arm has a swollen red hard lump, the size of an orange; arm has a swollen red hard lump, the size of an orange/it is very red and itchy; arm has a swollen red hard lump, the size of an orange; arm has a swollen red hard lump, the size of an orange/it is very red and itchy; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP). The reporter is the patient.  A 66-year-old female patient received pneumococcal 20-val conj vac (dipht crm197 protein) (PREVNAR 20), on 21Oct2023 at 12:00 as dose number unknown, single (Batch/Lot number: unknown) at the age of 66 years, in left arm for immunisation; for immunisation; influenza vaccine (FLU VACCINE VII), on 14Oct2023 as dose number unknown, single (Batch/Lot number: unknown) for immunisation. The patient's relevant medical history included: "Diabetes" (unspecified if ongoing); "Blood pressure high" (unspecified if ongoing); "High cholesterol" (unspecified if ongoing); "Hypothyroidism" (unspecified if ongoing); "GERD" (unspecified if ongoing); "Anxiety" (unspecified if ongoing); "Asthma" (unspecified if ongoing). Concomitant medication(s) included: SYNTHROID taken for hypothyroidism; COZAAR taken for hypertension; INSULIN GLARGINE taken for diabetes mellitus; OZEMPIC taken for diabetes mellitus; METFORMIN taken for diabetes mellitus; PROTONIX [OMEPRAZOLE] taken for gastrooesophageal reflux disease; BUSPAR taken for anxiety; CRESTOR taken for blood cholesterol increased; SINGULAIR taken for asthma; TOPROL XL taken for hypertension; ZETIA taken for blood cholesterol increased; MAXZIDE taken for hypertension. Past drug history included: Pfizer covid-19 vaccine, start date: 07Oct2023, stop date: 07Oct2023, reaction(s): "pain in arms like two days, may be three days", notes: Anatomical Location: left arm, in the same muscle, Number of Previous Doses: Fifth shot. The following information was reported: VACCINATION SITE SWELLING (non-serious), VACCINATION SITE MASS (non-serious) all with onset 23Oct2023, outcome "unknown" and all described as "arm has a swollen red hard lump, the size of an orange"; VACCINATION SITE ERYTHEMA (non-serious), VACCINATION SITE PRURITUS (non-serious) all with onset 23Oct2023, outcome "unknown" and all described as "arm has a swollen red hard lump, the size of an orange/it is very red and itchy". Therapeutic measures were taken as a result of vaccination site swelling, vaccination site erythema, vaccination site mass, vaccination site pruritus.  Additional information: Patient stated that she had a Prevnar 20 vaccine on Saturday and today her arm has a swollen red hard lump, the size of an orange and she got the shot 2 days ago. Patient just took Benadryl because she does not know if its allergic reaction, she does not know what. Ask if this is normal and has this been known to happen two days after the shot. Patient stated that it is hard like lump and it is very red and itchy. They did not give the patient a vaccination card. Patient stated that they did put a sticker on the bag, and she threw them in the garbage, she did not think she would need it. Patient do not know dose of the vaccine. They said she should take it. Patient got the COVID shot two weeks ago. Last week she got the flu shot and this week she got the Prevnar 20. Diagnosis dates of the other medical conditions (unspecified): 20 years ago. There was no lab work done. Patient was asked if the event required a visit to emergency room or physician office and stated that "Not yet may be tomorrow. I have not done it yet."  The information on the batch/lot number for pneumococcal 20-val conj vac (dipht crm197 protein), pneumococcal 20-val conj vac (dipht crm197 protein)  has been requested and will be submitted if and when received.