Evaluation of adherence to anti-rabies vaccination schedule and its predictive factors at Addis Alem hospital, Bahir Dar, Ethiopia

Rabies is a dangerous viral neglected tropical disease and infects humans, causing big problems for health authorities in Ethiopia. Though PEP is available, still there is insufficient awareness, difficulties of accessing to healthcare and logistics issues still make it hard for some to properly follow the rabies vaccination schedule. The primary aim of this study is to measure how properly the anti-rabies vaccine is given and to determine which factors influence the schedule among patients in Addis Alem General Hospital, Bahir Dar.From June to July 2024, a facility-based cross-sectional study was set up with 190 participants who were initiating rabies vaccination. Data were collected by using planned questionnaires and reviewing charts. To study both adherence rates and their causes, we used descriptive statistics and multivariate logistic regression and considered results significant if p < 0.05. Adherence rates declined significantly across vaccination doses that could be due to several factors such as vaccine hesitancy, misinformation, lack of access to follow-up doses, or diminished perceived risk after the initial dose. While each participant has received the first shot, but fewer received the second and those numbers dropped further for the third and fourth, fifth doses: 97.3%, 95.7% and 94.7%, 93.6% respectively. The majority or 81.6%, displayed good adherence. Significant factors predicting better adherence were being aged 20–40 years (2.15 times the odds, p = 0.023), having only basic education (2 times the odds, p = 0.027) and residing a short distance (5 km or less) from a healthcare facility (2.49 times the odds, p = 0.042). Concerningly, over 40% of those surveyed recognized that they should have started PEP at least 4 days ago but did not and only 39% knew that an anti-rabies vaccine was available prior to this. The findings highlight critical gaps in knowledge and timely access to rabies PEP, despite relatively high initial vaccine uptake. Targeted interventions such as public education, decentralized vaccine distribution, and cost-reduction strategies are essential to improving adherence and achieving the WHO’s 2030 rabies elimination goal.