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For Muslims around the world, Hajj and Umrah represent journeys of profound personal and spiritual significance. For Saudi Arabia, welcoming those pilgrims also brings an important responsibility: protecting their health and wellbeing throughout that journey.As we mark World Meningitis Day, that responsibility takes on particular significance. Meningococcal disease presents a distinct public health challenge in mass gathering settings. It can progress rapidly with serious consequences, while its epidemiology can be dynamic and unpredictable. During pilgrimage, where close contact and population mixing occur at extraordinary scale, these factors make prevention particularly important, not only for individual pilgrims, but also for their families and wider communities in the Kingdom.As Saudi Arabia advances its Vision 2030 ambition to welcome 30 million pilgrims annually, there is a critical opportunity to ensure that health protection evolves alongside every other aspect of the pilgrim experience. Prevention as part of the pilgrim experienceProtecting health during mass gatherings requires a comprehensive approach, bringing together vaccination, disease surveillance, outbreak preparedness, risk communication and international coordination. Today, that approach is evolving further, with prevention becoming more firmly embedded within public health policy.The September 2026 update to Saudi Arabia’s National Immunization Schedule for Adults is a significant example of that progress. The schedule identifies Hajj and Umrah pilgrims among groups at increased risk of meningococcal ACWY disease, alongside residents of Makkah and Madinah, and particularly those working in the central areas of the Two Holy Mosques. For these high-risk groups, one dose of the quadrivalent meningococcal (MCV4) vaccine is recommended, followed by a booster every five years if the risk remains.The importance of this update goes beyond the recommendation itself. By clearly defining the groups at increased risk and the vaccination approach recommended for them, the updated schedule provides a stronger framework for prevention around Hajj and Umrah. It also reflects a broader evolution in pilgrim health: ensuring protection begins before people arrive at the Holy Sites and extends to the communities that welcome them across the Kingdom.From evidence to actionThe policy direction is clear, and the data demonstrates what prevention at scale could achieve. Recent evidence shows that cases of invasive meningococcal disease associated with Umrah travel have been identified across multiple regions, with secondary transmission documented among household contacts, including children who had not travelled themselves.Further, a recently published modelling study suggests that achieving high meningococcal vaccination coverage among Umrah pilgrims could reduce expected meningococcal meningitis cases across Saudi Arabia by more than 80% compared with no vaccination.The studies reinforce why a holistic view of the entire pilgrim ecosystem matters: vaccination among domestic pilgrims plays a particularly important role in reducing disease within the Kingdom. The priority now is turning that policy and evidence into impact. Effective implementation will be critical to ensuring that clear recommendations ultimately lead to greater protection for pilgrims and communities across the Kingdom.The Himaya pilgrim health initiative is an example of how this approach can work in practice. Developed through collaboration with health authorities in Saudi Arabia, the initiative works across the ecosystem to raise awareness of vaccine-preventable diseases and reinforce vaccination as part of pre-pilgrimage health preparation, to encourage pilgrims to consider their health and protection well before their journey begins.Setting the standard for the future of pilgrim healthAs Saudi Arabia advances its Vision 2030 ambitions for Hajj and Umrah, the updated National Immunization Schedule signals how the Kingdom is truly creating a new standard for pilgrim health. It creates an opportunity to accelerate the journey from recommendation to awareness, and ultimately from action to greater protection. We are proud to contribute through Himaya and to work alongside Saudi Arabia and its partners towards a shared ambition for safer, healthier pilgrimage. The impact of prevention extends beyond the individual pilgrim. By strengthening protection for pilgrims living in Saudi Arabia, we can also help safeguard their families and the communities they return to, creating a wider public health impact across the Kingdom.
