Which of the following is a pneumococcal vaccine contraindication?

• A. Allergy to peanuts
• B. Active varicella infection
• C. Age over 65
• D. Any allergies to the pneumococcal vaccine or DTaP/Tdap vaccine

Answer: (D)

Vaccination safety hinges on true contraindications, which are severe allergic reactions to a vaccine or to a component shared by vaccines. The pneumococcal vaccine (especially the conjugate type) uses a carrier protein derived from diphtheria toxin, so a history of a severe allergy to diphtheria-containing vaccines (DTaP/Tdap) can make giving the pneumococcal vaccine dangerous. That’s why a history of any allergy to the pneumococcal vaccine or to DTaP/Tdap is a valid contraindication.

Allergy to peanuts isn’t related to the vaccine components, so it’s not a contraindication. An active varicella infection represents an acute illness that warrants postponing vaccination, not a true contraindication. Age over 65 isn’t a contraindication—it’s an indication for pneumococcal vaccination in many guidelines.