severe nausea; swelling in arm from shoulder to elbow in arm that injection was given in, very swollen, red, hot.; swelling in arm from shoulder to elbow in arm that injection was given in, very swollen, red, hot.; severe dizziness; Vomiting; increased brain fog; Low grade fever; This is a spontaneous report received from contactable reporter(s) (Consumer or other non HCP). The reporter is the patient.  A 47-year-old female patient received pneumococcal 20-val conj vac (dipht CRM197 protein) (PREVNAR 20), on 15May2022 as dose 1, single (Batch/Lot number: unknown) at the age of 47 years, in left arm for immunisation. The patient's relevant medical history included: "long Covid diagnosis", start date: 26Jan2021, stop date: Mar2021, notes: Got Covid on 26Jan2021 and believes by end of Mar2021 doctor gave caller the long Covid diagnosis.; "brain fog" (unspecified if ongoing), notes: Caller has brain fog, is a long Covid patient, confirmed occurred prior to Prevnar 20. There were no concomitant medications. The following information was reported: PYREXIA (non-serious) with onset 15May2022, outcome "recovered" (18May2022), described as "Low grade fever"; VOMITING (non-serious) with onset 16May2022, outcome "recovered" (May2022); CONDITION AGGRAVATED (non-serious) with onset 16May2022, outcome "unknown", described as "increased brain fog"; DIZZINESS (non-serious) with onset 16May2022, outcome "recovered" (25May2022), described as "severe dizziness"; VACCINATION SITE SWELLING (non-serious), VACCINATION SITE ERYTHEMA (non-serious) all with onset 16May2022, outcome "recovered" (May2022) and all described as "swelling in arm from shoulder to elbow in arm that injection was given in, very swollen, red, hot."; NAUSEA (non-serious), outcome "recovered" (25May2022), described as "severe nausea". Relevant laboratory tests and procedures are available in the appropriate section. Therapeutic measures were taken as a result of vaccination site swelling, vaccination site erythema, vomiting.   Additional Information: It was reported that patient thinks she had a adverse reaction, doctor even thinks patient had a adverse reaction, not sure if doctor reported patients adverse reaction so patient called to report. Swelling in arm: Had a lot of swelling in arm from shoulder to elbow in arm that injection was given in, very swollen, red, hot. when patient got the injection arm was just slightly swollen and patient iced arm before bed, resolved by the end of that week after taking steroids. Swelling was the least of worries. Had severe dizziness. Resolved by the following week, would say 25May2022 sever dizziness had improved. The patient had vomiting, was put on Zofran. By 18May2022 vomiting was better but still had severe nausea until the following week, probably had severe nausea until 25May2022 as well. patient has brain fog, is a long Covid patient, confirmed occurred prior to Prevnar 20. But patient had increased brain fog after Prevnar 20. Increased brain fog is not currently ongoing, just has the regular brain fog that patient had prior to Prevnar 20. Took about a month for the brain fog to get back to the base level that patient had before Prevnar 20. patient was scary, thought had Covid again, first time ever having a reaction to a vaccine, thinks immune system is weaker since having Covid.   Follow-up attempts are completed. No further information is expected.