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ACWY quadrivalent vaccine for hajj pilgrimage

Meningococcal infection can cause meningitis, septicaemia or both. Five

strains of meningococcal bacteria (A, B, C, W135 and Y) cause most cases.

Although it occurs in all countries, it is much more common in certainareas, for example there are epidemics in the meningitis belt of sub-

Saharan Africa, usually due to meningococcal A or W135 bacteria, and from

time to time there are outbreaks in other countries.

Large epidemics of meningococcal disease have also been linked to the Hajj

pilgrimage, at first due to A-strain and then in 2000 and 2001 due to

W135[1]. Many 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,

W135 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.

Pilgrims on Hajj or Umrah are required to present a certificate of

vaccination with ACWY, issued at least 10 days, but not more than 3 years

before arrival. This also applies to seasonal workers in Hajj areas.

What vaccines are available?

There are two ACWY vaccines available. The old one (ACWY Vax), a

polysaccharide vaccine, is based on meningococcal sugars, and sugar-

based vaccines do not work very well in young children. The newer one

(Menveo) is a conjugate vaccine, with the meningococcal sugars linked toa protein, and protein vaccines work very well even in babies. Although

both vaccines are suitable for travel, the Department of Health

recommends that children over 5 years of age and adults are vaccinated

with Menveo because it provides better and longer lasting protection.

Children under 5 should always be vaccinated with Menveo. For babies

under one year of age, two doses one month apart are needed for

protection, but older children and adults should receive a single dose[3].

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Meningitis

Meningitis is a very real and serious risk for you and your family. You could

also bring the meningitis germs back to your family and friends at home. A

dangerous strain of meningitis has affected travellers to the Hajj in theprevious years, and some people have died after contracting it.

Pilgrims going to Hajj or Umrah are required by the Government of Saudi

Arabia to have a valid certificate of vaccination every two years against

meningitis before they are issued with a visa. If you were vaccinated more

than two years ago, you will need to get re-vaccinated otherwise your visa

application will be turned down.

Please make sure that:

you get the right vaccine. You need to make sure your doctor gives you the

' quadrivalent' meningococcal vaccine (ACWY Vac) which protects against

four different strains of meningitis: A, C, W135 and Y.

if you are planning to take children under the age of two years to Hajj or

Umrah you will need to get them vaccinated with two doses of ACWY

vaccine, ideally three months apart.

you and your family get this vaccine even if you have had a different

meningitis vaccine in the past. Neither the meningitis vaccine your

child(ren) will have had as part of their routine vaccinations (called Men C),

nor the vaccine previously recommended for travel will give you the

protection you need.

you get a certificate after having had the vaccination providing it's given

within the last two years.

Talk to your doctor if you are in any doubt or phone NHS Direct on

0845 46 47*

*Calls charged at local rates.

NHS Direct can provide confidential interpreters, in many languages

including Urdu, Bengali, Punjabi, Gujarati, Arabic,Turkish and Somali,

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within minutes of your call. All you need to do is state in English the

language you would prefer to use.

Why do I need this quadrivalent immunisation for Hajj?

The W135 strain of meningitis is deadly and differs from other meningitis

strains usually caught in the UK. Previous vaccination against meningitis A

and C does not protect you against the W135 strain. Receiving the

quadrivalent meningitis vaccination will not only protect you, but will

substantially reduce the risk of infecting your friends, family and

community on your return.

The Saudi Arabian Government has made vaccination against the ACWY

strains a visa entry requirement, so you may be refused entry if you do not

have a valid certificate showing that you have received the quadrivalent

meningitis vaccination within the last two years.

Pilgrims are strongly advised to book an appointment with their GP three

or more weeks before travel to allow time for the practice to order the

ACWY vaccine, and to allow sufficient time for it to become fully effective.

And if you are planning to take children under the age of two years, you

should book about four months in advance. Please take a copy of this leaflet

with you to your GP.

An official certificate of vaccination must be obtained from the

vaccinator, clearly indicating your full name as it appears in your

passport, date of vaccination, signature and official stamp of the

vaccinator for the following two very important reasons:

a) This certificate is mandatory legal requirement without which

your Hajj and Umra visa application will be rejected by the Saudi

Embassy.

b) You are protected against this disease for 3 years from the time

of vaccination. Should you wish to perform Hajj and Umrah again

within those 3 years, revaccination will be un-necessary.