Vaccine education in undergraduate health-related curricula: a mixed-methods study based on curriculum guidelines and student perspectives from a Chinese medical university

Healthcare professionals’ recommendations can influence public vaccination decisions; however, insufficient vaccine-related literacy and hesitancy among HCPs remain persistent challenges. Examining undergraduate health-related curricula and identifying students’ learning needs are therefore essential for developing evidence-informed vaccine education. Research in this field remains limited in China. A two-phase explanatory sequential mixed-methods design with triangulation was used. In Phase 1 (March – May 2025), 708 curriculum guidelines from a medical university in Anhui, China, were collected. Following screening and systematic content extraction, the distribution, proportion, and topical coverage of vaccine-related content were descriptively analyzed. In Phase 2 (June – July 2025), semi-structured interviews were conducted with 23 senior students who had completed their undergraduate coursework and had either completed or were completing their required graduation internships under these guidelines. The interviews explored students’ experiences, confusion, and expectations regarding vaccination education, as well as their perceived knowledge gaps and learning needs. Only 30 of 708 curriculum guidelines (4.2%) explicitly documented vaccine-related content. Across these 30 guidelines, the median character count of the teaching-related sections was 7,894 Chinese characters (IQR, 5,505–10,989; range, 1,482–24,080), while that of vaccine-related content was 49 Chinese characters (IQR, 17–89; range, 10–146). The median proportion of vaccine-related content was 0.7% (IQR, 0.2%–0.9%; range, 0.1%–10.0%), and vaccine-related content accounted for less than 1% of the teaching-related character count in 24 guidelines (80.0%). Four themes were identified from interviews: 1) vaccine cognition and risk perception; 2) assessment of vaccine education; 3) professional role identity and learning expectations; 4) acquisition and identification of vaccine information. This study suggests that the formal curriculum guidelines at the study site explicitly documented limited vaccine-related content and relatively narrow teaching approaches. Interview data further indicated that some students perceived gaps in practical preparation and vaccine-related learning support. These findings help clarify potential directions for further optimizing the documented curriculum. Educational institutions could consider strengthening vaccine education by making learning objectives and core content more explicit in curriculum guidelines, broadening vaccine-related topics, diversifying teaching approaches, and enhancing practical competency development.