Age: 26.0
Sex: F
Vaccine: HPV4
Symptoms: Anxiety, Arthralgia, Arthritis, Autoimmune disorder, Autonomic neuropathy
Clinical narrative: Autonomic injuries; autoimmune injury/Gardasil-induced autoimmune disorder; fibromyalgia/fatigue, joint pain, neck stiffness, neck pain, brain fog, shortness of breath, headaches; exacerbation of pre-existing anxiety; exacerbation of pre-existing depression; idiopathic hypersomnia/neurological injuries; falling asleep while driving, falling asleep while talking; excessive daytime sleepiness; joint inflammation/decreased range of motion; Information has been received from a lawyer, regarding a case in litigation and concerning an adult female patient (pt).  Prior to receiving quadrivalent human papillomavirus (HPV) (types 6,11,16,18) recomb. vaccine (GARDASIL), the pt was able to work longer hours, go to school, and stay engaged in family and social relationships. No other information concerning the pt's medical history, concurrent conditions or concomitant medications was provided. On 09-SEP-2019, at the age of 26 years old, 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 25-OCT-2019, 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) for preventing cervical cancer. On unspecified dates, after receiving the first and second vaccinations, the pt began experiencing fatigue, falling asleep while driving, falling asleep while talking, excessive daytime sleepiness, and exacerbation of pre-existing anxiety. On 12-JUN-2020, the pt received her third 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 unspecified dates, after receiving the third vaccination, the pt's symptoms worsened and she began experiencing joint pain, joint inflammation, neck stiffness, neck pain, decreased range of motion, brain fog, shortness of breath, exacerbation of pre-existing depression and headaches, and exacerbation of fatigue, falling asleep while driving, falling asleep while talking, and excessive daytime sleepiness. As a result of her post-quadrivalent human papillomavirus (HPV) (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. Her fatigue and sleep issues overwhelm her life. She falls asleep at work and even while driving. Her joint pain makes it difficult to complete daily personal and professional responsibilities. On unknown dates, based upon her chronic and severe post-quadrivalent human papillomavirus (HPV) (types 6,11,16,18) recomb. vaccine (GARDASIL) symptoms, the pt has been diagnosed with various medical conditions, including but not limited to, idiopathic hypersomnia and fibromyalgia. The pt sustained serious autoimmune, autonomic, and neurological injuries as a result of her quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) injection. The pt contended that her quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) injection(s) caused her to develop and exacerbate serious and debilitating autoimmune, autonomic, and neurological injuries and resulting sequelae, including but not limited to idiopathic hypersomnia and fibromyalgia, as well as a constellation of adverse symptoms, complications, injuries, and other adverse events, many of which were 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 has suffered at the time of report and continued to suffer severe and permanent physical injuries and associated symptomology and had suffered severe and permanent emotional injuries, including pain and suffering. She also has 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 had 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 of autonomic neuropathy, autoimmune disorder, idiopathic hypersomnia, fibromyalgia, exacerbation of anxiety, arthritis and depression aggravated was considered to be not recovered.  The lawyer considered the events of autonomic neuropathy, autoimmune disorder, idiopathic hypersomnia, fibromyalgia, exacerbation of anxiety, arthritis and depression aggravated to be related to quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL).  Upon internal review, the events of autonomic neuropathy and autoimmune disorder was determined to be medically significant.  The events of autonomic neuropathy, autoimmune disorder, idiopathic hypersomnia, fibromyalgia, exacerbation of anxiety, arthritis and depression aggravated was considered to be disabling.