Published online Dec 26, 2018. doi: 10.12998/wjcc.v6.i16.1128
Peer-review started: October 2, 2018
First decision: October 11, 2018
Revised: October 19, 2018
Accepted: November 23, 2018
Article in press: November 24, 2018
Published online: December 26, 2018
Processing time: 82 Days and 15.7 Hours
In the last few decades, meningococcal outbreaks from Hajj gathering have been a major global public health concern. It is now compulsory for anyone who is going to attend Hajj congregation or serve the pilgrims to be vaccinated with a quadrivalent meningococcal vaccine (against serogroups A, C, W and Y). Seasonal influenza vaccine is also highly advised for all Hajj attendees, and pneumococcal vaccine is recommended for pilgrims with co-morbidities.
The uptake of these vaccines among health care workers (HCWs) at Hajj has been suboptimal and there is no data on pneumococcal vaccine uptake. In previous reports non-availability of vaccine and lack of time were key barriers to vaccination among HCWs at Hajj, however there is no data on facilitators of vaccination.
The objectives are to evaluate the uptake of meningococcal, influenza, pneumococcal vaccines among HCWs who serve at Hajj, and to explore the key factors, including facilitators, affecting their vaccination rate.
An anonymous cross-sectional online survey was conducted among HCWs and trainees who worked or volunteered at the Hajj 2015-2017 in Makkah and Mina. Pearson’s chi-squared test was used to compare categorical variables; and odds ratio (OR) was calculated by “risk estimate” statistics along with 95% confidence interval (95%CI).
A total of 138 respondents aged 20 to 59 (median 25.6) years with a male to female ratio of 2.5 participated in the survey. Only 11.6% (16/138) participants reported receiving all three vaccines, 15.2% (21/138) did not receive any vaccine; 76.1% (105/138) received meningococcal, 68.1% (94/138) influenza and 13.8% (19/138) pneumococcal vaccine. Females were more likely to receive a vaccine than males (OR 3.6, 95%CI: 1.0-12.7, P < 0.05). Willingness to follow health authority’s recommendation was the main reason for receipt of vaccine (78.8%) while believing that they were up-to-date with vaccination (39.8%) was the prime reason for non-receipt.
This survey shows that many HCWs at Hajj miss out the compulsory and highly recommended vaccines; lack of awareness is a key barrier and authority’s advice is an important motivator.
Achieving satisfactory vaccination coverage among local HCWs at Hajj remains a challenge. Health education followed by stringent measures may be required to improve their vaccination rate. Evaluation of the role of workplace vaccination campaigns and the “Basic Infection Control Skills License” should be considered to better understand the uptake of vaccination among HCWs at Hajj.