Vaccine antigen-based genotyping of <i>Bordetella pertussis</i> by direct Sanger sequencing of clinical samples in Peru from 2018 to 2019

Despite widespread vaccination, pertussis (caused by <i>Bordetella pertussis</i>) still causes severe outbreaks in infants worldwide. Genetic changes in the vaccine antigens of <i>B. pertussis</i> strains may drive this resurgence. Current culture-based typing methods limit our understanding of these genotypes, particularly in developing countries. This study provides valuable insights into the genotypic variability of <i>B. pertussis</i> in Peru from 2018 to 2019, employing an isolation-free genotyping method allowing the direct Sanger sequencing of vaccine antigen genes from clinical samples. These findings can enhance public health decision-making by improving our understanding of the genetic changes that drive severe pertussis outbreaks, particularly in developing countries that use whole-cell vaccines. This knowledge enables rapid outbreak responses, improved vaccine strategies, and strengthened surveillance, prevention, and control measures.