Pilgrims at Cross Road

The Saudi Arabian authorities and information from vaccine manufacturers in South African have left pilgrims in a quandary over the quadrivalent meningococcal vaccine (MCV4).

While the Saudi’s have made it clear that all pilgrims must have this vaccination and it is a condition to obtain a visa to enter that country, the South African authorities say that it is not licensed for people over 55. This means that all pilgrims going on Haj or Umrah who are over the 55 age limit would should not have this vaccination which means that the Saudi authorities could deny them entry.

Dr Salim Parker, the Immediate Past President of the South African Society of Travel Medicine (SASTM) the meningococcal polysaccharide vaccine (MPSV4) that is currently not in supply or available and unlikely to be so in the future has no upper age limit.   “Other MCV4 vaccines are currently not available in South Africa.  The safety and efficacy of MCV4 has been demonstrated in adults up to the age of 65 but is not licensed at that age in South Africa. The practitioner must decide on the risk of the disease to the pilgrim (up to 640 per 100 000, which is close to the 800 per 100 000 during the epidemic peak in the meningitis belt) versus the license issue.”

South African meningitis experts and the USA Centres for Disease Control (CDC) consider the risk to be high during the Hajj and Umrah.  “The pilgrim is not exempt from meningococcal vaccination; the available MCV4 is just not licensed for the age group over 55. The travel medicine practitioner should inform the pilgrim that the MCV4 is a visa requirement, that the risk of disease acquisition is high during travel, and that the current vaccine has license restrictions. The pilgrim then must make an informed choice,” he said.

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