**4. Conclusions**

Health education programs are needed to improve adherence to the pertussis immunization programs. Scientific divulgation of the disease and its prevention strategies are fundamental. Vaccination, especially for pregnant women and young infants, must also be publicized, as well as the discussion for incorporation of the vaccine against pertussis into the vaccination programs for adolescents, adults, and the elderly.

Vaccination for pertussis has had a major impact in reducing the overall burden of the disease, with a general reduction in its incidence and, in particular, a reduction in infant mortality. Nevertheless, the cyclic and recurrent patterns of whooping cough are still observed in countries with high vaccine coverage. New vaccination schemes against pertussis have been developed to reduce the risk of serious illness in young infants and young children. It is necessary that all children worldwide, including HIV-positive individuals, be immunized against pertussis, and every country should seek to reach the entire population with anti-pertussis vaccination and also maintain high coverage (≥90%) at all levels (national and district).

Both the wP and aP vaccines are effective in reducing infant mortality, highlighting the importance of timely vaccination and the need to maintain high coverage, as current data point to a decrease in aP-related immunity. One future challenge may be the improvement of new vaccines considering all these factors, as well as the importance of the production of vaccines against parapertussis, which seems to be more frequent than originally imagined.

Determining the true incidence of pertussis in each country is vital in order for health authorities to devise the best vaccine strategies to control the disease and its consequences.
