Age: 65.0
Sex: F
Vaccine: PNC20, PNC20
Symptoms: Lymphadenopathy, Peripheral swelling, Pyrexia, Sleep disorder, Somnolence
Clinical narrative: had easily a baseball size where her axillary nodes and tissue underneath were so swollen; fever; sleepless night; feeling so much pain/getting a lot of pain in left axillary; swelling/arm swollen; exhausted; slept most of the day; stomach pain; This is a spontaneous report received from contactable reporter(s) (Consumer or other non HCP) from medical information team. The reporter is the patient.  A 65-year-old female patient received pneumococcal 20-val conj vac (dipht crm197 protein) (PREVNAR 20), on 14Sep2023 as dose number unknown, single (Batch/Lot number: unknown) at the age of 65 years intramuscular, in left arm for immunisation. The patient's relevant medical history included: "mastectomy", start date: 2003 (unspecified if ongoing), notes: she had a mastectomy on the left side; "breast cancer", start date: 2020 (unspecified if ongoing), notes: she had breast cancer again on the right side; "smoldering multiple myeloma", start date: Sep2021 (unspecified if ongoing); "generalized anxiety" (unspecified if ongoing); "axillary nodes removed /with surgery on axillary lymph nodes" (unspecified if ongoing); "acid reflux" (unspecified if ongoing). Concomitant medication(s) included: LETROZOLE taken for breast cancer, start date: 2020; ESCITALOPRAM taken for generalised anxiety disorder. Past drug history included: Famotidine. Vaccination history included: Covid-19 vaccine, administration date: 2020, for COVID-19 Immunization. The following information was reported: FATIGUE (non-serious) with onset 15Sep2023, outcome "recovering", described as "exhausted"; AXILLARY PAIN (non-serious) with onset 15Sep2023, outcome "recovering", described as "feeling so much pain/getting a lot of pain in left axillary"; SOMNOLENCE (non-serious) with onset 15Sep2023, outcome "unknown", described as "slept most of the day"; ABDOMINAL PAIN UPPER (non-serious) with onset 15Sep2023, outcome "unknown", described as "stomach pain"; PERIPHERAL SWELLING (non-serious) with onset 15Sep2023, outcome "recovering", described as "swelling/arm swollen"; PYREXIA (non-serious) with onset 16Sep2023, outcome "unknown", described as "fever"; INSOMNIA (non-serious) with onset 16Sep2023, outcome "unknown", described as "sleepless night"; LYMPHADENOPATHY (medically significant), outcome "unknown", described as "had easily a baseball size where her axillary nodes and tissue underneath were so swollen". The patient underwent the following laboratory tests and procedures: Body temperature increased: 102, notes: unknown unit. Clinical course:  Some time in afternoon, around 2 or 3PM, started getting a lot of pain in left axillary, really bad. It was increasing, when it started out, thought she pulled something. Was slightly to right side but left side was getting worse. By that night, it was swollen, would say, it got to medium until next day. The patient was exhausted, did have to stay in bed most of the day. Swelling continued, was literally, probably size of softball where her axillary nodes and tissue underneath were so swollen. Whole arm was swollen. Saturday, spiked fever of 102. Last night, also had sleepless night. Used used heating pad last night. Does not think it did any good. Had to sleep with pillow under that part of her arm. Was really painful. Still has pain now, not to where it was. Patient also has history acid reflux, did take famotidine twice. Did not take Tylenol or Advil. Did not take anti inflammatory, they irritate her stomach, did not want to make it worse.   The information on the batch/lot number for pneumococcal 20-val conj vac (dipht crm197 protein), pneumococcal 20-val conj vac (dipht crm197 protein)  has been requested and will be submitted if and when received.