has reactions to shots, but usually it was just the injection site; did have some mild issues; muscle cramps on the left part of her leg; didn't sleep/couldn't sleep/kept waking up, so let's just say if I slept it was for a short amount of time; little dull pain that I got shortly after the shot; it has just gotten a lot worse; exhaustion; finding it difficult, basically it was tough to walk on that leg/difficult for her to walk; has pain behind her knee/got it down on her buttocks and went down to her knee/bends her knee it hurts; joint pain; has pain behind her knee/got it down on her buttocks and went down to her knee; almost like a nerve pain/got it down on her buttocks and went down to her knee; This is a spontaneous report received from a contactable reporter (Consumer or other non HCP) from medical information team. The reporter is the patient.  A 65-year-old female patient received pneumococcal 20-val conj vac (dipht crm197 protein) (PREVNAR 20), on 22Aug2023 as dose number unknown, single (batch/lot number: unknown) for immunization. The patient's relevant medical history and concomitant medications were not reported. The following information was reported: NEURALGIA (non-serious) with onset Aug2023, outcome "unknown", described as "almost like a nerve pain/got it down on her buttocks and went down to her knee"; GAIT DISTURBANCE (non-serious) with onset Aug2023, outcome "unknown", described as "finding it difficult, basically it was tough to walk on that leg/difficult for her to walk"; MUSCULOSKELETAL PAIN (non-serious) with onset Aug2023, outcome "unknown", described as "has pain behind her knee/got it down on her buttocks and went down to her knee"; ARTHRALGIA (non-serious) with onset Aug2023, outcome "unknown", described as "has pain behind her knee/got it down on her buttocks and went down to her knee/bends her knee it hurts; joint pain"; VACCINATION SITE REACTION (non-serious), outcome "unknown", described as "has reactions to shots, but usually it was just the injection site; did have some mild issues"; MUSCLE SPASMS (non-serious), outcome "unknown", described as "muscle cramps on the left part of her leg"; SLEEP DISORDER (non-serious), outcome "unknown", described as "didn't sleep/couldn't sleep/kept waking up, so let's just say if I slept it was for a short amount of time"; VACCINATION SITE PAIN (non-serious), outcome "not recovered", described as "little dull pain that I got shortly after the shot; it has just gotten a lot worse"; FATIGUE (non-serious), outcome "not recovered", described as "exhaustion".  Additional information: The patient informed that everything was fine, sometimes she has reactions to shots, but usually it was just the injection site. The patient did have some mild issues with a little bit of not cramping, but like muscle cramps on the left part of her leg, a typical side effect not a big deal. The past few weeks, and this was 22Aug2023 and everything had been fine, but she has been still feeling it and in the past 3 days what happened was that she was finding it difficult, basically it was tough to walk on that leg, it was like she has pain behind her knee, and she was getting like this, it was almost like a nerve pain. The patient got it down on her buttocks and went down to her knee. The patient was not so glad today (unspecified) because she didn't sleep. The patient wanted to know if this was related to this Prevnar 20. The patient stated "It feels very much like the little dull pain that I got shortly after the shot; it has just gotten a lot worse. I couldn't sleep last night; you know how you fall asleep from exhaustion? I fell asleep on my side, and I could not sleep on my side because it hurt on either side and then I think like at 4 o'clock in the morning or something, I just fell asleep on my back, but I can't sleep on my back so I kept waking up, so let's just say if I slept it was for a short amount of time. Eventually from pure exhaustion I finally did, but it was the only way I wasn't having pain on my leg." The patient informed that the injection site was actually the site that was affected. Her injection was on her left side because she was right-handed and usually taking injections in the left side. The patient informed that when she bends her knee it hurts. So, it was joint pain as well. That was why it was difficult for her to walk right now because her knee hurts.  It was the front, but it was mostly the back and the side of the knee that hurts. The patient did not have a doctor.  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.