joint pain/both my shoulders are hurting; knuckles swelling; elevated white blood cells; muscle pain; stiffness; pain at the injection site; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP) from medical information team. The reporter is the patient.  A 65-year-old male patient received pneumococcal 20-val conj vac (dipht CRM197 protein) (PREVNAR 20), in Mar2023 as dose number unknown, single (Batch/Lot number: unknown) for immunisation. The patient's relevant medical history and concomitant medications were not reported. The following information was reported: ARTHRALGIA (non-serious), outcome "not recovered", described as "joint pain/both my shoulders are hurting"; JOINT SWELLING (non-serious), outcome "not recovered", described as "knuckles swelling"; WHITE BLOOD CELL COUNT INCREASED (non-serious), outcome "unknown", described as "elevated white blood cells"; MYALGIA (non-serious), outcome "not recovered", described as "muscle pain"; MUSCULOSKELETAL STIFFNESS (non-serious), outcome "not recovered", described as "stiffness"; VACCINATION SITE PAIN (non-serious), outcome "not recovered", described as "pain at the injection site". Relevant laboratory tests and procedures are available in the appropriate section. Therapeutic measures were taken as a result of arthralgia, vaccination site pain.  Additional information: "I have a lot of pain in my joints, and muscle pain, and stiffness, and then I'm getting- I just seemed to be getting, with my muscles, I'm getting so I can't even take the top off of like an orange juice bottle. I'm just not- it's not getting any better. My knuckles in my hands feel like they're swelling up. And I had some blood work done recently too and the physician's assistant said my white blood cells were elevated significantly and so they're going after something. This all started after I got the vaccine-- after I got vaccinated so just to let you know. let me just back track a second, cause this-after I got the vaccination, this stuff started happening shortly after I got the vaccination. It just didn't start happening now. It started back then. And now it's just been progressively getting worst or the same and it has not changed. My doctor wants me to go see a rheumatologist. And I don't know a rheumatologist is somebody who looks for, you know, arthritis. I don't have or I didn't have arthritis before and it doesn't run my family. It's just that my knuckles are swelling up. From the beginning I've had pain at the injection site, but it just seemed to progress from there and then it went in now both my shoulders are hurting. And I can't lift my arms above my head. I mean, it's really to wash my hair in the shower is a real challenge. And it's, that is not getting any better. I've been trying to put hot and cold compresses on there and it's started with the left shoulders where I had the injection. And it just kinda spread from there. But this-- like I say, this is over a 5-month period, it's gonna be 6 months next month. My doctor can't seem to come up with much other than send me to a rheumatologist. "   The information on the batch/lot number for pneumococcal 20-val conj vac (dipht CRM197 protein) has been requested and will be submitted if and when received.