Influenza Vaccination Among Saudi Hajj Pilgrims: Revealing the Uptake and Vaccination Barriers

Overview

Journal Vaccine

Specialty Allergy & Immunology

Date 2018 Mar 21

PMID 29555221

Citations 9

Authors

Mohammad Alfelali

Osamah Barasheed

Al-Mamoon Badahdah

Hamid Bokhary

Mohammed I Azeem

Turki Habeebullah

Marwan Bakarman

Atif Asghar

Robert Booy

Harunor Rashid

Affiliations

Soon will be listed here.

Abstract

Background: Hajj is the world's largest annual mass gathering that attracts two to three million Muslims from around the globe to a religious assemblage in Makkah, Saudi Arabia. The risk of acquisition and transmission of influenza among Hajj pilgrims is high. Therefore, influenza vaccination is recommended, and was monitored frequently among pilgrims from different countries. However, the vaccination uptake among Saudi pilgrims has not been assessed in recent years.

Objective: This analysis aims to evaluate influenza vaccine uptake among Saudi Hajj pilgrims, and identify the key barriers to vaccination.

Method: Data on influenza vaccination were obtained from Saudi pilgrims who took part in a large trial during the Hajj of 2013, 2014 and 2015. Pilgrims were met and recruited in Mina, Makkah during the peak period of Hajj and were asked to complete a baseline questionnaire that recorded their influenza vaccination history, including reason(s) for non-receipt of vaccine.

Results: A total of 6974 Saudi pilgrims aged between 18 and 95 (median 34) years were recruited; male to female ratio was 1:1.2. Of the total, 90.8% declared their influenza vaccination history, 51.3% of them reported receiving influenza vaccine before travel to Hajj. The vaccination rates for the years 2013, 2014 and 2015 were 21.4%, 48.2% and 58.1%, respectively (P < 0.001). Of 1,269 pilgrims who were at higher risk of severe disease, 54.5% received the vaccine. Lack of awareness (47.5%), reliance on natural immunity (15.8%) and being busy (15.5%) were the main reasons for non-receipt.

Conclusion: These data from a convenience sample indicate that influenza vaccine uptake among Saudi Hajj pilgrims is increasing over years but still needs further improvement. Lack of awareness and misperceptions are the main barriers. Education of Saudi pilgrims and health professionals is required to raise awareness about influenza vaccination. Further studies are needed to understand pilgrims' misperceptions.

Citing Articles

Attitudes, motivators, and barriers toward influenza vaccination for children: a study from a conflict-ridden country.

Ahmed W, Halboup A, Alshargabi A, Al-Mohamadi A, Al-Ashbat Y, Al-Jamei S Confl Health. 2024; 18(1):26.

PMID: 38566200 PMC: 10988905. DOI: 10.1186/s13031-024-00590-9.

Comparative analysis of COVID-19 and influenza prevalence among Egyptian pilgrims returning from Hajj and Umrah in 2022: epidemiology, clinical characteristics, and genomic sequencing.

Kandeel A, Fahim M, Deghedy O, BahaaEldin H, Roshdy W, Khalifa M Arch Public Health. 2024; 82(1):6.

PMID: 38216978 PMC: 10785524. DOI: 10.1186/s13690-023-01229-6.

Threat of Antimicrobial Resistance among Pilgrims with Infectious Diseases during Hajj: Lessons Learnt from COVID-19 Pandemic.

Haseeb A, Saleem Z, Faidah H, Saati A, AlQarni A, Iqbal M Antibiotics (Basel). 2023; 12(8).

PMID: 37627718 PMC: 10451798. DOI: 10.3390/antibiotics12081299.

Evaluation of the rate, pattern and appropriateness of antibiotic prescription in a cohort of pilgrims suffering from upper respiratory tract infection during the 2018 Hajj season.

Bokhary H, Research Team H, Barasheed O, Othman H, Saha B, Rashid H Access Microbiol. 2022; 4(4):000338.

PMID: 35812707 PMC: 9260093. DOI: 10.1099/acmi.0.000338.

Beyond fragmentary: A proposed measure for travel vaccination concerns.

Adongo C, Amenumey E, Kumi-Kyereme A, Dube E Tour Manag. 2020; 83:104180.

PMID: 32952254 PMC: 7487078. DOI: 10.1016/j.tourman.2020.104180.

References

Benkouiten S, Charrel R, Belhouchat K, Drali T, Salez N, Nougairede A . Circulation of respiratory viruses among pilgrims during the 2012 Hajj pilgrimage. Clin Infect Dis. 2013; 57(7):992-1000. PMC: 7108031. DOI: 10.1093/cid/cit446. View

Alborzi A, Aelami M, Ziyaeyan M, Jamalidoust M, Moeini M, Pourabbas B . Viral etiology of acute respiratory infections among Iranian Hajj pilgrims, 2006. J Travel Med. 2009; 16(4):239-42. DOI: 10.1111/j.1708-8305.2009.00301.x. View

Gautret P, Hai V, Sani S, Doutchi M, Parola P, Brouqui P . Protective measures against acute respiratory symptoms in French pilgrims participating in the Hajj of 2009. J Travel Med. 2011; 18(1):53-5. DOI: 10.1111/j.1708-8305.2010.00480.x. View

