Pertussis before, during and after Covid-19.

After the Covid-19 pandemic, pertussis has made a spectacular comeback in Europe and many other parts of the world, while during the pandemic it had essentially disappeared because of the social distancing requirements. However, even before the Covid-19 pandemic, the disease was on the rise in many countries, especially those that have replaced whole-cell pertussis vaccines by acellular pertussis vaccines. Several reasons may account for this upsurge, including strain adaptation to escape vaccine-induced immunity, rapid waning of immunity after vaccination and the failure of current vaccines to prevent infection by and transmission of the causative agent Bordetella pertussis. Various strategies have been deployed to control the disease, the most effective of which is maternal vaccination during pregnancy to protect the newborn against the most severe and deadly forms of the disease. However, ultimate control of pertussis likely requires novel vaccines, which prevent infection and transmission, not only disease. One of them is the live attenuated BPZE1 vaccine, which has shown promise in pre-clinical and clinical studies and may therefore perhaps become a gamechanger.