Pertussis is a particular concern in infants under 6 months of age. They have the highest rates and severity of disease resulting in hospitalisation or death but are too young to be protected by current vaccination schedules. We outline the current epidemiology of pertussis in Australia and four potential strategies to prevent pertussis in the very young. First, universal adult and or adolescent vaccination; second, indirect protection of infants by immunisation of parents and possibly others in close contact with the newborn, such as grandparents and health-care workers; third, newborn and early infant vaccination (from birth to 1 month of age) and fourth maternal vaccination.