The caller reported a "fairly severe reaction" after receiving PNEUMOVAX 23, "the flu vaccine" (brand unknown), and "the shingles vaccine" (brand unknown) at the same time "in late October or early November," (2020).; The arm all the way around swelled and was warm. The "full blown" reaction of swelling extended "from shoulder to elbow, but did not cross the elbow joint.; The arm all the way around swelled and was warm.; This spontaneous report has been received from a 74 year old female patient with severe chronic asthma, and 4th stage kidney failure caused by nocturnal hypertension. Additionally, it was reported that the patient had slight, but increasingly severe reactions to "the pneumonia shot throughout the adult years". Concomitant therapies included unspecified high blood pressure medication, a water pill, a beta blocker, losartan, venlafaxine hydrochloride(EFFEXOR) and bupropion hydrochloride(WELLBUTRIN)and asthma inhalers (unspecified brands unknown).  In 2020 (reported as "in late October or early November," (2020 )), the patient was vaccinated with pneumococcal vaccine, polyvalent (23-valent)(PNEUMOVAX23) 0.5-mL injection (strength, route, dose, frequency, anatomical location, indication, lot # and expiration date were unknown) for pneumonia prevention,and with influenza virus vaccine (unspecified)(INFLUENZA VIRUS VACCINE (UNSPECIFIED)) and zoster vaccine live(manufacturer unknown) at the same time for unknown indication.   On the same date after vaccination, the patient had a fairly severe reaction. The patient reported receiving the influenza virus vaccine (unspecified)(INFLUENZA VIRUS VACCINE (UNSPECIFIED)) and pneumococcal vaccine, polyvalent (23-valent)(PNEUMOVAX23) in one arm and the zoster vaccine live(manufacturer unknown) in the other arm. Later, the caller reported receiving the zoster vaccine live(manufacturer unknown) shot and pneumococcal vaccine, polyvalent (23-valent)(PNEUMOVAX23)in one arm and the influenza virus vaccine (unspecified)(INFLUENZA VIRUS VACCINE (UNSPECIFIED)) shot in the other arm.  The patient stated suffering no wheezing, did not need her inhaler, and had no heart palpitations. Additionally, the caller reported the arm all the way around swelled and was warm, and that she believed this was a local rather than systemic reaction because the "full blown" reaction of swelling extended "from shoulder to the elbow, but did not cross the elbow joint.", it was full blown, red hot, swollen - completely circled her entire arm. Subsequently, the patient reported the swelling began immediately when she got the shot, grew for three or four hours, and continued until next day when they put her on a steroid and antibiotic," (brands unknown).   At the time of the report, the patient reported being fully recovered within a week. The patient reported receiving a second zoster vaccine live(manufacturer unknown) four weeks after the pneumococcal vaccine, polyvalent (23-valent)(PNEUMOVAX23) vaccine with no reaction, not even soreness. The reporter did not mention the causality assessment between the events and  pneumococcal vaccine, polyvalent (23-valent)(PNEUMOVAX23), influenza virus vaccine (unspecified)(INFLUENZA VIRUS VACCINE (UNSPECIFIED)) and zoster vaccine live(manufacturer unknown) vaccination.