Information has been received from a consumer concerning his 87 year old mother with temporal arteritis who on 13-MAY-2008 was vaccinated with pneumococcal 23v polysaccharide vaccine (Lot #, site and route not reported). Concomitant therapy included prednisone (unspecified) and methotrexate (unspecified). On 13-MAY-2008, "3 - 4 hours after vaccination," the patient experienced severe back pain. The patient sought medical attention by visiting the doctor. The doctor advised her to take ibuprofen, but the pain gets worse daily. The patient's severe back pain persisted. No additional information was provided. Additional information has been requested. This is in follow-up to report (s) previously submitted on 7/30/2008.  Information has been received from a consumer concerning his 87 year old mother with temporal arteritis and polymyalgia rheumatica (PMR) who on 13-MAY-2008 was vaccinated into the left deltoid with 0.3 mL of PNEUMOVAX (Lot # 659150/1384U).  Concomitant therapy included PREDNISONE (unspecified) and methotrevate (unspecified).  On 13-MAY-2008, 3 - 4 hours after vaccination", the patient experienced severe back pain.  The patient sought medical attention by visiting the doctor.  "The doctor advised her to take ibuprofen, but the pain gets worse daily.  The patient's severe back pain persisted.  Follow up information was received from the physician and his office worker who reported that on 15-MAY-2008 the patient called the office with complaint of extreme pain in back since getting the PNEUMOVAX vaccine.  The patient was told to come to the office or she could call 911 and go to the emergency room.  On 16-MAY-2008 at 9:05, the patient's son called the office to report that his mother's pain was not any better and needed to be seen by the physician or to go to the emergency room.  He said his mother was unable to get out of bed today.  The physician spoke with the patient's son.  At 10:53 the office worker called the patient and left message for the patient to call back and let the office know how the patient was doing and if they were coming in the office or going to the emergency room, as the physician was only in for half day.  On 16-MAY-2008 the patient was seen by the physician.  The physician reported that she came in for low back pain which she said occurred after she got her PNEUMOVAX vaccine.  She had been taking ibuprofen 200 mg every 4 hours which had relieved the pain.  She had known temporal arteritis and polymyalgia rheumatica (PMR) for which she was on PREDNISONE (unspecified) and methotrexate (unspecified).  Physical exam revealed a weight of 118.  B/P 170/80, P 70, R 12 and T 97.0 degrees.  She was well appearing in no acute distress.  Her lumbar spine non-tender (NT) to percussion.  The area of her pain was bilaterally in the paralumbar musculature.  Neurologically, there was no pain elicited with straight leg raise or hip rotation.  The patient ws able to ambulate with assistance as per her usual.  The physician's assessment was low back pain.  The physician explained to the patient that he thought it was unlikely related to the PNEUMOVAX vaccine.  She had no pain at the injection site.  He suspected this to be low back pain possibly related to her polymyalgia rheumatica PMR vs. unrelated.  Her sed rate was 10.  The physician's plan and recommendation was that the patient should continue on the ibuprofen 200 mg Q 4 hours, to be taken wit ha small amount of food.  He noted that she was on a proton pump inhibitor (PPI) (unspecified) to protect her stomach and she should call if she worsened.  Additional information is not expected.