healthcare workers are particularly at risk due to their exposure to infected blood and bodily fluids, and they play a vital role as health role models; however, their vaccination rates for hepatitis B and tetanus are often inadequate, risking both their health and potential transmission to patients. This study aimed to assess the vaccination coverage and associated factors among health personnel in teaching hospitals affiliated with Kabul University of Medical Sciences, providing insights to inform strategies for improving immunization practices and occupational safety.

methodsA cross-sectional study was conducted at three teaching hospitals affiliated with Kabul University of Medical Sciences. The study sample included medical personnel (physicians, nurses, midwives, laboratory technicians, and other clinical staff) actively engaged in patient care with direct exposure to blood or bodily secretions. Demographic and vaccination information were gathered from them using questionnaires. Descriptive statistics and logistic regression were performed using Stata version 18.0.

resultsA total of 284 professional staff members from the three teaching hospitals of Kabul University of Medical Sciences participated in this study from 20 December 2024 to 20 March 2025. The majority were male (52.8%), with ages ranging from 19 to 62 years. Hepatitis B vaccination coverage was 57.8% (full) and 67.3% (partial or full); tetanus toxoid vaccination coverage was 45.5% (full) and 49.3% (partial or full). Factors associated with hepatitis B vaccination included profession and work experience. Tetanus vaccination was strongly associated with gender and profession, with a trend toward higher odds among those with higher income. The most commonly cited reason for non-vaccination was lack of access (48.4%), including geographical barriers, unavailability of vaccines at health facilities, and cost.

conclusionHepatitis B and tetanus vaccination coverage among healthcare workers in Kabul was suboptimal but comparable to that reported in other developing countries, with distinct factors driving uptake for each vaccine. Despite near-universal positive attitudes toward vaccination, the primary barrier was lack of access, highlighting systemic gaps in occupational health services. Institutional vaccination programs with free, on-site access are needed to protect healthcare workers and their patients. Further studies with larger samples across diverse settings are needed to confirm these findings.