decline in her health from heaving pneumococcal pneumonia.; mild bronchiectasis; No blood flow to right lung; fevers; she is having so much discomfort; Diaphragm not working correctly; been able to resume some of her activity but has not been able to be as active as she was; more difficulty breathing; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP).  A 70-year-old female patient received pneumococcal 20-val conj vac (dipht CRM197 protein) (PREVNAR 20), in 2021 as dose number unknown, single (Batch/Lot number: unknown) for pneumonia pneumococcal. The patient's relevant medical history and concomitant medications were not reported. The following information was reported: DYSPNOEA (non-serious) with onset Nov2021, outcome "unknown", described as "more difficulty breathing"; DRUG INEFFECTIVE (hospitalization), outcome "unknown", described as "decline in her health from heaving pneumococcal pneumonia."; BRONCHIECTASIS (medically significant), outcome "unknown", described as "mild bronchiectasis"; PULMONARY ARTERY ATRESIA (medically significant), outcome "unknown", described as "No blood flow to right lung"; PYREXIA (non-serious), outcome "unknown", described as "fevers"; DISCOMFORT (non-serious), outcome "unknown", described as "she is having so much discomfort"; DIAPHRAGMATIC DISORDER (non-serious), outcome "unknown", described as "Diaphragm not working correctly"; LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (non-serious), outcome "unknown", described as "been able to resume some of her activity but has not been able to be as active as she was". The patient underwent the following laboratory tests and procedures: Body temperature: 100.4; Computerised tomogram: Mild bronchiectasis. Therapeutic measures were taken as a result of pyrexia.  Clinical course: The patient age was approximately 70. Vaccinations: 14May withheld, Caregiver, could not recall what vaccination withheld, patient had but thought it was another one besides Pfizer. Withheld has had the Prevnar 20 vaccination within the last year (2021). The timeline for health issues and when she was vaccinated was unclear. The different Pneumonias over the time periods were a case of damage from the original pneumococcal pneumonia in 2014. Since 2021, when withheld had her Prevnar 20 vaccination withheld has had many fevers. Withheld had fevers every 3 weeks or so but most of them resolved. The minute she got a fever over 100.4 they would place her on an antibiotic (Levofloxacin). They did not know the etiology of the fever. They are looking for fevers of 100.4 or over. Withheld had taken about 3 rounds of Levofloxacin since 2021. In June withheld had CT that showed mild bronchiectasis. Stated that, they would continue to follow-up with the withheld clinic. Stated that, 2018 - present - She has had 3 more bouts of pneumonia and last year's Nov2021 she had more difficulty breathing. Stated that, they did lots of tests at withheld State and did not find anything. In Oct2022, they went to the withheld Clinic, and they were working with them now. Stated that, their hypothesis was 1). No blood flow to right lung. Stated that, they think the scar tissue had taken over various area and she was having so much discomfort. Diaphragm not working correctly. Stated that, his wife had been able to resume some of her activity but had not been able to be as active as she was. Withheld had numerous surgeries, hospitalizations and had really seen a decline in her health from heaving pneumococcal pneumonia.  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.