Community Pharmacists Role on Hepatitis B Vaccination and Immunization in Nigeria

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Okpalanma, Chisom MC Chukwulokwu, Nnedimma E Okoli This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7550193/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 29 Apr, 2026 Read the published version in Discover Public Health → Version 1 posted 11 You are reading this latest preprint version Abstract Background: Hepatitis B is an infectious disease of the liver, affecting millions of people throughout the world. Objectives : The aim of the study was to evaluate the roles of community pharmacist in Nigeria on Hepatitis B Vaccination and immunization Methods: A cross-sectional descriptive study was conducted among 49 registered community pharmacists in a state in Nigeria. Convenience sampling technique was employed. Ethical approval was obtained for the study. A structured questionnaire was adapted and used as instrument for data collection. Data was analyzed using SPSS version 23 and summarized using descriptive statistics frequency (%), mean. The scores obtained were compared using ANOVA and Independent student’s test. The relationship between sociodemographic characteristics of the respondents and their role on Hepatitis B vaccination was assessed using Chi square. Statistical significance was established at p<0.05 Results: More females 31(63.3%) than males participated in the study. Majority of the pharmacists 46(93.3%) had B.Pharm. as the highest qualification while 40(81.6%) of the pharmacists were within the first five years of practice. A good number of the respondents 45(91.8%) do not provide immunization services in their pharmacies while only 1(2%) pharmacist administer Hepatitis B vaccine to their clients. Community pharmacists’ provision of immunization services and their role on Hepatitis B vaccination and immunization had no statistically significant relationship with their sociodemographic characteristics. Conclusion: The Community pharmacists were involved in educating clients on Hepatitis B vaccination through campaign programs. Adequate efforts should be made to empower community pharmacists through trainings in other areas. Community pharmacists Hepatitis B virus Immunization Role Vaccination INTRODUCTION Background of the Study Hepatitis B infection is a global health problem that can cause both acute and chronic infection in man and is characterized by replicative and non-replicative phases of host-virus interaction, present in all infected patients [1]. Hepatitis B virus is one of the most common human viral infections in the world, which has infected about two billion people worldwide most especially in Africa and Asia [2]. Infection caused by Hepatitis virus have been reported to be 50-100 times more infectious than HIV and 10 times more infectious than Hepatitis C Virus [3]. Little attention was given to Hepatitis B virus infection until recently even though it’s a global public health problem [4]. Hepatitis is a silent epidemic in Nigeria which has led to increased morbidity and mortality. Meta-analysis has shown that Nigeria is hyper-endemic for Hepatitis B virial infection with 13.6% prevalence rate [5]. The global health sector strategy for viral hepatitis was adopted by WHO in 2016 in which the goal for eliminating viral hepatitis as a global public health problem was set by 2030 [4]. Studies have shown that about 60 million people live with Hepatitis B virial infection in Africa, with a prevalence rate of 6.2% [4]. Nigeria has one of the highest rates of cancers in the entire west Africa as a result of Hepatitis B viral infection [5]. Vaccination is the key in order to ensure adequate eradication of Hepatitis B viral infection by 2030 [2]. There have been debates on the advantages and disadvantages of Hepatitis B vaccination, but the advantages outweighed the disadvantages. Immunization is one of the safest, most efficient and cost-effective means of preventing and controlling infectious diseases. Adequate human and material resources are essential to meet the continuous need for immunization. According to reports by WHO, 2 to 3 million lives can be saved each year, as well as 1.5 million deaths prevented by vaccination [6]. Pharmacists are health professionals adequately trained and professionally competent to provide vaccination and immunization services. Their participation in vaccination services will lead to increased vaccination sites and number of vaccination providers [7]. Community pharmacists are the first and, in most case, the last contact for most people. The role of community pharmacists have been expanded in many countries, allowing pharmacists to offer vaccination services thus resulting in greater vaccination access and improved rates of vaccination [6 ] . The traditional roles of community pharmacists regarding immunization services have been that of distribution and retailing of vaccines but these roles are now changing [8]. One of the recent roles of community pharmacists centers on promoting immunization as immunization advocates, facilitators and vaccine administrators [8]. Studies have shown that some countries still place limits on pharmacists vaccination and immunization services [7]. In Nigeria, however, there are no official restrictions limiting community pharmacist from providing immunization services [8]. With the increase in prevalence of HBV coupled with gaps in immunization delivery, there is a need to assess the role of community pharmacists in Hepatitis B immunization and vaccination. This study aimed to assess the role of community pharmacists on hepatitis B vaccination and immunization in Nigeria. METHODS Study Design : A cross-sectional descriptive study was carried out amongst registered community pharmacists to determine community pharmacist’s role in Hepatitis B vaccination and immunization. Study Area : The study was conducted out among selected registered community pharmacists within Awka, Anambra state, Nigeria. Anambra state a state in Nigeria was originally created in 1976 when the East Central State was broken into Anambra State and Imo State. Study Population : There are 56 registered community pharmacists in Awka, Anambra State from the data obtained from Pharmacy Council of Nigeria (PCN) as of December 2022. Ethics Approval : Ethical approval for the study was obtained from the Ethics Committee of Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH) Amaku-Awka: COOUTH/CMAC//ETH.C/VOL.1/FN:04/259 Eligibility Criteria : Community pharmacists in retail registered with Pharmacy Council of Nigeria (PCN) for the study year, community pharmacists who were available during the study and gave their informed consent to participate in the study. Sampling Technique : Convenience sampling technique was employed in selecting the pharmacists that participated in the study Sample size : Sample size was calculated from the population size using Yamane formula (1967) Using the above formula, a sample size of 49 was obtained. To account for attrition, 10% was added to the sample size making the sample size 54. Fifty-five questionnaires were distributed to the community pharmacists. Out of the 55 questionnaires, 6 were not completely filled so were discarded. The sample size used for this study was 49 community pharmacists. Instrument for Data Collection : A structured questionnaire adapted from a previous study by [9] was modified to suit the objectives of the study and used as instrument for data collection. The questionnaire consisted of two sections. The first section (questions 1 to 5) consisted of information on the demographic characteristics of the respondents. The second section (questions 6 to 15) contained information on the respondent’s knowledge and attitude in Hepatitis B vaccination and immunization. The questionnaire was first piloted among 10 community pharmacists who did not participate in the study. The response rate was 100%. At the end of the pilot study, the questionnaire was summarized for the main study. Method of Data Collection : The questionnaire was distributed by direct contact with the respondents. The aim of the study was communicated to the pharmacists and written consent obtained from those that met the inclusion criteria before commencement of the study. Some of the questionnaires were collected back immediately after filling while some were picked up at a later date not exceeding five days. Confidentiality of the participants was maintained throughout the process of data collection. Method of Data Analysis : Data collected were collated and coded into Microsoft excel, 2010. Coded data were imported to SPSS version 23 for analysis. Data was summarized using descriptive statistics and presented as frequency, percentages (%), mean and standard deviation. Relationship between the sociodemographic characteristics of the respondents and their role in Hepatitis B vaccination and immunization was determined using Chi-square test for association. Statistical significance was established at p<0.05 RESULTS Sociodemographic Characteristics of the Respondents Forty-nine community pharmacists that participated in the study out of which 18(36.7%) were males while 31(63.3%) were females. Forty-six (93.9%) respondents had B.Pharm. as highest qualification, and 40(81.6%) respondents have 1-5 years of practice experience. Detailed analysis is shown in Table 1. Table 1: Demographic details of community pharmacists in Awka, Anambra State (n=49) Role of Community Pharmacists on Hepatitis B Vaccination and Immunization Result from the analysis showed that a good number of the community pharmacists 29(59.2%) educate clients on Hepatitis vaccination and immunization while only 1(2.0%) community pharmacists administer Hepatitis B vaccination to their clients. The analysis is shown in Table 2 Table 2: Role of community pharmacists in Awka on Hepatitis B vaccination and immunization Relationship between community pharmacists sociodemographic characteristics and Hepatitis B immunization and vaccination Result from the analysis revealed that the community pharmacists sociodemographic characteristics had no statistically significant relationship with their provision of immunization and their willingness to be involved in immunization services. Details of the analysis is shown in Table 3. Table 3: Relationship between Sociodemographic characteristics of the respondents and Hepatitis B Immunization and Vaccination Relationship between community pharmacists sociodemographic characteristics and their role in Hepatitis B immunization and vaccination Result of the analysis revealed that the community pharmacists sociodemographic characteristics had no statistically significant relationship in