title: Predictors for the uptake of recommended vaccinations in Mecca travelers who visited the Public Health Service Amsterdam for mandatory meningitis vaccination.
abstract: BACKGROUND
  Hajj, the pilgrimage to Mecca, is one of the obligatory religious duties of Islam. The travel clinic of the Public Health Service (PHS) Amsterdam administers vaccinations, including the required meningitis ACYW135 vaccine, and provides travelers with individual recommendations for all their travels.
  
  
  METHODS
  We extracted all data from the PHS database pertaining to Muslims who visited the clinic before travel to Mecca. From 2001 to 2009, the characteristics are described and trends are analyzed retrospectively. Acceptance of dTP vaccine was used as a proxy for acceptance of recommended vaccinations. For the years 2007 to 2009, predictive factors for the acceptance of advised vaccinations are analyzed.
  
  
  RESULTS
  From 2001 to 2009, significantly more women and people older than 50 years of age traveled to Mecca. Since 2007, only 527 of 2,156 (24%) of those who were advised to take vaccines accepted the recommendation. Independent factors for acceptance were being female, of younger age, and being less healthy. Specifically, Mecca travelers with heart disorders and with liver or gastrointestinal disorders accepted recommended vaccinations more often than those without.
  
  
  CONCLUSIONS
  Only a quarter of Mecca travelers who visit the travel clinic for their mandatory meningitis vaccination also take other, recommended, vaccinations. To improve the acceptance rate, Islamic organizations that inform Mecca travelers in preparation for their travel should be supplied with up-to-date advice, not only about the requirements but also about recommended vaccinations and health precautions.
authors.affiliation: Department of Infectious Diseases, Public Health Service Amsterdam (GGD Amsterdam), Amsterdam, The Netherlands.
authors.forename: Havva
authors.initials: H
authors.lastname: Keles
authors.forename: Gerard J B
authors.initials: GJ
authors.lastname: Sonder
authors.forename: Anneke
authors.initials: A
authors.lastname: van den Hoek
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007514:Islam; D008297:Male; D008581:Meningitis / Q000517:prevention & control*; D022401:Meningococcal Vaccines / Q000627:therapeutic use*; D008875:Middle Aged; D009426:Netherlands; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011635:Public Health Administration; D012044:Regression Analysis; D017678:Sex Distribution; D014195:Travel; D014611:Vaccination / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D022401:Meningococcal Vaccines