Large epidemics of meningococcal disease have been linked to the Hajj pilgrimage, at first due to group A bacteria and then in 2000/2001 to group W1. Cases of meningococcal disease also occurred world-wide after pilgrims returned to their own countries2.
Because of these epidemics, quadrivalent ACWY vaccination has been a compulsory entry requirement into Saudi Arabia for pilgrims on Hajj and Umrah, and for other travellers in Hajj season since 2002. It protects against meningitis and septicaemia caused by four different strains: A, C, W and Y. Vaccination is also recommended for travel to sub-Saharan Africa and certain other countries, especially if travellers will be living or working with local people or visiting during an outbreak. An up-to-date list of countries with potential risk can be obtained from www.nathnac.net
It is recommended that all pilgrims on Hajj or Umrah regardless of age be vaccinated with ACWY. Pilgrims on Hajj or Umrah aged 2 and above are required to present a certificate of vaccination with ACWY before they can gain entry into Saudi Arabia. The certificate must have been issued at least 10 days before arrival. This also applies to seasonal workers in Hajj areas.