Dr. Lukong Hubert Shalanyuy1*, Pr Samje Moses2, Dr. Tanlaka Lucas Mengnjo3, Wam Elvis Chongsi1, Leonard Nyuyseni Randze4, Gewun Braindaline2, Dor Mari Claire Wiydzerla1, Lukong Jude Thaddeus Veranso3, Fongum Evans Kobbi5

Background: Hepatitis B virus (HBV) remains a major global public health problem despite highly effective vaccines. While most recipients develop protective anti-HBs antibody titres (≥10 mIU/mL), a minority fail to seroconvert, posing risks for ongoing transmission. This systematic review quantified the prevalence of hepatitis B vaccine non-response and evaluated genetic, immunological, behavioral, and clinical determinants. Methods: Following PRISMA 2020 guidelines, we searched PubMed/MEDLINE, EMBASE, Scopus, Web of Science, CINAHL, Cochrane Library, African Index Medicus, and gray literature up to November 2025. Eligible studies included RCTs, cohort, case-control, cross-sectional, and genetic association studies reporting post-vaccination anti-HBs titres. Non-response was defined as anti-HBs