Table 1.

Required and recommended vaccination for the 2019 Hajj season

	Pilgrims coming from	Vaccination
Yellow fever	Africa: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, Côte d’Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Ethiopia, Gabon, Guinea, Guinea-Bissau, Gambia, Ghana, Kenya, Liberia, Mali, Mauritania, Niger, Nigeria, Rwanda, Senegal, Sierra Leone, Sudan, South Sudan, Togo and Uganda	•Yellow fever vaccination (≥10 days after the date of vaccination) •If no proof of vaccination, pilgrims will be placed under surveillance for 6 days from the last date of potential exposure
	South and Central America: Argentina, Venezuela, Brazil, Colombia, Ecuador, French Guiana, Guyana, Panama, Paraguay, Peru, Bolivia, Suriname, and Trinidad and Tobago
Meningococcal vaccine (polysaccharide or conjugate)	(a) Any visitor	(a) Vaccination with ACYW135: vaccine within the last 3 years (polysaccharide vaccines); within 5 years (conjugate vaccines), and >10 days before arriving Saudi Arabia
	(b) Visitors from African meningitis belt: Benin, Burkina Faso, Cameroon, Chad, Central African Republic, Côte d’Ivoire, Eritrea, Ethiopia, Gambia, Guinea, Guinea-Bissau, Mali, Niger, Nigeria, Senegal and Sudan	(b) ACYW135 vaccine (as above)
	(c) Pilgrims from within Saudi and the Hajj workers: all citizens and residents of Medina and Makkah	(c) ACYW135 vaccine (as above)
Poliomyelitis	(a) Pilgrims from areas with active poliovirus transmission of a wild or vaccine-derived poliovirus: Afghanistan, Nigeria and Pakistan	(a) At least one dose of bivalent oral polio vaccine (bOPV), or inactivated poliovirus vaccine (IPV), in the last 12 months and ≥ 4 weeks prior to departure
	(b) Countries at risk of polio reintroduction: Cameroon, Central African Republic, Chad, Guinea, Laos People’s Democratic Republic, Madagascar, Myanmar, Niger, and Ukraine	(b) As above
	(c) Countries which remain vulnerable to Polio: Afghanistan, Nigeria, Pakistan, Papua New Guinea, Syria, Myanmar, Yemen and Somalia	(c) As above and additionally those pilgrims will receive 1 dose of OPV on arrival to Saudi Arabia
Seasonal influenza	All pilgrims (internal and international) and all health-care workers in the Hajj area	A recommendation
Cholera		No specific vaccine requirement