their role in Hepatitis B immunization and vaccination. Details of the analysis is shown in Table 4. Table 4: Relationship between Sociodemographic Characteristics of respondents and their role in Hepatitis B vaccination and immunization DISCUSSION This study aimed to evaluate the role of community pharmacists on Hepatitis B vaccination and immunization in Nigeria. This study revealed that a good number of the community pharmacists do not provide immunization service in their pharmacies. This is consistent with the study by [ 10 ] which revealed that a good number of community pharmacists in Nigeria do not provide immunization services. Non provision of immunization and vaccination services by community pharmacists may be as a result of lack of training or inadequate infrastructure in the pharmacies. It has been shown that including community pharmacies into the national vaccination plans can help improve vaccine awareness and acceptance especially among those at risk [ 11 ]. Community pharmacists are the first and, in most case, the last contact for most patients in Nigeria, hence they are indispensable in modern healthcare. There is need for professional training programs to be organized for community pharmacists especially those in Low-and -Middle Income countries. A good number of community pharmacists in our study were involved in educating clients on Hepatitis B vaccination and immunization while very few pharmacists administered Hepatitis B vaccine to clients. This is consistent with the study by [ 7 ] which showed that community pharmacists were involed in educating clients on Hepatitis B vaccination. The study by [ 12 ] which showed that community pharmacies were involved in storage, preparation, distribution, education, and were immunization providers in their practice contrasts with the result obtained from this study. Vaccination is one effective public health strategy for reducing disease burdens and saving lives [ 13 ]. The role of community pharmacists in improving vaccination and immunization services has been recognized in recent times [ 9 ]. Community pharmacists have been involved in direct patient care in the community pharmacy setting but their role in immunization has not yet been defined. It has also been shown that community pharmacists are greatly underutilized in acheving health coverage in Nigeria [ 10 ]. Expanding the scope of practice for community pharmacists to include pharmacy-led immunization programs may increase accessibility to immunization programs. Community pharmacists age, marital status, gender, highest qualification, years of practice had no statistical significant relationship with their provision of immunization and vaccination services. This is consistent with the study by [ 9 ] which revealed that the demographic characteristics of community pharmacists in Nigeria had no statistically significant relationship with their provision of vaccination and immunization services and their role on Hepatitis B vaccination and immunization. This study has some limitations. First is the small sample size. There may be issues with representation. Secondly, is the self-assessment nature of the questionnaire. CONCLUSION The role of the community pharmacists in Hepatitis B vaccination and immunization was in educating clients on Hepatitis B vaccination immunization mostly through campaigns. Adequate efforts should be made to empower the community pharmacists through trainings in other areas such as storing and distribution of Hepatitis B vaccines as well as in administering the vaccine to clients. Declarations All Methods were carried out in accordance with relevant guidelines and regulations. Written informed consent was obtained from all participants in the study Acknowledgement The authors wish to acknowledge all the community pharmacists that participated in this study. Funding No funding was received for conducting this study Authors contributions N.N.O: Supervised the study; wrote the final paper C.MC.C: Wrote the initial paper; collected data, analyzed data N.E.O: Analyzed data All authors commented on the manuscript at every stage and approved the final manuscript Conflict of Interest Financial interest: The authors declare that they have no financial interest Non-financial interest : None Ethical approval Ethical approval for the study was obtained from the Ethics Committee of Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH) Amaku-Awka: COOUTH/CMAC//ETH.C/VOL.1/FN:04/259 Consent to participate Written informed consent was obtained from all the respondents before commencement of the study Consent to publish Informed consent to publish was obtained from all authors before sending out this manuscript for publication Data Availability Data is available on request Clinical Trial Number: Clinical trial number not applicable Clinical Trial Registration Details : Clinical trial number not applicable References Heath RD, Tahan V. Natural history of hepatitis b virus. Viral Hepatitis: Chronic Hepatitis B. 2018. 1–10. https://doi.org/10.1007/978-3-319-93449-5_1 Daniel FM, Ukoaka BM, Emeruwa VB, Oti-Ashong RC, Falaiye GO. Addressing vaccination gaps among healthcare workers in sub-saharan Africa: the role of mandatory hepatitis B vaccination. Trop. Med. Health. 2024. 52: 80 Umego, C., Mboto, C., Mbim, E., Edet, U., George, U., Tarh, J. Epidemiology of Hepatitis B Virus Infection in South-South, Nigeria: A Review. International STD Research & Reviews , 2018. 