Vaccination coverage, seroprotection, and perceived immunity to hepatitis B among medical students in Brazil: implications for occupational safety in medical education

Background Hepatitis B remains an important occupational health concern for healthcare workers and medical students due to the risk of exposure to blood and body fluids during clinical training. Medical students begin clinical activities early in their training, which may increase exposure to biological risks, including infection with the hepatitis B virus (HBV). This study aimed to analyze vaccination status and immunological protection against hepatitis B among medical students from two universities in Fortaleza, Ceará, Brazil, as well as their perception of immunity and the performance of post-vaccination serological testing. Methods A cross-sectional study was conducted with 163 medical students from two universities in Fortaleza, Ceará, Brazil. Data were collected using a structured questionnaire including information on vaccination history, perception of immunity, and post-vaccination serological testing. Descriptive statistics were used to calculate absolute and relative frequencies. Associations between variables were assessed using Pearson’s chi-square test or Fisher’s exact test. Prevalence ratios (PR) with 95% confidence intervals were also calculated. Results Complete hepatitis B vaccination coverage (three doses) was reported by 81% of participants. Although 91% of students believed they were immune, only 23% reported having undergone post-vaccination serological testing. Among the 38 students who performed serology, 38% of fully vaccinated individuals had reactive anti-HBs results. A statistically significant association was observed between perceived immunity and performance of serological testing. Conclusions A relevant discrepancy was observed between self-reported vaccination coverage, perceived immunity, and effective serological protection among medical students. These findings highlight the importance of implementing institutional protocols for serological verification and integrating vaccination monitoring and biosafety education into undergraduate medical training.