Uptake of hepatitis B vaccination among nursing students in Cameroon: a mixed-methods study

SETTING Three purposively identified nursing education institutions (Ayos, EITMS/GS, and the Virginia Henderson Foundation) in the Centre Region of Cameroon. OBJECTIVE To evaluate the psychological, socio-cognitive, economic, and institutional factors associated with hepatitis B (HBV) vaccine uptake among nursing students. DESIGN A mixed-methods cross-sectional study was conducted between June and July 2025. Quantitative data ( n = 325) were collected via self-administered electronic surveys, supplemented by qualitative focus group discussions. Quantitative analysis was performed using SPSS. Qualitative themes were synthesised via a hybrid inductive–deductive thematic analysis, using QCAmap. RESULTS HBV vaccination was critically low at 29.54%, with only 50.04% of those vaccinated completing the full three-dose series. Multivariate analysis identified female gender, age, advanced study level, a solid knowledge level, high perceived self-efficacy, low vaccine-related anxiety, and encouragement from the educational institution as significant predictors of uptake. Qualitative findings highlighted as primary barriers: prohibitive costs, inadequate information, weak institutional mandates, and traditional prejudices. CONCLUSION Immunisation rates among high-risk nursing students are alarmingly insufficient. To mitigate occupational risk, public health policy should mandate HBV vaccination at school matriculation and implement subsidies to facilitate economic access together with systematic sensitisation.