7 (1), 1–17. https://doi.org/10.9734/isrr/2018/36989 Ajuwon B, Yujuio I, Roper K, Richardson A, Sheel M, Liabury BA. Hepatitis B virus infection in Nigeria: a systematic review and meta analysis of data published between 2010 and 2019. BMC Infectious Dis. 2021. 21: 1120. Akabuike OM, Aworh MK, Uzochukwu NL, Erwat J, Agukwe O, Ngong K. Evaluating hepatitis B screening, prevalence, vaccination coverage and linkage to care in Abuja, Nigeria: insights from a cross sestional study. BMC Public Health.2024. 24: 3475. https://doi.org/10.1186/s12889-024-21017-3 McMillan S. A systematic review of the role of pharmacists in vaccination services in low-and middle-income countries. Research in Social and Administrative Pharmacy. 2020. 17(2), 300–306. https://doi.org/10.1016/j.sapharm.2020.03.016 Bach A and Goad J. The role of community pharmacy-based vaccination in the USA: current practice and future directions. Integrated Pharmacy Research and Practice 2015. 67. https://doi.org/10.2147/iprp.s63822 Agbo B B, Esienumoh E, Inah SA, Eko JE, Nwachukwu EJ Community pharmacists’ participation in immunization services in Cross River state, Nigeria. International Journal of Public Health, Pharmacy and Pharmacology. 2019. 4(3):11-25 Abeje G, Azage M. Hepatitis B vaccine knowledge and vaccination status among health care workers of Bahir Dar City Administration, Northwest Ethiopia: a cross sectional study. BMC Infect Dis 2015. 15:30 Oladigbolu AA, Okafor UG, Oluwasere CO, Ashore OM. Community pharmacy workforce willingness, readiness, and infrastructural capacity to deliver vaccination services: a cross-sectional survey in Nigeria. BMC Health Serv Res. 2025. 25: 485 Lampasona M, Pantaleo L. The role of pharmacies in immunization programs and Health promotion. Arch. Pharm. Pract.2022. 13(2): 62-5 Hogue MD, Grabenstein JD, Foster SL, Rothholz MC. Pharmacist involvement with immunizations: a decade of professional advancement. JAPhA. 2006. 46(2):168–179. https://doi/org/10.1331/154434506776180 Le ML, Veettil SK, Donaldson D, Kategeaw W, Hutubessy R, Lambach P, Chaiyakunapruk N. The impact of pharmacist involvement on immunization uptake and other outcomes: An updated systematic review and meta-analysis. 2022. 62(5):1499–1513.e16 Tables Tables 1 to 4 are available in the Supplementary Files section. Additional Declarations No competing interests reported. Supplementary Files Tables.docx Cite Share Download PDF Status: Published Journal Publication published 29 Apr, 2026 Read the published version in Discover Public Health → Version 1 posted Editorial decision: Revision requested 04 Dec, 2025 Reviews received at journal 12 Nov, 2025 Reviews received at journal 03 Nov, 2025 Reviewers agreed at journal 29 Oct, 2025 Reviewers agreed at journal 24 Oct, 2025 Reviewers agreed at journal 24 Oct, 2025 Reviewers invited by journal 24 Oct, 2025 Editor assigned by journal 24 Oct, 2025 Editor invited by journal 08 Oct, 2025 Submission checks completed at journal 05 Oct, 2025 First submitted to journal 05 Oct, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Hepatitis B virus is one of the most common human viral infections in the world, which has infected about two billion people worldwide most especially in Africa and Asia [2]. Infection caused by Hepatitis virus have been reported to be 50-100 times more infectious than HIV and 10 times more infectious than Hepatitis C Virus [3]. Little attention was given to Hepatitis B virus infection until recently even though it\u0026rsquo;s a global public health problem [4]. Hepatitis is a silent epidemic in Nigeria which has led to increased morbidity and mortality. Meta-analysis has shown that Nigeria is hyper-endemic for Hepatitis B virial infection with 13.6% prevalence rate [5]. The global health sector strategy for viral hepatitis was adopted by WHO in 2016 in which the goal for eliminating viral hepatitis as a global public health problem was set by 2030 [4]. Studies have shown that about 60 million people live with Hepatitis B virial infection in Africa, with a prevalence rate of 6.2% [4]. Nigeria has one of the highest rates of cancers in the entire west Africa as a result of Hepatitis B viral infection [5]. Vaccination is the key in order to ensure adequate eradication of Hepatitis B viral infection by 2030 [2]. There have been debates on the advantages and disadvantages of Hepatitis B vaccination, but the advantages outweighed the disadvantages. Immunization is one of the safest, most efficient and cost-effective means of preventing and controlling infectious diseases. Adequate human and material resources are essential to meet the continuous need for immunization. According to reports by WHO, 2 to 3 million lives can be saved each year, as well as 1.5 million deaths prevented by vaccination [6]. