Vaccination for Hajj and Umrah pilgrims from the UK



  • Meningococcal meningitis and septicaemia occurs in all countries, although it is much more common in certain areas. 
  • Epidemics linked to Hajj
  • Vaccine compulsory for all Hajj and Umrah pilgrims
  • Two vaccines available in the UK
  • Both vaccines certified as Halal


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 W[1]. Cases of meningococcal disease also occurred world-wide after pilgrims returned to their own countries[2].

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.org.

Pilgrims on Hajj or Umrah 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.

What vaccines are available?

There are now two ACWY vaccines available: Menveo® and Nimenrix®. In children less than 1 year of age, Menveo® should be used. Those over 1 year of age should receive a single dose of either Nimenrix® or Menveo®. Babies under one year of age, should receive two doses of Menveo® one month apart for protection[3].

There are two ‘conjugate’ (see box 1 for explanation) ACWY vaccines available in the UK, Menveo® and Nimenrix®. Those over 1 year of age should receive a single dose of either Nimenrix® or Menveo®. Babies under one year of age, should receive two doses of Menveo® one month apart for protection[3].
Polysaccharide ACWY vaccines are available in some countries outside of the UK, but protection from these vaccines do not last as long as protection from conjugate vaccines.

It is important to make sure that the name of the vaccine given is clearly recorded on the certificate. Certificates of vaccination which state that conjugate vaccine was received are valid for 8 years, but certificates which do not state the name of the vaccine received or which state that a polysaccharide vaccine was received are only valid for travel 3 years after the date of immunisation[4].

The Muslim Council of Britain (MCB) can offer more information about vaccination and pilgrimage to Hajj. Visit them at  http://www.mcb.org.uk/health-and-travel-advice-for-hajj-pilgrims/

Safety and acceptability

The ingredients of both the newer conjugate vaccines have been in use for many years. Both Menveo® and Nimenrix® have been used as travel vaccines for several years are now routinely used in the UK as teenage immunisations. 
 
Both vaccines have an excellent safety profile, although mild side effects are fairly common, including pain where the vaccine was injected, and sometimes headache, or nausea.
Menveo® has been certified as Halal by the Indonesian Council of Ulama and the Islamic Services of America. Nimenrix® has been certified as Halal by the Halal Food Council of Europe.

Know the symptoms

Remember there are strains of meningitis that cannot be prevented, so it is important to know the symptoms to look out for, because early treatment saves lives.

References
  1. Lingappa, J.R., et al., Serogroup W-135 meningococcal disease during the Hajj, 2000. Emerg Infect Dis, 2003. 9(6): p. 665-71.
  2. Hahne, S.J., et al., W135 meningococcal disease in England and Wales associated with Hajj 2000 and 2001. Lancet, 2002. 359(9306): p. 582-3.
  3. 'Green Book'. Department of Health. Immunisation against infectious diseases. Chapter 22: Meningococcal. Updated April 2011. http://www.dh.gov.uk/en/Publichealth/Healthprotection/Immunisation/Greenbook/DH_4097254
  4. Saudi Arabian Ministry of Health. Health Requirements for Travellers to Saudi Arabia for Pilgrimage to Makkah (2016/1437H Hajj) Available from: http://www.moh.gov.sa/en/Hajj/Pages/HealthRegulations.aspx..

Page last updated 08.11.16