The initial case was missing the following minimum criteria: no adverse effect. Upon receipt of follow-up information on 11Jun2018, this case now contains all required information to be considered valid. This is a spontaneous report from a contactable consumer (patient). A 53-year-old female patient received pneumococcal 13-valent conjugate vaccine (diphtheria crm197 protein) via an unspecified route of administration on 24May2012 at a single dose for immunization (reported by patient as "I was overdue on my booster." Medical history included asthma, hyperparathyroidism (patient stated she just got 3 of her parathyroid hormones taken out because she has had hyperparathyroidism, so those were removed on 10May, and that is why she did a check with her surgeon before she even thought of getting the shot), surgeries, allergic to citrates, and hives. The patient's concomitant medications were not reported. On 24May2012, the patient experienced inappropriate schedule of vaccine administered described as she was overdue on her booster, she was late on a day over and she had surgeries so she did not want to get it too soon and vaccination site reaction. The patient reported that she has had a reaction on 24May2012 when she had the first one and now she really did not want to have a severe one when she is older and have to deal with it. It was reported that the patient recently (at the time of the report) received pneumococcal polysaccharide 23-valent, the patient clarified she received PNEUMOVAX and not PREVNAR 13 and she wanted to make sure that there were no citrates in the serum because she was allergic to citrates. She got the shot on a Wednesday, in her left arm and the first day was great, she did not have any soreness related with this but on Thursday her whole arm where she was given the shot, had redness extended and covered her whole biceps and it was red, warm and super tender and actually very warm to touch and not really swollen necessarily. It was not bumpy or anything. What alarmed her was that she never had that problem in her whole entire upper arm so it was not normal to have that much of a reaction which lasted for about 4 days, the redness and the pain and everything. She did not want to have the reaction to get worse and get a booster when she is older, and did not want a worse reaction the next time. The patient even called the pharmacist and was told to take TYLENOL and put ice on it. She stated that she just went to the office, the nurse gave her the shot, and she thought everything would be great but she wanted to make sure because she did have asthma and was allergic to citrates. She used to donate platelets and once, experienced hives on the top of her shoulder blades to down to her mid legs. She was told that she could never platelets again, she was allergic to citrates. The symptoms of the reaction to pneumococcal Polysaccharide 23-Valent had resolved but it took 4 days to resolve. The patient underwent lab tests and procedures which included blood work and lab work which were fine. The patient stated she was told she was overdue on her booster so they kept reminding her. Her caretaker kept saying to get it done but she did not want to until she got an ok from the doctor that did the surgery who said that she could do it as soon as she get your blood work done. It was a follow up blood work on her surgery and said it was fine. The patient had reported her lab work to her doctor online and who said she will be fine. Outcome of the event vaccination site reaction was unknown. Pfizer is a marketing authorization holder of pneumococcal 13-valent conjugate vaccine (diphtheria crm197 protein) in the reporter's country. This may be a duplicate report if another marketing authorization holder of pneumococcal 13-valent conjugate vaccine (diphtheria crm197 protein) has submitted the same report to the regulatory authorities.