Memish Z, Zumla A, Alhakeem R, Assiri A, Turkestani A, Al Harby K . Hajj: infectious disease surveillance and control. Lancet. 2014; 383(9934):2073-2082. PMC: 7137990. DOI: 10.1016/S0140-6736(14)60381-0. View

Stiver H . Influenza vaccination guidelines: A special case for Saudi Arabia. Ann Thorac Med. 2015; 10(4):221-2. PMC: 4652286. DOI: 10.4103/1817-1737.167063. View

Rehmani R, Memon J . Knowledge, attitudes and beliefs regarding influenza vaccination among healthcare workers in a Saudi hospital. Vaccine. 2010; 28(26):4283-7. DOI: 10.1016/j.vaccine.2010.04.031. View

Refaey S, Amin M, Roguski K, Azziz-Baumgartner E, Uyeki T, Labib M . Cross-sectional survey and surveillance for influenza viruses and MERS-CoV among Egyptian pilgrims returning from Hajj during 2012-2015. Influenza Other Respir Viruses. 2016; 11(1):57-60. PMC: 5155725. DOI: 10.1111/irv.12429. View

Madani T, Ghabrah T, Al-Hedaithy M, Alhazmi M, Alazraqi T, Albarrak A . Causes of hospitalization of pilgrims in the Hajj season of the Islamic year 1423 (2003). Ann Saudi Med. 2006; 26(5):346-51. PMC: 6074103. DOI: 10.5144/0256-4947.2006.346. View

Mayet A, Al-Shaikh G, Al-Mandeel H, Alsaleh N, Hamad A . Knowledge, attitudes, beliefs, and barriers associated with the uptake of influenza vaccine among pregnant women. Saudi Pharm J. 2017; 25(1):76-82. PMC: 5310150. DOI: 10.1016/j.jsps.2015.12.001. View

10.

Memish Z, Assiri A, Hussain R, Alomar I, Stephens G . Detection of respiratory viruses among pilgrims in Saudi Arabia during the time of a declared influenza A(H1N1) pandemic. J Travel Med. 2012; 19(1):15-21. PMC: 7537650. DOI: 10.1111/j.1708-8305.2011.00575.x. View

11.

Emamian M, Hassani A, Fateh M . Respiratory Tract Infections and its Preventive Measures among Hajj Pilgrims, 2010: A Nested Case Control Study. Int J Prev Med. 2013; 4(9):1030-5. PMC: 3793484. View

12.

Arda B, Durusoy R, Yamazhan T, Sipahi O, Tasbakan M, Pullukcu H . Did the pandemic have an impact on influenza vaccination attitude? A survey among health care workers. BMC Infect Dis. 2011; 11:87. PMC: 3084177. DOI: 10.1186/1471-2334-11-87. View

13.

Gautret P, Yong W, Soula G, Gaudart J, Delmont J, Dia A . Incidence of Hajj-associated febrile cough episodes among French pilgrims: a prospective cohort study on the influence of statin use and risk factors. Clin Microbiol Infect. 2009; 15(4):335-40. PMC: 7128324. DOI: 10.1111/j.1469-0691.2009.02816.x. View

14.

Meysamie A, Ardakani H, Razavi S, Doroodi T . Comparison of mortality and morbidity rates among Iranian pilgrims in Hajj 2004 and 2005. Saudi Med J. 2006; 27(7):1049-53. View

15.

Rashid H, Shafi S, Haworth E, Memish Z, El Bashir H, Ali K . Influenza vaccine in Hajj pilgrims: policy issues from field studies. Vaccine. 2008; 26(37):4809-12. DOI: 10.1016/j.vaccine.2008.07.001. View

16.

Haridi H, Salman K, Basaif E, Al-Skaibi D . Influenza vaccine uptake, determinants, motivators, and barriers of the vaccine receipt among healthcare workers in a tertiary care hospital in Saudi Arabia. J Hosp Infect. 2017; 96(3):268-275. DOI: 10.1016/j.jhin.2017.02.005. View

17.

Al-Tawfiq J, Gautret P, Memish Z . Expected immunizations and health protection for Hajj and Umrah 2018 -An overview. Travel Med Infect Dis. 2017; 19:2-7. PMC: 7110709. DOI: 10.1016/j.tmaid.2017.10.005. View

18.

Alqahtani A, Rashid H, Heywood A . Vaccinations against respiratory tract infections at Hajj. Clin Microbiol Infect. 2015; 21(2):115-27. DOI: 10.1016/j.cmi.2014.11.026. View

19.

Al-Tawfiq J, Zumla A, Memish Z . Travel implications of emerging coronaviruses: SARS and MERS-CoV. Travel Med Infect Dis. 2014; 12(5):422-8. PMC: 7110592. DOI: 10.1016/j.tmaid.2014.06.007. View

20.

Brien S, Kwong J, Buckeridge D . The determinants of 2009 pandemic A/H1N1 influenza vaccination: a systematic review. Vaccine. 2012; 30(7):1255-64. DOI: 10.1016/j.vaccine.2011.12.089. View