{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T03:18:14Z","timestamp":1790479094847,"version":"4.1.0"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T00:00:00Z","timestamp":1754524800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T00:00:00Z","timestamp":1754524800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Epidemiol Glob Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Hajj pilgrimage poses significant public health challenges due to the risk of infectious disease transmission. Despite mandatory vaccination policies, barriers such as hesitancy, logistical issues, and vaccine availability persist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study assesses vaccine uptake, reasons for compliance or non-compliance, and barriers among Hajj pilgrims.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional study was conducted during the 2024 Hajj season, with data collected via structured interviews from 5,355 participants. Descriptive statistics and logistic regression analyzed vaccination status and influencing factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the participants, 4298 (80.3%) reported receiving mandatory or recommended vaccines, including influenza, COVID-19, and meningococcal. Primary motivators for vaccination were compliance to mandatory requirements 2240 (52.1%) and healthcare provider recommendations 2018 (46.9%). Among non-vaccinated respondents, the main reasons included belief in vaccine ineffectiveness 250(23.7%), reliance on natural immunity 243(23%), and lack of awareness 174(16.5%). Common barriers included long wait times 721(13.5%) and limited access to vaccination centers 543(10.1%). Women and individuals with higher education demonstrated greater vaccine uptake, while logistical barriers were more prevalent among self-employed and less-educated participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite high vaccine uptake, barriers remain. Addressing hesitancy, improving access, and aligning vaccine availability with Hajj timing are essential to enhance coverage and reduce disease transmission risks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Number<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s44197-025-00447-1","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T09:39:05Z","timestamp":1754559545000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Immunization Coverage and Barriers among Hajj and Umrah Pilgrims: Insights into Vaccine Uptake and Compliance"],"prefix":"10.1007","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5857-7097","authenticated-orcid":false,"given":"Adeeb A.","family":"Bulkhi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2582-8317","authenticated-orcid":false,"given":"Hani M.","family":"Almoallim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0719-5632","authenticated-orcid":false,"given":"Majed S.","family":"Obaid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0098-0187","authenticated-orcid":false,"given":"Nahla H.","family":"Hariri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7904-7795","authenticated-orcid":false,"given":"Hamsah S.","family":"Alqashqri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismail A.","family":"Alghamdi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8376-7059","authenticated-orcid":false,"given":"Amar Mohammad A.","family":"Alkhotani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8610-5388","authenticated-orcid":false,"given":"Muhammad Irfanullah","family":"Siddiqui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9222-9149","authenticated-orcid":false,"given":"Heba M.","family":"Adly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1317-1186","authenticated-orcid":false,"given":"Mohammed A.","family":"Garout","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7387-3271","authenticated-orcid":false,"given":"Elbagir A.","family":"Elfaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9522-9198","authenticated-orcid":false,"given":"Saleh A. 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