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePharmacists are health professionals adequately trained and professionally competent to provide vaccination and immunization services. Their participation in vaccination services will lead to increased vaccination sites and number of vaccination providers [7]. Community pharmacists are the first and, in most case, the last contact for most people. The role of community pharmacists have been expanded in many countries, allowing pharmacists to offer vaccination services thus resulting in greater vaccination access and improved rates of vaccination [6\u003cstrong\u003e]\u003c/strong\u003e. The traditional roles of community pharmacists regarding immunization services have been that of distribution and retailing of vaccines but these roles are now changing [8]. One of the recent roles of community pharmacists centers on promoting immunization as immunization advocates, facilitators and vaccine administrators [8]. Studies have shown that some countries still place limits on pharmacists vaccination and immunization services [7]. In Nigeria, however, there are no official restrictions limiting community pharmacist from providing immunization services [8]. With the increase in prevalence of HBV coupled with gaps in immunization delivery, there is a need to assess the role of community pharmacists in Hepatitis B immunization and vaccination. This study aimed to assess the role of community pharmacists on hepatitis B vaccination and immunization in Nigeria.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cp\u003e\u003cstrong\u003eStudy Design\u003c/strong\u003e: A cross-sectional descriptive study was carried out amongst registered community pharmacists to determine community pharmacist\u0026rsquo;s role in Hepatitis B vaccination and immunization.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Area\u003c/strong\u003e: The study was conducted out among selected registered community pharmacists within Awka, Anambra state, Nigeria. Anambra state a state in Nigeria was originally created in 1976 when the East Central State was broken into Anambra State and Imo State.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Population\u003c/strong\u003e: There are 56 registered community pharmacists in Awka, Anambra State from the data obtained from Pharmacy Council of Nigeria (PCN) as of December 2022.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics Approval\u003c/strong\u003e: Ethical approval for the study was obtained from the Ethics Committee of Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH) Amaku-Awka: COOUTH/CMAC//ETH.C/VOL.1/FN:04/259\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEligibility Criteria\u003c/strong\u003e: Community pharmacists in retail registered with Pharmacy Council of Nigeria (PCN) for the study year, community pharmacists who were available during the study and gave their informed consent to participate in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSampling Technique\u003c/strong\u003e: Convenience sampling technique was employed in selecting the pharmacists that participated in the study\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSample size\u003c/strong\u003e: Sample size was calculated from the population size using Yamane formula (1967)\u003c/p\u003e\n\u003cp\u003e\u003cimg src=\"https://myfiles.space/user_files/58895_8739fc6c57c1c19a/58895_custom_files/img1762351656.png\" width=\"169\" height=\"50\"\u003e\u003c/p\u003e\n\u003cp\u003eUsing the above formula, a sample size of 49 was obtained. To account for attrition, 10% was added to the sample size making the sample size 54. Fifty-five questionnaires were distributed to the community pharmacists. Out of the 55 questionnaires, 6 were not completely filled so were discarded. The sample size used for this study was 49 community pharmacists.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInstrument for Data Collection\u003c/strong\u003e:\u0026nbsp;A structured questionnaire adapted from a previous study by [9] was modified to suit the objectives of the study and used as instrument for data collection. The questionnaire consisted of two sections. The first section (questions 1 to 5) consisted of information on the demographic characteristics of the respondents. The second section (questions 6 to 15) contained information on the respondent\u0026rsquo;s knowledge and attitude in Hepatitis B vaccination and immunization. The questionnaire was first piloted among 10 community pharmacists who did not participate in the study. The response rate was 100%. At the end of the pilot study, the questionnaire was summarized for the main study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod of Data Collection\u003c/strong\u003e: The questionnaire was distributed by direct contact with the respondents. The aim of the study was communicated to the pharmacists and written consent obtained from those that met the inclusion criteria before commencement of the study. Some of the questionnaires were collected back immediately after filling while some were picked up at a later date not exceeding five days. Confidentiality of the participants was maintained throughout the process of data collection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod of Data Analysis\u003c/strong\u003e: Data collected were collated and coded into Microsoft excel, 2010. Coded data were imported to SPSS version 23 for analysis. Data was summarized using descriptive statistics and presented as frequency, percentages (%), mean and standard deviation. Relationship between the sociodemographic characteristics of the respondents and their role in Hepatitis B vaccination and immunization was determined using Chi-square test for association. Statistical significance was established at p\u0026lt;0.05\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003e\u003cstrong\u003eSociodemographic