Hajj Vaccination Requirements Updated for 2019
Level 1 Travel vaccine requirements updated for pilgrims attending the Hajj
The Hajj, or annual pilgrimage to Mecca, Saudi Arabia, is scheduled for August 9–14, 2019, which enables those planning on attending this worldwide event have ample time to prepare for the trip.
The Hajj is one of the world’s largest mass gatherings each year and is associated with unique health risks.
More than 2 million Muslims from over 183 countries make Hajj each year, with approximately 11,000 of these Hajj pilgrims traveling from the United States.
Before attending the Hajj, both the US Centers for Disease Control and Prevention (CDC) and the Ministry of Health in the Kingdom of Saudi Arabia published updated vaccine requirements and travel recommendations for 2019.
The CDC says the measles virus is extremely contagious, and the crowded conditions during Hajj provide an ideal opportunity for measles transmission.
As of May 7, 2019, the European Region reported 34,300 measles cases in 42 countries during 2019.
For travelers who do not have evidence of measles immunity or who lack written documentation of measles vaccination, the CDC recommends 2 doses of MMR vaccine separated by at least 28 days, to be completed before travel.
Additionally, the Saudi Ministry of Health recommends that Hajj pilgrims confirm they have been vaccinated against these diseases:
- Yellow Fever: All travelers arriving from countries or areas at risk of yellow fever transmission must present a valid yellow fever vaccination certificate, stating vaccinated against the disease before the arrival of the Kingdom no later than (10) days and not more than (10) years. The Stamaril vaccine is available in the USA.
- Meningococcal meningitis: Visitors are required to submit a valid vaccination certificate with a tetravalent (ACYW135) meningococcal vaccine administered no less than 10 days prior to arrival to Saudi Arabia.
- Poliomyelitis: Travelers arriving from countries with circulating wild or vaccine-derived poliovirus (cVDPV2) and from countries at risk of polio reintroduction, are required to submit a valid polio vaccination certificate. A new study found the Sabin strain–based Inactivated Polio Vaccine (sIPV) demonstrated an immunogenicity profile non-inferior to that of the conventional Inactivated Polio Vaccine. This is good news since the WHO encourages the development of new IPVs that use less virulent strains, which carries a lower bio-safety risk and demonstrates long-term affordability and accessibility.
- Seasonal Influenza: The Ministry of Health in the kingdom of Saudi Arabia recommends that all pilgrims get vaccinated against the 2018/19 seasonal influenza.
Previously, on April 15th, a joint declaration regarding vaccinations was issued at the Afghanistan-Pakistan Eminent Ulama Conference. In his opening address, His Excellency the Deputy of Al Azhar Al Sharif, Dr. Saleh Abbas Goma Saleh, called upon parents to vaccinate their children to protect them from harm.
“The family bears the responsibility of the proper upbringing of, and caring for children and maintaining their health,” he said.
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Additional CDC Hajj travel insights
- Tuberculosis: The crowded conditions during Hajj increase the probability of tuberculosis transmission. Risk is estimated to be about 10% in those with high level of exposure. Many pilgrims come from highly endemic areas and some arrive for Hajj with active pulmonary disease.
- Diarrheal disease: A pre-travel visit should include discussions about prevention, oral rehydration strategies, antimotility agents, and emergency antibiotic use for treatment of travelers’ diarrhea.
- Nasal ablution: Often called ‘istinshaaq’, is the practice of rinsing your nose with water before performing some rituals during the Hajj. Medical literature has identified cases of primary amebic meningoencephalitis (PAM) caused by Naegleria fowleri transmitted as a result of nasal ablution. Nasal ablution is common during Hajj, and pilgrims are advised to use safe water to protect themselves from this potential risk.
- At the end of Hajj, Muslim men shave their heads. The use of unclean blades can transmit bloodborne pathogens, such as hepatitis B virus, hepatitis C virus, and HIV. Licensed barbers are tested for these bloodborne pathogens and are required to use disposable, single-use blades. Unfortunately, unlicensed barbers continue to operate by the roadside, where they use non-sterile blades on multiple men. Male travelers should be advised to be shaved only at officially designated centers, which are clearly marked.
- People with chronic medical conditions should undergo a functional assessment before leaving for Hajj. Close to 64% of admissions to intensive care units and deaths among pilgrims during Hajj are caused by cardiovascular conditions. Pilgrims with heart disease should carry a supply of all their medications, including copies of all prescriptions.
The CDC suggests scheduling a visit with a travel vaccine specialist at least 4 to 6 weeks before departure.
Travel vaccine counseling sessions can be scheduled at Vax-Before-Travel.
And, pack enough prescription and over-the-counter medicines to last your entire trip.
The CDC says if you develop a fever and symptoms of respiratory illness within 14 days after traveling from countries in or near the Arabian Peninsula, you should call a healthcare provider and mention your recent international travel.
Americans traveling abroad can enroll with the nearest US embassy or consulate through the Smart Traveler Enrollment Program to receive the latest safety updates and assistance in an emergency.
- SAUDI MINISTRY OF HEALTH REQUIREMENTS FIRST: REQUIREMENTS MUST BE MET BEFORE OBTAINING A VISA FOR THE HAJJ AND UMRAH
- Hajj Requirements
- Hajj in Saudi Arabia
- Health Information for Travelers to Saudi Arabia
- Hajj Pilgrimage Vaccination Requirements Updated by CDC
- CDC: Saudi Arabia: Hajj/Umrah Pilgrimage
- WHO:Health Requirements and Recommendations for Travellers to Saudi Arabia for Hajj and Umrah