Postural orthostatic tachycardia syndrome/autonomic, neurological, heterogenous autoimmune disease/persistent tachycardia requiring an implanted heart monitor/syncope/chest pain/chronic fatigue syndrome/headache/dizziness; dislocation of her joints; dysautonomia; exhibits symptoms mimicking Reynard's Syndrome; Information has been received from a lawyer regarding a case in litigation and referred to a 14-year-old female patient (pt). Prior to quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) vaccination, she had no autoimmune diseases, and no autonomic issues. She was actively involved in playing volleyball, running track, and cheerleading prior to receiving her quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) injections. She enjoyed a very social and interactive youth and enjoyed being with her friends and playing sports. Information on the pt's concomitant therapies was not reported. On 07-AUG-2017, the pt's health care provider (HCP) recommended that pt receive quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) vaccine. On the same date, (at age of 14), the pt was vaccinated with the first dose of quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL). Therefore, on 02-MAR-2018, she received her second dose of quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) as safe and effective vaccine for preventing cervical cancer (prophylaxis) (lot #, expiration date, dose, route of administration and anatomical location were not reported). After receiving her second dose of vaccine, the pt began experiencing various symptoms including frequent dislocation of her joints, chronic fatigue syndrome, persistent tachycardia requiring an implanted heart monitor, dysautonomia, and syncope. As the months progressed, so did pt's injuries. On 22-OCT-2019, the pt visited a clinic for complaints of tachycardia, chest pain, dizziness, and headache. Since that time, pt had continued to experience similar symptoms. She was seen by multiple physicians and specialists for her complaints which now included: dizziness, syncope, tachycardia, dysautonomia, and postural orthostatic tachycardia syndrome (POTS). As a result of her post- quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) symptoms, she was unable to engage in normal activities that a normal young person would enjoy. After being diagnosed with various conditions, the pt was unable to keep her former job due her medical condition. She was also no longer able to participate in sports and spent a significant amount of time attending doctors' appointments. Pt was no longer able to engage in a normal high school experience. Since completing high school pt had been able to obtain a job, but pt still needs to seek medical care and fluids to treat her ongoing symptoms on occasion.  Based upon her chronic and severe post quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) she had been diagnosed with various medical conditions including but not limited to POTS, dysautonomia, chronic fatigue, syncope, tachycardia, and exhibits symptoms mimicking Reynard's Syndrome (Raynaud's syndrome). Pt's contends that her quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) caused her to develop serious and debilitating injuries, including but not limited to autonomic, neurological, heterogenous autoimmune disease, POTS, and dysautonomia, 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. As a proximate result of vaccination, pt had suffered and continued to suffer severe and permanent physical injuries including and associated symptomology and had suffered severe and permanent emotional injuries, including pain and suffering. 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). At the reporting time, the outcome of the events was considered as not recovered.The reporter considered all the events related to quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL). All the events were considered as disabling events.   Upon internal reviewed the event of Postural orthostatic tachycardia syndrome (POTS) was considered to be medically significant due implant heart monitor