The patient was finally diagnosed with dysmenorrhea; The patient was finally diagnosed with heavy metal poisoning; The patient was finally diagnosed with cranio cervical instability; The patient was finally diagnosed with eczema/tinea corporis; The patient was finally diagnosed with acid reflex/GERD; The patient was finally diagnosed with yeast infections; The patient was finally diagnosed with bacterial vaginosis; light and noise sensitivity; aching joints; painful breast lumps; Plaintiff also has a substantial fear of suffering additional and ongoing harms; The patient was finally diagnosed with POTS; The patient was finally diagnosed with autonomic dysfunction; Information has been received from a lawyer regarding a case in litigation and referring to a currently 14-year-old female patient. No information was provided regarding medical history, concurrent conditions, or concomitant medications.  On 08-FEB-2018 and 09-AUG-2018 the patient was vaccinated with a first and second dose of quadrivalent human papillomavirus (types 6,11,16,18) recomb. Vaccine (GARDASIL) respectively (lot #, expiration date, anatomical location, route and frequency were not reported) for prophylaxis.      On 09-AUG-2018, shortly after the second dose (reported as "the same evening"), the patient developed headache, followed by severe fatigue, energy loss, and digestive discomfort. Then, her digestive symptoms increased in severity. She also developed difficulty breathing,  tightness and pain in her chest, heart palpitations, a full feeling in her throat, difficulty swallowing, dizziness, abdominal pain, loss of appetite, difficulty eating, nausea, body aches, weakness, particularly in her limbs, and persistent rashes. The patient's fatigue continued to the point where she had difficulty staying awake during class, missed school days and had to take frequent naps. It was also mentioned that the patient experienced constipation, near syncope, blurred/loss of vision, vomiting, blackouts, visual disturbances, light and noise sensitivity, lightheadedness, shakiness, aching joints, temperature regulation problems, reflux, heat intolerance, insomnia, brain fog, cognition problems, learning impairment, menstrual abnormality, painful breast lumps, changes in body odor, itchy rashes, poor liver function, bladder pain, urethra discomfort after urinating and pelvic pain. Furthermore, between February and June of 2019, the patient went to emergency rooms 4 times and, on unspecified dates, the patient was hospitalized due to her symptoms. It was also mentioned that the patient was diagnosed with Postural Orthostatic Tachycardia Syndrome (including symptoms of dyspnea, anxiety disorder, insomnia and shaking), autonomic dysfunction (including symptoms of constipation, gastroesophageal reflux disease and hyperacusia), dysmenorrhea, heavy metal poisoning, cranio-cervical instability, eczema/tinea corporis, acid reflex/gastroesophageal reflux disease (GERD), yeast infections, bacterial vaginosis and anxiety disorder. In addition, the patient mentioned that she 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 injuries caused by quadrivalent human papillomavirus (types 6,11,16,18) recomb. Vaccine (GARDASIL).  The outcome of postural orthostatic tachycardia syndrome, bacterial vaginosis, fungal infection, eczema, spinal instability, metal poisoning, dysmenorrhea, autonomic nervous system imbalance, fear of disease, breast mass, arthralgia and photophobia was reported as not recovered.   The reporter considered all the events to be triggered by quadrivalent human papillomavirus (types 6,11,16,18) recomb. Vaccine (GARDASIL).  Upon internal review, metal poisoning were determined to be medically significant. All events were considered disabling since it was mentioned that the patient could no longer participate in her normal daily activities due to her ongoing symptoms.