27 June 2023 –  The World Health Organization (WHO) has developed a list of recommendations that each pilgrim should follow. These recommendations are in line with the health requirements set by the health authorities in Saudi Arabia for pilgrims in the Hajj season this year. 

Physical ability, chronic diseases and health education

WHO recommends that authorities at pilgrims’ countries of origin should take into account that a pilgrim should have minimum physical ability for Hajj. It also alerts to the high risk of infectious diseases in older people and those with severe chronic diseases such as advanced cancers, heart and respiratory diseases, advanced liver or kidney diseases, and senility. 

Furthermore, WHO recommends that pilgrims and individuals with chronic diseases should bring a proof of their health condition and the medicines they take, and bring a sufficient amount of these medicines in their original packaging.

WHO also recommends that pilgrims should update their vaccination status against vaccine-preventable diseases such as diphtheria, tetanus, pertussis, polio, measles, varicella and mumps. 

Infectious respiratory diseases

WHO advises pilgrims to comply with following health advice. 

Wash hands with soap and water or a disinfectant, especially after coughing and sneezing, after using toilets, before handling and consuming food, and after touching animals.

Use disposable tissues when coughing or sneezing and dispose of used tissues in a wastebasket.

Wear face masks in crowded places and replace wet masks with dry ones.

Avoid direct contact with those who appear ill and avoid sharing their personal belongings.

Avoid direct contact with camels in farms, markets, or barns, and avoid drinking unpasteurized milk or eating raw meat or animal products that have not been thoroughly cooked. 

Food and waterborne diseases

WHO advises pilgrims to observe the following health advice.

Wash hands before and after eating and after going to the toilet.

Thoroughly clean and wash fresh vegetables and fruit.

Store at safe temperatures.

Cook food thoroughly.

Do not eat uncovered cooked foods or those stored outside refrigerators. 

Heat stress and heat strokes

WHO recommends that pilgrims, especially older individuals, avoid direct sun exposure and to drink sufficient amount of water. It also advises that pilgrims on medications that can exacerbate dehydration, such as diuretics, should see their attending doctors prior to travelling for Hajj. 

Zika virus disease and dengue fever

WHO advises pilgrims to take necessary measures and precautions to avoid mosquito bites, which include wearing protective clothing (preferably light-coloured) that covers as much of the body as possible; using physical barriers such as window screens and closed doors; and applying insect repellent as per the label instructions on the product to skin or clothing. 

Mandatory vaccinations

The Saudi health authorities have developed a list of vaccinations that pilgrims should take as follows:

Vaccine	Target group	Target countries	Approved vaccine
SARS-COV-2 (COVID-19)	All travelers aged 12 years and over, intending to perform or attend Hajj	All countries	https://www.moh.gov.sa/en/HealthAwareness/Pilgrims_Health/Approved-Vaccines/Pages/Outside-the-Kingdom.aspx
Meningococcal meningitis	All individuals, aged 1 year and over, arriving for Hajj or for work in Hajj zones	All countries	Quadrivalent (ACYW) polysaccharide vaccine within the last 3 years. Quadrivalent (ACYW) conjugate vaccine within the last 5 years. Health authorities at the pilgrims' country of origin should ensure their vaccination within the required validity period and make sure that the type of vaccine is clearly shown in the vaccination certificate. If the vaccine type is not indicated on the certificate, it will be considered valid for 3 years only.
Poliomyelitis	All travellers	States reporting cases of WPV1 or cVDPV1 (Appendix 1-Table 1)	At least one dose of bivalent oral polio vaccine (bOPV) or inactivated polio vaccine (IPV)
Poliomyelitis	All travellers	States reporting cVDPV2 positive human sources samples or acute flaccid paralysis (AFP) cases (Appendix 1-Table 2)	At least one dose of IPV3, if (IPV) is not available, it is acceptable to be vaccinated with at least one dose of the oral polio vaccine (OPV).
Yellow fever	All travellers above nine months of age	Countries or areas at risk of yellow fever transmission (Appendix 2)	Yellow fever vaccine. The Yellow Fever vaccination certificate is valid for life starting 10 days after vaccination.

Recommended vaccinations

Vaccine	Target group	Target countries	Approved vaccine
Poliomyelitis	All travellers	States reporting positive Environmental Sources samples of cVDPV2 (Appendix 1-Table 3)	At least one dose of (IPV) 5 , if (IPV) is not available, it is recommended to be vaccinated with at least one dose of the oral polio vaccine (OPV)
Seasonal influenza	Travellers arriving for Hajj or for seasonal work in Hajj areas particularly pregnant women, children under 5 years, the elderly, individuals with chronic medical conditions (such as chronic cardiac, pulmonary, renal, metabolic, neurodevelopmental, liver, or hematologic diseases) and individuals with immunosuppressive conditions (such as HIV/AIDS, receiving chemotherapy or steroids, or malignancy).	All countries	Seasonal influenza vaccine