Abstract: Background: Hepatitis B virus (HBV) is a major occupational hazard for healthcare workers (HCWs), particularly in low- and middle-income countries like Sierra Leone, where institutional weaknesses, vaccine hesitancy, and poor public health infrastructure undermine prevention efforts. Despite high awareness of HBV risks, vaccine uptake among HCWs remains suboptimal, with little known about the role of advocacy and sponsorship in improving coverage.