Vaccination Adherence and Barriers Among Non-healthcare Workers and Volunteers During the Hajj

Hajj is one of the world's largest annual mass gatherings and is associated with increased risks of communicable diseases. While healthcare workers are subject to mandatory vaccination policies, non-healthcare workers and volunteers lack clear immunization requirements. This cross-sectional online survey assessed vaccination adherence, identified barriers, and generated evidence to inform the development of inclusive vaccination policies for non-healthcare workers and volunteers.

A cross-sectional survey was conducted among 68 non-healthcare workers and volunteers during the 2024 Hajj season. A structured self-administered online questionnaire was used to collect data on sociodemographic characteristics, vaccination status, and perceived barriers. Given the small sample size (n=68), findings should be interpreted as exploratory.

Survey results revealed low uptake of meningococcal (n = 11; 16.2%) and pneumococcal (n = 10; 14.7%) vaccines, moderate adherence to influenza vaccination (n = 34; 50.0%), and higher coverage for COVID-19 vaccination (n = 48; 70.6%). Knowledge level was a significant predictor of vaccination uptake (p < 0.05). Reported barriers included a lack of awareness of vaccination requirements, misconceptions about side effects, and limited access to vaccination services. Despite high recognition of infection risks, adherence remained suboptimal.

Vaccination adherence among non-healthcare Hajj workers and volunteers appeared insufficient in this exploratory study, particularly for meningococcal and pneumococcal vaccines. The observed patterns suggest that educational gaps, unclear policy guidance, and limited vaccine accessibility may contribute to suboptimal adherence in this population; however, these observations should be interpreted cautiously, given the small sample size and exploratory design. Strategies such as improving health communication, facilitating vaccine access, and clarifying official vaccination requirements may be worth exploring in future interventions, though firm policy recommendations cannot be drawn from the current data alone. Future research with larger and more representative samples is needed to substantiate these findings and provide a more comprehensive assessment of adherence patterns and barriers among this understudied group.