could not raise her arm "to reach the steering wheel; chest congestion; significant mucous production/ /mucous production is very bad; Patient informed nurse that the redness expanded from her elbow to her shoulder and up to her chest and clavicle area and was swollen and hard; Patient informed nurse that the redness expanded from her elbow to her shoulder and up to her chest and clavicle area and was swollen and hard; injection site reaction of swelling; injection site reaction of swelling, warmth, redness; injection site reaction of swelling, warmth, redness; with a headache and nausea.; with a headache and nausea.; experienced chills; This spontaneous report was received from a registered nurse referring to a 66 years old female patient. The patient's concomitant therapies included escitalopram oxalate (LEXAPRO), lisinopril (manufacturer unknown), simvastatin (manufacturer unknown), potassium, hydrochlorothiazide, alprazolam (XANAX), fluticasone propionate (FLONASE) and vitamin B complex. The patient's concurrent condition included seasonal allergic rhinitis. The patient's historical conditions included paroxysmal supraventricular tachycardia and benign paroxysmal positional vertigo. The patient was allergic to sulfites.  On 02-MAR-2020 the patient was vaccinated with pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) syringes (0.5 ml, once, lot # S024808, expiration date 02-JUN-2021) via intramuscular route for prophylaxis (prevention of pneumonia).  On 02-MAR-2020 the patient experienced an injection site reaction of swelling, warmth, redness and could not raise her arm to reach the steering wheel after receiving the injection (Joint range of motion decreased) . The redness expanded from her elbow to her shoulder and up to her chest and clavicle area and was swollen and hard (redness and peripheral swelling). Approximately 9 hours after receiving the pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) she experienced chest congestion and significant mucous production. The patient took diphenhydramine hydrochloride (BENADRYL), which helped with the mucous production, but she later awoke with a headache and nausea. Then she took two acetaminophen (TYLENOL EXTRA STRENGTH), that was effective. The patient had experienced chills and was continuing the acetaminophen (TYLENOL EXTRA STRENGTH) for relief. However, the mucous production was very bad. None lab diagnostics/studies were performed. The patient had sought medical attention, she called physician office. Outcome of the events was not recovered. The causality assessment between pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) and the events was not reported. combinationproductreport: Yes; brandname: PNEUMOVAX23 SYRINGE (DEVICE); commondevicename: Pneumococcal Vaccine, Polyvalent (23-valent); productcode: FMF; devicetype: SYRINGE, PISTON (FMF); manufacturername: Merck Sharp & Dohme Corp. devicelotnumber: S024808; expirationdate: 02-JUN-2021; deviceage and unit: 0 ; malfunction: Unknown; deviceusage: Unknown; evaluatedbymfr: No; reasonfornoneval: 81 Other; reasonfornonevalother: No information about availability; labeledsingleusedevice: No; mdcpreportability: No; mdcpreprationale: Case information does not suggest a causal association with the device or device constituent