Hospital Course:Patient admitted to the hospital with complaints of bilateral lower extremity weakness. An MRI of the lumbar spine was completed and showed severe stenosis of L4-L5 with moderate sten; severe stenosis of L4-L5 with moderate stenosis of L3-L4 with severe DJD.; MRI of the cervical spine, which showed multilevel degenerative spondylosis superimposed upon developmental narrowing of the canal -C4-C6 with moderate central canal stenosis.; patient appeared more fatigued with rapidly progressive weakness; patient appeared more fatigued with rapidly progressive weakness; This is a spontaneous report received from a contactable reporter(s) (Other HCP).  A 64-year-old female patient received pneumococcal 20-val conj vac (dipht CRM197 protein) (PREVNAR 20), on 02Jun2023 at 12:15 as dose 1, single (Lot number: GR3620) at the age of 64 years, in left deltoid for immunisation. The patient's relevant medical history was not reported. Concomitant medication(s) included: CLARITINE; KLONOPIN; AMBIEN; MOBIC; HCTZ; OMEPRAZOLE. The following information was reported: MUSCULOSKELETAL DISORDER (hospitalization) with onset 18Jun2023, outcome "recovering", described as "Hospital Course:Patient admitted to the hospital with complaints of bilateral lower extremity weakness. An MRI of the lumbar spine was completed and showed severe stenosis of L4-L5 with moderate sten"; SPINAL OSTEOARTHRITIS (hospitalization) with onset 18Jun2023, outcome "recovering", described as "MRI of the cervical spine, which showed multilevel degenerative spondylosis superimposed upon developmental narrowing of the canal -C4-C6 with moderate central canal stenosis."; FATIGUE (hospitalization), ASTHENIA (hospitalization) all with onset 18Jun2023, outcome "recovering" and all described as "patient appeared more fatigued with rapidly progressive weakness"; STENOSIS (hospitalization) with onset 18Jun2023, outcome "recovering", described as "severe stenosis of L4-L5 with moderate stenosis of L3-L4 with severe DJD.". The patient was hospitalized for musculoskeletal disorder, stenosis, spinal osteoarthritis, fatigue, asthenia (hospitalization duration: 11 day(s)). The patient underwent the following laboratory tests and procedures: Protein total: 113.3, notes: Lumbar Puncture Showed An Elevated Protein At 113.3. Therapeutic measures were taken as a result of musculoskeletal disorder, stenosis, spinal osteoarthritis, fatigue, asthenia.  Clinical course: Patient admitted to the hospital with complaints of bilateral lower extremity weakness. An MRI of the lumbar spine was completed and showed severe stenosis of L4-L5 with moderate stenosis of L3-L4 with severe did. Patient was evaluated by the spine surgery team and was recommended to complete an MRI of the cervical spine, which showed multilevel degenerative spondylosis superimposed upon developmental narrowing of the canal -C4-C6 with moderate central canal stenosis. Spine surgery reviewed imaging and did not recommend any surgical intervention. Based on clinical presentation and history, neurology recommended to complete a lumbar puncture. Lumbar puncture showed an elevated protein at 113.3. Patient was started on IVIG x5 days, ending on 24Jun2023. Patient's respiratory parameters were being monitored closely. On Jun2021 patient appeared more fatigued with rapidly progressive weakness. Patient was transferred to the ICU for closer respiratory monitoring.; Sender's Comments: All events are considered as unrelated to PREVNAR 20 use but represent intercurrent medical conditions/spinal disorder.   The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate