Cairo - Saudi Arabia, home to the sacred cities of Mecca and Medina, has recommended that all Muslim pilgrims get vaccinated for A(H1N1) before going on the hajj, as the pilgrimage is called - but Egypt took it one step further, ordering the travelers to receive ajab to ensure no one returned carrying the virus.
However, things are not always that simple.
"Basically, we were told we could take a (health) certificate - without getting a vaccination," said one Egyptian man, requesting anonymity, as he was about to leave for hajj.
It appears a number of health officials ready to comply with people'sconcerns over the safety of the vaccine, by handing out certificates without the necessary vaccine - even though international medical authorities insist that all data proves they are sound.
However, some Egyptians see an upside to this scenario.
Shaden Diab, an accountant in her 40s, was desperately looking for the vaccine. She hopes the rumours that people are getting the health certificate without a vaccine are true because if so, she believes the unused doses will make it to the black market.
"I want to get my family and myself vaccinated at any price," she said.
Among those who refused the shot, there is a feeling the vaccine was marketed too quickly and that it is untested. With the virulence of the disease appearing to be mild, some felt it was not worth what they perceived as a risk.
Samia Fadel, a 39-year-old dentist who was embarking on the pilgrimage, said she only agreed to take the vaccine once she was assured of its safety.
"My fears were only calmed when a fellow doctor who is living in Austria assured me that it is safe and that he took the shots along with his five-member family," Fadel said.
Not everyone though has friends abroad who offer such assurances.
The Egyptian minister of health was forced to take his vaccination on national television, along with a religious figure, the grand sheikh of Al-Azhar mosque Mohamed Sayed Tantawy, in order to ally concerns.
Egypt, a country of about 80 million people, ordered 5 million doses of swine flu vaccine. The first 80,000 jabs arrived on November 2, followed shortly by another 70,000.
The first shipments had two main target audiences: hajj pilgrims and frontline health workers, including medical staff at hospitals.
So an accountant like Diab might have a long wait for a vaccine from official channels.
"I do not mind buying them from the black market. As an accountant I expect to get the vaccine officially a year from now - if ever," she complained.
Swine flu, though, remains a hot topic of conversation for those going on the pilgrimage. Newspapers across the Arab world carry daily updates on the virus and the latest on swine flu in Mecca.
Reports of deaths, infection or even of a clean bill of health spread like wildfire.
"People are starting to say, let's see what hygiene measures we can take to help prevent us from contracting the virus," said Ahmed, an excited middle-class Egyptian father doing his last minute errands before leaving on hajj.
The pilgrims were buying surgical masks and hand sanitizers and were changing habits to fit the guidelines and recommendations of health professionals.
Despite hajj being a key tenant of Islam, many people in vulnerable groups have taken the advice of health authorities and stayed away from the crowded event.
Others have simply decided not to go on their own accord, scared of being in a large crowd when a pandemic virus is spreading.
Saudi Arabia has already reported a significant drop in religious tourism this year. Even so, some 3 million people were still expected to be in attendance, mostly foreigners.
With all these measures, it is ironic but perhaps not surprising that the Saudi ministry of health was reporting a healthier hajj season this year.
There were 55 per cent per cent fewer outpatient cases at hospitals, compared to last year, 20 per cent fewer ambulance calls, and 16 per cent fewer inpatient hospital admissions.
