fatigue; fever; This is a spontaneous report received from a Pharmacist. An 89-year-old female patient (not pregnant) received pneumococcal 20-val conj vac (dipht CRM197 protein) (PREVNAR 20), on 14Jan2025 as dose number unknown, single (Batch/Lot number: unknown) for immunisation. The patient’s relevant medical history included: “Restless leg syndrome” (unspecified if ongoing); “depression” (unspecified if ongoing); “type 2 diabetes” (unspecified if ongoing); “hypertension” (unspecified if ongoing); “CHF” (unspecified if ongoing); “CAD” (unspecified if ongoing); “hypercholesterolemia” (unspecified if ongoing); “obesity” (unspecified if ongoing); “hypothyroidism” (unspecified if ongoing). Concomitant medication(s) included: ACETAMINOPHEN; ASCORBIC ACID; ASPIRIN (E.C.); CETIRIZINE; VIT D3; DULOXETINE; FUROSEMIDE; LACTOBACILLUS ACIDOPHILUS; LEVOTHYROXINE; MULTIVITAMIN [ASCORBIC ACID;BIOTIN;CALCIUM PANTOTHENATE;CYANOCOBALAMIN;FOLIC ACID;NICOTINIC ACID;PYRIDOXINE HYDROCHLORIDE;RIBOFLAVIN;THIAMINE HYDROCHLORIDE;TOCOPHERYL ACETATE]; OLOPATADINE; OMEGA 3 FISH OIL [FISH OIL]; OMEPRAZOLE; POLYETHYLENE GLYCOL COMPOUND; KCL oral; ROPINIROLE; ROSUVASTATIN; TROSPIUM. Past drug history included: No, reaction(s): “Hypersensitivity”. The following information was reported: FATIGUE (non-serious) with onset 15Jan2025, outcome “recovered” (15Jan2025); PYREXIA (non-serious) with onset 15Jan2025, outcome “recovered” (15Jan2025), described as “fever”. Therapeutic measures were taken as a result of fatigue, pyrexia. The information on the batch/lot number for pneumococcal 20-val conj vac (dipht CRM197 protein) will be requested and submitted if and when received.