The findings from this study suggest a high incidence of influenza as a cause of upper respiratory tract infection among pilgrims, estimated to be 24,000 cases per Hajj season, excluding those becoming ill from contact with Hajj pilgrims returning home. They also indicate a very low vaccination rate for the influenza vaccine; as well as poor knowledge of its existence. Continued surveillance during the Hajj pilgrimage is necessary. The influenza vaccine should be a priority for those attending the Hajj pilgrimage, and should also be considered for antiviral prophylaxis.

BackgroundThe H1N1 influenza pandemic had garnered a large amount of attention. Currently, the most effective preventive measure available is the H1N1 vaccine. We aimed to assess the willingness of our study participants to receive the H1N1 vaccination prior to the annual Hajj season. If any participant declined, we investigated the reasons for vaccine rejection.FindingsWe conducted a prospective cohort study of National Guard employees during the 1430 (2009) Hajj season. A survey was used as the primary method for data collection. Participants were vaccinated one to two weeks prior to their trip to Mona, and any side effects reported at the time of injection and three weeks post vaccination were recorded.There were 100 male and 26 female participants in the study. In total, 66.7% (n = 84) of the participants were health care workers (HCWs) and 33.3% (n = 42) were non-health care workers (non-HCWs). Less than half of the respondents (46.8%, n = 59) accepted the vaccination. The vaccination acceptance rate was higher among non-HCWs, at a rate of 71.4% (n = 30); HCWs only accepted at a rate of 34.5% (n = 29) (OR 1.103, 95% CI [0.488-2.496]). The most common reason for vaccine refusal was the impression that the disease was not fatal (25.4%, n = 32). Finally, all participants reported pain at the injection site and 18.3% (n = 11) reported swelling. All other side effects were reported in less than 15% of the participants.ConclusionsDespite fears of the new H1N1 vaccine, there was a reasonable rate of vaccine acceptance among our study participants. Early health education may increase the rate of acceptance of the H1N1 vaccine. Furthermore, additional research is needed on long-term adverse effects of the H1N1 vaccine.