Characteristics of the Respondents\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eForty-nine community pharmacists that participated in the study out of which 18(36.7%) were males while 31(63.3%) were females. Forty-six (93.9%) respondents had B.Pharm. as highest qualification, and 40(81.6%) respondents have 1-5 years of practice experience. Detailed analysis is shown in Table 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1: Demographic details of community pharmacists in Awka, Anambra State (n=49)\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRole of Community Pharmacists on Hepatitis B Vaccination and Immunization\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eResult from the analysis showed that a good number of the community pharmacists 29(59.2%) educate clients on Hepatitis vaccination and immunization while only 1(2.0%) community pharmacists administer Hepatitis B vaccination to their clients. The analysis is shown in Table 2\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2: Role of community pharmacists in Awka on Hepatitis B vaccination and immunization\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRelationship between community pharmacists sociodemographic characteristics and Hepatitis B immunization and vaccination\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eResult from the analysis revealed that the community pharmacists sociodemographic characteristics had no statistically significant relationship with their provision of immunization and their willingness to be involved in immunization services. Details of the analysis is shown in Table 3.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3: Relationship between Sociodemographic characteristics of the respondents and Hepatitis B Immunization and Vaccination \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRelationship between community pharmacists sociodemographic characteristics and their role in Hepatitis B immunization and vaccination\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eResult of the analysis revealed that the community pharmacists sociodemographic characteristics had no statistically significant relationship in their role in Hepatitis B immunization and vaccination. Details of the analysis is shown in Table 4. \u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4: Relationship between Sociodemographic Characteristics of respondents and their role in Hepatitis B vaccination and immunization\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThis study aimed to evaluate the role of community pharmacists on Hepatitis B vaccination and immunization in Nigeria. This study revealed that a good number of the community pharmacists do not provide immunization service in their pharmacies. This is consistent with the study by [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] which revealed that a good number of community pharmacists in Nigeria do not provide immunization services. Non provision of immunization and vaccination services by community pharmacists may be as a result of lack of training or inadequate infrastructure in the pharmacies. It has been shown that including community pharmacies into the national vaccination plans can help improve vaccine awareness and acceptance especially among those at risk [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Community pharmacists are the first and, in most case, the last contact for most patients in Nigeria, hence they are indispensable in modern healthcare. There is need for professional training programs to be organized for community pharmacists especially those in Low-and -Middle Income countries.\u003c/p\u003e\u003cp\u003eA good number of community pharmacists in our study were involved in educating clients on Hepatitis B vaccination and immunization while very few pharmacists administered Hepatitis B vaccine to clients. This is consistent with the study by [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] which showed that community pharmacists were involed in educating clients on Hepatitis B vaccination. The study by [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] which showed that community pharmacies were involved in storage, preparation, distribution, education, and were immunization providers in their practice contrasts with the result obtained from this study. Vaccination is one effective public health strategy for reducing disease burdens and saving lives [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. The role of community pharmacists in improving vaccination and immunization services has been recognized in recent times [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Community pharmacists have been involved in direct patient care in the community pharmacy setting but their role in immunization has not yet been defined. It has also been shown that community pharmacists are greatly underutilized in acheving health coverage in Nigeria [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Expanding the scope of practice for community pharmacists to include pharmacy-led immunization programs may increase accessibility to immunization programs.