shaky and quivering/would not stop shaking; uncontrolled jerking in her upper extremities/involuntary jerking movements/uncontrollable upper extremity movements; neurological and heterogenous autoimmune injuries/neurological injuries/autoimmune and neurological disorders/autoimmune neurological dysfunction; neurological and heterogenous autoimmune injuries/neurological injuries/autoimmune and neurological disorders/autoimmune neurological dysfunction; allergic reaction to the Gardasil vaccination; fevers intermingled with chills; muscle cramping and joint pains; muscle cramping and joint pains; significant menstrual bleeding/Menorrhagia; Her monthly cycle became and continued to be completely irregular./irregular cycle; severe that she suffered significant anemia; Information has been received regarding a case in litigation from a lawyer and referred to a 16 years old (also reported as adult, confliction information) female patient (pt). Information regarding the pt's pertinent medical history, concurrent condition and concomitant medication was not provided. On 17-JAN-2019, the pt was vaccinated with the first of quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) shot for prophylaxis at local health center. The pt's initial vaccination seemed to be without incident. The pt's pediatrician told her mother that quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) was saving young women like her daughter from contracting human papillomavirus (HPV) which could lead to vaginal and other serious cancers. After that meeting, her mother believed the vaccination was prudent and necessary. On 18-MAR-2019, the pt was vaccinated with the second dose of quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) prophylaxis, at another health center, during a "well-child" adolescent exam. The dose, strength, route, lot number and expiration date were not reported for suspect vaccine. On the same day (reported as shortly after receiving her second quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) vaccination), the pt began having uncontrolled jerking in her upper extremities causing her school to contact her mother to come pick her up. The pt's mother immediately took the pt to the emergency room at local hospital. The pt was administered diphenhydramine (BENADRYL), believing she was having an allergic reaction to the quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) vaccination. During the night on that day, the pt experienced fevers intermingled with chills. The pt's mother followed the recommendations of the emergency room and provided acetaminophen for the fever, along with further dosage of diphenhydramine (BENADRYL). On 19-MAR-2019 (reported as the following morning), the pt remained shaky and quivering, but the involuntary jerking movements had calmed down. Despite her lingering symptoms, the pt attended school on that day. Shortly after the pt arrived at school on the same day, her mother received another call from the school stating that her daughter would not stop shaking. The pt was rushed to the local hospital where they immediately started running tests. The following afternoon, the pt's mother took the pt to see her original pediatrician at the facility. Further tests were conducted, and the pt's mother was advised to keep her daughter home from school and to continue diphenhydramine (BENADRYL). The pt's condition became worse as the day progressed. the pt was continuing to run fevers and experiencing extreme muscle cramping and joint pains throughout the night, along with the uncontrollable upper extremity movements. On 22-MAR-2019, the pt's mother was advised to take her daughter to the  emergency department. The pt was admitted for intravenous (IV) fluids and then discharged home under her mother's care on unknown date. On an unknown date, plaintiff began experiencing significant menstrual bleeding, so severe that she suffered significant anemia, at times requiring blood transfusions. Her monthly cycle became and continued to be completely irregular. On 04-JAN-2021, the hospital assessment included menorrhagia with irregular cycle. Those conditions continued to date, along with the involuntary movement and body spasms. The pt contended her involuntary movement, neurological injuries, and menstrual irregularity was caused by her quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) vaccinations. She had not been physically the same since that time, and she was never able to run track and field again. The pt contended that her quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) injections caused her to develop serious and debilitating injuries, including but not limited to autoimmune neurological dysfunction/ neurological and heterogenous autoimmune injuries (autoimmune disorder and neurological disorder), as well as resulting sequalae/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 injuries. The pt had suffered and continued to suffer severe and permanent physical injuries, and associated symptomology and had suffered severe and permanent emotional injuries, including pain and suffering. The pt 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 had suffered and continues to suffer economic losses, including considerable financial expenses for medical care and treatment, and diminished income capacity, and she would continue to incur those losses and expenses in the future. The outcome of the events was considered as not recovered. The causality was related.   Upon internal review, the autoimmune disorder was determined to be medically significant  The reporter considered the events to be disability.