Age: 19.0
Sex: F
Vaccine: HPV4
Symptoms: Asthenia, Autonomic nervous system imbalance, Balance disorder, Blood pressure decreased, Body temperature decreased
Clinical narrative: POTS (autonomic, neuroloical  injuries,shaky hands,heart palpitations,change in color of her hands and feet, gravity dependent discoloration, lightheadedness,blurred vision,nausea,weak,sensations of fainting,unsteadiness,,confusion, extremities weak); Raynaud's (neurological injuries, numbness and change in color of her hands and feet, tingling and numbness in fingers and toes associated with a decrease in temperature; Autoimmune injuries; vertigo; Information has been received from a lawyer, regarding a case in litigation and concerning an adult female patient (pt) of an unknown age. No information concerning the pt's medical history, concurrent conditions or concomitant medications was provided. On 29-AUG-2018, at the age of 19 years old, as recommended by the physician, the pt received her first dose of quadrivalent human papillomavirus (HPV) (types 6,11,16,18) recomb. vaccine (GARDASIL) (dose, route of administration, anatomical location, lot # and expiration date were not reported) for preventing cervical cancer. On an unknown date, the pt received her second dose of quadrivalent human papillomavirus (HPV) (types 6,11,16,18) recomb. vaccine (GARDASIL) (dose, route of administration, anatomical location, lot # and expiration date were not reported). On 01-MAR-2019, the pt received her third (last) dose of quadrivalent human papillomavirus (HPV) (types 6,11,16,18) recomb. vaccine (GARDASIL) (dose, route of administration, anatomical location, lot # and expiration date were not reported). On an unknown date, also reported as by June 2019, the pt was experiencing frequent heart palpitations and shaky hands. She experienced numbness and change in color of her hands and feet. Pt also experienced unsteadiness, lightheadedness, and dizziness associated with her heart palpitations upon standing. Her numbness, heart palpitations, and dizziness progressively got worse. Her doctors noted that in addition to the foregoing, she had gravity dependent discoloration and purple coloring of upper and lower extremities and that palpitations were accompanied by blurred vision, nausea, weakness, vertigo, shakiness and unsteadiness among other symptoms. She was seen by multiple physicians and specialists for her complaints which now included: extreme dizziness immediately upon standing, sensations of fainting, tingling and numbness in fingers and toes associated with a decrease in temperature, weakness and confusion, increased heart rate virtually daily where her heart will speed up and flutter for hours, decreased blood pressure, headaches, weakness in her extremities including gripping, and feeling on the verge of passing out or fainting or losing consciousness, among other continuing related problems. As a result of her post-quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) symptoms, the pt has been unable to engage in activities that a normal young person would enjoy. She has altered her lifestyle to accommodate her new normal. She has virtually eliminated working out, taking walks, baths, or hiking by herself for fear of passing out and being alone or among strangers, and the possibility of fainting or passing out in water is simply too risky. Pt's symptoms interfered with her business as an esthetician and being a nursing student. Plaintiffs quadrivalent human papillomavirus (HPV) (types 6,11,16,18) recomb. vaccine (GARDASIL) related injuries have changed her life by affecting her career, income, health and vitality, as well as her relationships. On unknown dates, based upon her chronic and severe post-quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) symptoms, the pt was diagnosed with various medical conditions, including but not limited to postural orthostatic tachycardia syndrome (POTS), autonomic dysfunction, and Raynaud's which pt contended were caused by and/or significantly aggravated by her quadrivalent human papillomavirus (HPV) (types 6,11,16,18) recomb. vaccine (GARDASIL) injection of 01-MAR-2019. As a result of receiving human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) vaccine, the pt sustained serious and debilitating injuries, including but not limited to autonomic, autoimmune, and neurological injuries and resulting sequalae. The pt contended that her quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) injection(s) caused her to develop serious and debilitating autoimmune, autonomic, and neurological, injuries, including but not limited to POTS, and Raynaud's, as well as a constellation of adverse symptoms, complications, injuries, and other adverse events, many of which are alleged herein and all of which were caused by quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) or otherwise linked to her quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL)-induced autoimmune disorder. The pt had suffered and at the time of report continued to suffer severe and permanent physical injuries, and associated symptomatology and had suffered severe and permanent emotional injuries, including pain and suffering. She also had a substantial fear of suffering additional and ongoing harms, including but not limited to now being at an increased risk of cancer, and future symptoms and harms associated with her autoimmune disease and other injuries caused by quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL). As a direct and proximate result of her quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL)-induced injuries, the pt suffered and at the time of report continued to suffer economic losses, including considerable financial expenses for medical care and treatment, and diminished income capacity, and she would continue to incur these losses and expenses in the future. The outcome of the events was considered to be not recovered. The reporter considered the events to be related to quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL).  The events were considered to be disabling.  Upon internal review, the event of autoimmune disorder was determined to be medically significant.