\u003c/p\u003e\u003cp\u003eCommunity pharmacists age, marital status, gender, highest qualification, years of practice had no statistical significant relationship with their provision of immunization and vaccination services. This is consistent with the study by [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] which revealed that the demographic characteristics of community pharmacists in Nigeria had no statistically significant relationship with their provision of vaccination and immunization services and their role on Hepatitis B vaccination and immunization.\u003c/p\u003e\u003cp\u003eThis study has some limitations. First is the small sample size. There may be issues with representation. Secondly, is the self-assessment nature of the questionnaire.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eThe role of the community pharmacists in Hepatitis B vaccination and immunization was in educating clients on Hepatitis B vaccination immunization mostly through campaigns. Adequate efforts should be made to empower the community pharmacists through trainings in other areas such as storing and distribution of Hepatitis B vaccines as well as in administering the vaccine to clients.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eAll Methods were carried out in accordance with relevant guidelines and regulations. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWritten informed consent was obtained from all participants in the study\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgement \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors wish to acknowledge all the community pharmacists that participated in this study.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was received for conducting this study\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eN.N.O: Supervised the study; wrote the final paper\u003c/p\u003e\n\u003cp\u003eC.MC.C: Wrote the initial paper; collected data, analyzed data\u003c/p\u003e\n\u003cp\u003eN.E.O: Analyzed data\u003c/p\u003e\n\u003cp\u003eAll authors commented on the manuscript at every stage and approved the final manuscript\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFinancial interest:\u0026nbsp;\u003c/strong\u003eThe authors declare that they have no financial interest\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNon-financial interest\u003c/strong\u003e: None\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval for the study was obtained from the Ethics Committee of Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH) Amaku-Awka: COOUTH/CMAC//ETH.C/VOL.1/FN:04/259\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWritten informed consent was obtained from all the respondents before commencement of the study\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to publish\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent to publish was obtained from all authors before sending out this manuscript for publication\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData is available on request\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical Trial Number:\u003c/strong\u003e Clinical trial number not applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical Trial Registration Details\u003c/strong\u003e: Clinical trial number not applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eHeath RD, Tahan V. Natural history of hepatitis b virus. Viral Hepatitis: Chronic Hepatitis B. 2018. 1\u0026ndash;10. https://doi.org/10.1007/978-3-319-93449-5_1\u003c/li\u003e\n\u003cli\u003eDaniel FM, Ukoaka BM, Emeruwa VB, Oti-Ashong RC, Falaiye GO. Addressing vaccination gaps among healthcare workers in sub-saharan Africa: the role of mandatory hepatitis B vaccination. Trop. Med. Health. 2024. 52: 80\u003c/li\u003e\n\u003cli\u003eUmego, C., Mboto, C., Mbim, E., Edet, U., George, U., Tarh, J. Epidemiology of Hepatitis B Virus Infection in South-South, Nigeria: A Review. \u003cem\u003eInternational STD Research \u0026amp; Reviews\u003c/em\u003e, 2018. \u003cem\u003e7\u003c/em\u003e(1), 1\u0026ndash;17. https://doi.org/10.9734/isrr/2018/36989\u003c/li\u003e\n\u003cli\u003eAjuwon B, Yujuio I, Roper K, Richardson A, Sheel M, Liabury BA. Hepatitis B virus infection in Nigeria: a systematic review and meta analysis of data published between 2010 and 2019. BMC Infectious Dis. 2021. 21: 1120. \u003c/li\u003e\n\u003cli\u003eAkabuike OM, Aworh MK, Uzochukwu NL, Erwat J, Agukwe O, Ngong K. Evaluating hepatitis B screening, prevalence, vaccination coverage and linkage to care in Abuja, Nigeria: insights from a cross sestional study. BMC Public Health.2024. 24: 3475. https://doi.org/10.1186/s12889-024-21017-3\u003c/li\u003e\n\u003cli\u003eMcMillan S. A systematic review of the role of pharmacists in vaccination services in low-and middle-income countries. Research in Social and Administrative Pharmacy. 2020. 17(2), 300\u0026ndash;306. https://doi.org/10.1016/j.sapharm.2020.03.016\u003c/li\u003e\n\u003cli\u003eBach A and Goad J. The role of community pharmacy-based vaccination in the USA: current practice and future directions. Integrated Pharmacy Research and Practice 2015. 67. https://doi.org/10.2147/iprp.s63822\u003c/li\u003e\n\u003cli\u003eAgbo B B, Esienumoh E, Inah SA, Eko JE, Nwachukwu EJ Community pharmacists\u0026rsquo; participation in immunization services in Cross River state, Nigeria. International Journal of Public Health, Pharmacy and Pharmacology. 2019. 4(3):11-25 \u003c/li\u003e\n\u003cli\u003eAbeje G, Azage M. Hepatitis B vaccine knowledge and vaccination status among health care workers of Bahir Dar City Administration, Northwest Ethiopia: a cross sectional study. BMC Infect Dis 2015. 