Why should I get the meningitis vaccine if I'm performing Umrah or Hajj? 

Hajj is a highly recommended form of worship for Muslims, and for those who can afford it, it is even obligatory. According to government regulations, pilgrims are required to be vaccinated against meningococcal meningitis before leaving for Saudi Arabia. Saudi Arabia is the destination for millions of Muslim pilgrims from around the world to perform the Hajj and Umrah pilgrimages. Saudi Arabia has been known as an endemic area for meningococcal meningitis since the discovery of the first case among pilgrims in 1987. Pilgrims from various countries from all over the world became one of the main sources of transmission risk for this dangerous disease.

Meningitis results from inflammation of the meninges, which protect the brain and spinal cord. This disease is caused by a variety of infections, including viruses, bacteria, and parasites, and it can be passed from person to person. Meningitis can be transmitted through the respiratory tract or splashes of saliva that enter the mouth or are inhaled. Meningitis transmission will be easier if you are in a crowd where you can interact closely with other people. 

Meningococcal meningitis was first identified as a type of meningitis caused by the bacterium Neisseria meningitidis, also known as Meningococcus. How dangerous is meningococcal meningitis to the point where a meningitis injection for Hajj is required as a preventative measure? Before reaching the meninges, meningococcal bacteria first infect the blood vessels, multiply, and then spread to the meninges. This bacterial infection then causes swelling in the meninges. However, the symptoms can be difficult to detect because they can appear suddenly. The incubation period for the disease is 3–4 days (range 2–10 days). Even though the initial symptoms appear, the complaints that are felt are almost the same as the flu.

You need to be vigilant if symptoms of meningitis appear, such as a stiff neck, severe headache, nausea, or vomiting. As explained, bacteria can infect blood vessels and cause bleeding. Therefore, symptoms of a rash in the form of red spots, which are caused by blood coming out of infected blood vessels, can also appear on the skin. Although meningitis can be disabling and life-threatening, it can be effectively prevented by vaccination. Vaccines can help the body produce antibodies to fight the bacteria that cause meningitis.

Currently, all domestic and international pilgrims must be vaccinated with the quadrivalent meningococcal vaccine (A, C, Y,W135).

There are two types of vaccines available in Indonesia, namely:

1. Meningococcal Polysaccharide Vaccine (MPSV4)

This type of vaccine can be used in all age groups. In adults, the duration of protection is 3-5 years. This type of vaccine is an option for pilgrims over 55 years old.

2. Conjugate Meningococcal Vaccine (MCV4/MenACWY)

This vaccine provides adequate protection and reduces the risk of becoming a carrier. However, until now, the BPOM has approved the use of vaccines for children aged 11 to 55. 

The validity period of the meningococcal meningitis vaccine set by the government is 2 (two) years. If the previous dose was more than two years ago, the meningococcal meningitis vaccine for Hajj must be repeated. The government of Saudi Arabia requires that the vaccine be carried out no less than 10 days before departure. Everyone who has been vaccinated will be given an international vaccination certificate, or International Certificate of Vaccination (ICV), known as the yellow book. Not all health facilities can issue these certificates, and their meaning is regulated by the government. Issuance of certificates after meningococcal meningitis vaccination can be done in hospitals that have received permission from the government.

The Saudi Arabian government requires the provision of a meningococcal meningitis vaccine and a complete COVID-19 vaccine to protect prospective pilgrims. Meningococcal meningitis vaccine can be administered 14 days after the second or third COVID-19 vaccination. 

Created by: Dr. Miranda Alina Nugrahananti

Reviewed by :Dr.Adam Iskandar,Sp.PD

Reference :

1. Ministry of Health of the Republic of Indonesia, 2019. Guidelines for Meningococcal Meningitis Detection and Response Jakarta: Indonesian Ministry of Health

2. ITAGI. 2022. Provision of Meningococcal Meningitis Vaccine for Prospective Hajj and Umrah Pilgrims, Jakarta

3. Lucas, M.; Matthijs, C.; Diederik, V. Neurological sequelae of bacterial meningitis infection, 73(1), pp. 18-27, 2016. 16.04.2016, doi: 10.1016/j.jinf.2016.04.009

4. Indonesian Ulema Council. 2010. Meningitis Vaccine Use for Hajj and Umrah Pilgrims.

5. Yezli, S., and M. Abdulah. Meningococcal Disease in Hajj and Umrah Mass Gatherings. Infectious Diseases International 2016;47:60-64. doi:10.1016/j.ijid.2016.04.007, April 2016. 6. World Health Organization. Meningitis [web page on the internet]. 2021 [Referenced: April 11, 2022] . . Availablat:om https://www.who.int/news-room/fact-sheets/detail/meningitis