not able to walk; cold; runny nose; voice was hoarse; sneezing; wet cough; chilled; shaking; diarrhea; Pneumonia; chewing some peanuts that night and did choke on them; This is a spontaneous report received from contactable reporter(s) (Consumer or other non HCP) from medical information team.  A 95-year-old female patient received pneumococcal 20-val conj vac (dipht CRM197 protein) (PREVNAR 20), on 03Aug2022 as dose number unknown, single (Batch/Lot number: unknown) at the age of 95 years, in left arm for immunisation. The patient's relevant medical history included: "thyroid"; "hospice care", notes: for a year and came off in November; "dementia". Concomitant medication(s) included: LATANOPROST; LEVOTHYROXINE taken for thyroid disorder; DORZOLAMIDE TIMOLOL. Vaccination history included: pfizer coviD-19 vaccine, administration date: 03Aug2021, for Covid-19 Immunization; Prevnar 13 (dose 1), administration date: 2014, for Immunization. The following information was reported: GAIT INABILITY (non-serious) with onset 03Aug2022, outcome "unknown", described as "not able to walk"; PNEUMONIA (medically significant) with onset Aug2022, outcome "unknown"; CHOKING (medically significant) with onset Aug2022, outcome "unknown", described as "chewing some peanuts that night and did choke on them"; CHILLS (non-serious) with onset Aug2022, outcome "recovered", described as "chilled"; NASOPHARYNGITIS (non-serious) with onset Aug2022, outcome "unknown", described as "cold"; DIARRHOEA (non-serious) with onset Aug2022, outcome "recovered", described as "diarrhea"; RHINORRHOEA (non-serious) with onset Aug2022, outcome "not recovered", described as "runny nose"; TREMOR (non-serious) with onset Aug2022, outcome "recovered", described as "shaking"; SNEEZING (non-serious) with onset Aug2022, outcome "not recovered"; DYSPHONIA (non-serious) with onset Aug2022, outcome "unknown", described as "voice was hoarse"; PRODUCTIVE COUGH (non-serious) with onset Aug2022, outcome "not recovered", described as "wet cough". The events "pneumonia", "not able to walk", "cold", "runny nose", "voice was hoarse", "sneezing", "wet cough", "chilled", "shaking" and "diarrhea" required physician office visit and emergency room visit. The patient underwent the following laboratory tests and procedures: Chest X-ray: Unknown Results, notes: ; SARS-CoV-2 test: Negative; Unknown Results, notes: an official COVID test which was done on Monday with results yesterday prior to her chest x-ray. Therapeutic measures were taken as a result of choking and included needed more water to get the peanuts down.  Clinical course: Her mother was perfectly healthy with no cold symptoms till the shot. The events progressively got worse and ended up going to the Emergency Room on Saturday. At the Emergency Room, the doctor didn't see pneumonia but has since progressed to pneumonia. The Prevnar 20 vaccine gave the patient pneumonia. The reporter took her mother to the emergency room and then waited till Monday and was not able to see the doctor so she saw the other doctor. Before she took her mother to the emergency room, the caller did a home COVID test on her mother and was negative. She doesn't take her mother anywhere. The doctor thought this might be COVID so wanted an official COVID test which was done on Monday with results yesterday prior to her chest x-ray. The reporter was concerned for aspiration pneumonia but wouldn't cause cold symptoms or sneezing and runny nose or stop her from standing that night.  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.