15:30\u003c/li\u003e\n\u003cli\u003eOladigbolu AA, Okafor UG, Oluwasere CO, Ashore OM. Community pharmacy workforce willingness, readiness, and infrastructural capacity to deliver vaccination services: a cross-sectional survey in Nigeria. BMC Health Serv Res. 2025. 25: 485\u003c/li\u003e\n\u003cli\u003eLampasona M, Pantaleo L. The role of pharmacies in immunization programs and Health promotion. Arch. Pharm. Pract.2022. 13(2): 62-5\u003c/li\u003e\n\u003cli\u003eHogue MD, Grabenstein JD, Foster SL, Rothholz MC. Pharmacist involvement with immunizations: a decade of professional advancement. JAPhA. 2006. 46(2):168\u0026ndash;179. https://doi/org/10.1331/154434506776180\u003c/li\u003e\n\u003cli\u003eLe ML, Veettil SK, Donaldson D, Kategeaw W, Hutubessy R, Lambach P, Chaiyakunapruk N. The impact of pharmacist involvement on immunization uptake and other outcomes: An updated systematic review and meta-analysis. 2022. 62(5):1499\u0026ndash;1513.e16\u003c/li\u003e\n\u003c/ol\u003e\n"},{"header":"Tables","content":"\u003cp\u003eTables 1 to 4 are available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Community pharmacists, Hepatitis B virus, Immunization, Role, Vaccination","lastPublishedDoi":"10.21203/rs.3.rs-7550193/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7550193/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eHepatitis B is an infectious disease of the liver, affecting millions of people throughout the world.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjectives\u003c/strong\u003e: The aim of the study was to evaluate the roles of community pharmacist in Nigeria on Hepatitis B Vaccination and immunization\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eA cross-sectional descriptive study was conducted among 49 registered community pharmacists in a state in Nigeria. Convenience sampling technique was employed. Ethical approval was obtained for the study. A structured questionnaire was adapted and used as instrument for data collection. Data was analyzed using SPSS version 23 and summarized using descriptive statistics frequency (%), mean. The scores obtained were compared using ANOVA and Independent student’s test. The relationship between sociodemographic characteristics of the respondents and their role on Hepatitis B vaccination was assessed using Chi square. Statistical significance was established at p\u0026lt;0.05\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eMore females 31(63.3%) than males participated in the study. Majority of the pharmacists 46(93.3%) had B.Pharm. as the highest qualification while 40(81.6%) of the pharmacists were within the first five years of practice. A good number of the respondents 45(91.8%) do not provide immunization services in their pharmacies while only 1(2%) pharmacist administer Hepatitis B vaccine to their clients. Community pharmacists’ provision of immunization services and their role on Hepatitis B vaccination and immunization had no statistically significant relationship with their sociodemographic characteristics.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eThe\u003cstrong\u003e \u003c/strong\u003eCommunity pharmacists were involved in educating clients on Hepatitis B vaccination through campaign programs. Adequate efforts should be made to empower community pharmacists through trainings in other areas.\u003c/p\u003e","manuscriptTitle":"Community Pharmacists Role on Hepatitis B Vaccination and Immunization in Nigeria","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-05 14:16:19","doi":"10.21203/rs.3.rs-7550193/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-12-04T13:50:04+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-12T21:06:52+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-03T13:24:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"298761026837455459138173694038834751240","date":"2025-10-29T06:54:30+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"202987949243386727827117094348679825004","date":"2025-10-24T07:44:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"159331955788347146949439215040213855500","date":"2025-10-24T07:11:34+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-24T06:36:44+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-24T06:35:18+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-08T16:38:16+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-05T14:24:03+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Public Health","date":"2025-10-05T14:21:10+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2149a200-8ea6-4619-aa6d-4a426945895c","owner":[],"postedDate":"November 5th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-05-04T16:00:43+00:00","versionOfRecord":{"articleIdentity":"rs-7550193","link":"https://doi.org/10.1186/s12982-026-01921-2","journal":{"identity":"discover-public-health","isVorOnly":false,"title":"Discover Public Health"},"publishedOn":"2026-04-29 15:57:56","publishedOnDateReadable":"April 29th, 2026"},"versionCreatedAt":"2025-11-05 14:16:19","video":"","vorDoi":"10.1186/s12982-026-01921-2","vorDoiUrl":"https://doi.org/10.1186/s12982-026-01921-2","workflowStages":[]},"version":"v1","identity":"rs-7550193","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7550193","identity":"rs-7550193","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}