About 2.5 million Muslims are converging on Mecca this week to take part in the annual Hajj. This year many pilgrims are adding extra step to their preparations for the ritual - getting the H1N1 vaccine.
Soad, a well-educated women in her 50s from Cairo, has made the Hajj several times before.
As usual getting ready for the trip, one of the five pillars of Islam, involved arranging visas, finding a travel agency and packing special clothes. But this year there was an added task, a trip to the doctor to get vaccinated against the so-called Swine Flu.
The idea of millions of people from all over the world standing shoulder to shoulder, sharing germs as well as spirituality, has health officials alarmed.
Precautions, vaccinations advised
Saudi authorities say that because it is a religious event, they are not banning anyone from taking part. But they have urged other countries to follow precautions, such as age restrictions and vaccinations, to slow the spread of the disease.
Soad, who prefers not to give her last name, is not particularly concerned.
"H1N1 is a flu like any other," she said. "Perhaps there has been a greater outcry because it spreads fast but it is not so extremely dangerous as to prevent us from doing the ordained proceeding or even repeating an event of such great merit."
No confidence in vaccine
Saudi Arabia reported four H1N1 deaths in the days leading up to the Hajj. It has boosted its already massive logistical planning this year, deploying 20,000 health workers and thermal-scanning arrivals for any sign of fever.
Having made the journey before, Soad says she has full confidence in the Saudi's ability to protect their visitors.
Her son, who is accompanying his mother in Mecca, agrees. But he has no confidence in the vaccine."
"I feel uncomfortable with it and I do not think it should be imposed. It should be suggested," he said. "Who wants to take it, it is his own free choice."
The 26-year-old banker says he got vaccinated against the regular flu. But he admits he skipped the H1N1 vaccine, which Egypt has mandated for all pilgrims.
He does not explain how he got the required certificate, but the nature of Egyptian bureaucracy has made many here experts in creative alternatives.
Soad's son says he does not think the vaccine has been tested enough and he worries about possible side effects.
Lack of testing
Reports that several people in Sweden died after getting vaccinated have fueled those concerns. The Polish government has held off buying the vaccine, citing a lack of testing.
But doctors point out that all the Swedish victims had other, underlying health problems. And the World Health Organization has repeatedly said the vaccine is safe.
Dr. el-Saeed Aly Aown, an advisor to the WHO and a former Egyptian government health official, says there has been sufficient testing. He says that for most people, especially those going on Hajj, the vaccine is a reasonable measure to take.
Dr. Aown says that "if the vaccine is given properly and is a valid vaccine, Hajj is safe and mixing with people is safe."
For Soad, a Hajj veteran, there are other factors to consider.
"God Almighty told us in the Koran that we will only get whatever God fated for us," she said. "And we rely on God. We take precautions, and rely on God."
Hajj Pilgrims Add H1N1 Vaccine to Ritual