Preventing invasive meningococcal disease during Hajj in Saudi Arabia

Hajj is associated with an increased risk of invasive meningococcal disease, because of close contact among large numbers of pilgrims from diverse geographic regions.

To recommend evidence-based vaccination strategies for strengthening the prevention of invasive meningococcal disease during Hajj.

We convened a panel of experts from 4 medical societies to review epidemiologic data, immunisation policies and other evidence on PubMed on meningococcal vaccines, including the quadrivalent conjugate vaccine against serogroups A, C, W and Y and meningococcal serogroup B vaccine (MenB), available in Saudi Arabia. Based on their findings they drafted a consensus statement of recommendations for the prevention of meningococcal disease during Hajj.

We found from our review that invasive meningococcal disease remains a significant health risk during Hajj. Based on the findings, we recommend MenB vaccination for adults intending to perform Hajj. Vaccination should specifically target vulnerable populations, particularly people with chronic disease, immunocompromised individuals, those with occupational risk, children aged 2 months to 18 years and adults aged ≥ 60 years. Integration of vaccination into Hajj and Umrah registration systems, clear communication, adverse event monitoring and evaluation of programme impact may support uptake.

Adding MenB vaccination to existing quadrivalent meningococcal conjugate vaccine recommendations can strengthen protection and reduce the risk of invasive meningococcal disease outbreaks during Hajj.