cropped-msidc-logo-600px.png

Malaysian Society of Infectious Diseases & Chemotherapy

Guidelines for Adult Immunisation

Content

Message from Editor

Editorial Panel

Adult Immunisation Schedule

Contraindications and Special Considerations

Temporary Deferral of Immunisation

Route and Site of Administration

Post Vaccination

Anaphylaxis

Vaccine Storage and Disposal of Vaccines

Vaccine Combinations

Multiple Vaccinations

Adverse Event Following Immunisation (AEFI)

Immunosenescence

Cholera

COVID-19

Dengue

Diphtheria

Tetanus

Pertussis

Haemophilus influenzae type b

Hepatitis A

Hepatitis B

Human Papillomavirus (HPV)

Influenza

Japanese Encephalitis (JE)

Measles

Mumps

Rubella

Meningococcal Disease

Mpox

Pneumococcal Disease

Poliomyelitis

Rabies

Respiratory Syncytial Virus (RSV)

Typhoid Fever

Chickenpox (Varicella)

Yellow Fever

Shingles (Zoster)

Passive Immunisation

Avian Influenza

Chikungunya

Clostridioides difficile

Ebola

Human Immunodeficiency Virus (HIV)

Malaria

Zika

Adults Who Missed Childhood Immunisation

Older Adults and Patients With Chronic Ilnesses

Healthcare workers

Human Immunodeficiency Virus (HIV)

Immunocompromised Patients

Miscellaneous Groups

Travelers

Vets & Animal Handlers

Abbreviations

Print-Friendly Download

Special Groups

Travellers

In this chapter:

Travellers are advised to consult a travel health specialist or doctor 4–8 weeks before departure to allow sufficient time for recommended vaccinations. However, if immediate travel is unavoidable, it is still important to seek medical advice to help prevent infections.

Vaccination for travellers will depend on:

  • country of visit
  • duration and place of stay
  • accommodation
  • intended activities
  • presence of comorbid medical conditions

The following websites provide updated information on immunisation for travellers and should be referred to when offering advice on travel vaccination.

Mandatory vaccines

Some countries require proof of vaccination for travellers entering or exiting their borders. Failure to obtain the necessary vaccines may result in denial of entry or quarantine at the destination or upon return. For details, refer to the country list on the WHO’s International Travel and Health (ITH) webpage. The International Certificate of Vaccination or Prophylaxis (ICVP), commonly known as the Yellow Card, is an official World Health Organization (WHO) document used to record vaccinations required for international travel.

Table 30.12 Mandatory vaccinations for Travellers

Recommended vaccines

Table 30.13 Recommended Vaccination for Travellers

Routine vaccines

Although not specific to travel, all travellers are generally advised to ensure that they are up to date with routine vaccinations and boosters, because the diseases remain endemic in some countries. These vaccines include MMR (measles, mumps, rubella), Tdap (tetanus-diphtheria-pertussis), hepatitis B, influenza, pneumococcal, tuberculosis, chickenpox and COVID-19.

Hajj and Umrah Pilgrimage

While all routine and standard travel vaccines apply to Hajj pilgrims, the crowded conditions and physically demanding rituals of the pilgrimage make certain vaccines especially important. Mandatory vaccine regulations may change from one Hajj season to another. The most up-to-date vaccination requirements are available on the Saudi Ministry of Health website (www.moh.gov.sa/en/) and the official health guidelines for Hajj pilgrimage (https://hajj.nusuk.sa/nusuk/health/guidelines).

For the Hajj season 1446H (2025), mandatory vaccinations include those against meningococcal disease (all pilgrims) and polio and yellow fever (for pilgrims from endemic countries). In addition, COVID-19 and seasonal influenza vaccines are required for pilgrims aged over 65 years or those at high risk of severe infection.

Umrah pilgrims that enter Saudi Arabia using an Umrah visa usually need to follow similar requirements as Hajj pilgrims. However, those requirements are not implemented for Umrah pilgrims entering Saudi Arabia with tourist visas, where they need to follow requirements for tourist visas by the Saudi Immigration Authority.

Mandatory and Recommended Vaccines or Hajj and Umrah pilgrimage

Table 30.14 Vaccinations for Hajj and Umrah Pilgrimage

Additional vaccinations and measures during Hajj

Pre-travel advice on Hajj rituals and associated health challenges is essential for all pilgrims. A general health assessment should evaluate existing medical conditions and overall physical fitness. Pilgrims should be encouraged to bring an adequate supply of their regular medications, including portable respiratory inhalers, if applicable.

Travel vaccines for diseases such as typhoid, hepatitis A and cholera are also important because the risk of food- and water-borne infections during Hajj is rather high, due to mass food preparation, overcrowding, limited toilet facilities, and difficulties in maintaining personal hygiene. Vaccination against blood-borne diseases, such as hepatitis B, is also encouraged, particularly because part of the Hajj and Umrah rituals involve head shaving that can pose a transmission risk if proper aseptic technique is not maintained.

References

  1. Centers for Disease Control and Prevention. (2025). Think travel vaccine guide. https://wwwnc.cdc.gov/travel/page/vaccine-guide
  2. Centers for Disease Control and Prevention. (April 23, 2025). Yellow Book. https://www.cdc.gov/yellow-book/hcp/contents/index.html
  3. World Health Organization. (June 1, 2024). International Health Regulations (3rd ed.) https://apps.who.int/gb/ebwha/pdf_files/WHA77/A77_ACONF14-en.pdf
  4. World Health Organization. (2025). Vaccines and travel. https://www.who.int/travel-advice/vaccines
  5. World Health Organization (2005). International certificate of vaccination or prophylaxis. https://www.medbox.org/document/international-certificate-of-vaccination-or-prophylaxis
  6. World Health Organization. (2019). International travel and health: Chapter 6 – Vaccine-preventable diseases and vaccines. https://www.who.int/publications/m/item/international-travel-and-health-chapter-6—vaccine-preventable-diseases-and-vaccines
  7. World Health Organization. (November 18, 2022). Countries with risk of yellow fever transmission and countries requiring yellow fever vaccination. https://www.who.int/publications/m/item/countries-with-risk-of-yellow-fever-transmission-and-countries-requiring-yellow-fever-vaccination-(november-2022)
  8. World Health Organization. (September 27, 2021). Following a successful mass vaccination campaign, the polio outbreak ends in Malaysia. https://www.who.int/malaysia/news/detail/27-09-2021-following-a-successful-mass-vaccination-campaign-the-polio-outbreak-ends-in-malaysia
  9. World Health Organization (April 10, 2025). Statement of the forty-first meeting of the Polio IHR Emergency Committee. https://www.who.int/news/item/10-04-2025-statement-of-the-forty-first-meeting-of-the-polio-ihr-emergency-committee
  10. National Health Service (March 2023). Available travel vaccines. https://www.nhs.uk/vaccinations/travel-vaccinations/available-travel-vaccines/
  11. Ministry of Health, Kingdom of Saudi Arabia. (2025). Hajj vaccinations 1446. https://www.moh.gov.sa/en/HealthAwareness/Pilgrims_Health/Approved-Vaccines/Pages/default.aspx
  12. Ministry of Hajj and Umrah, Kingdom of Saudi Arabia. (2025). Nusuk Hajj – Your gateway to a journey of a lifetime. https://hajj.nusuk.sa/nusuk/health/guidelines
  13. Centers for Disease Control and Prevention (April 23, 2025). Saudi Arabia: Hajj and Umrah pilgrimages.https://www.cdc.gov/yellow-book/hcp/africa-middle-east/saudi-arabia-hajj-and-umrah-pilgrimages.html