lupus nephritis class IV & V; alopecia, hair began falling out; cutaneous vasculitis; transaminitis; abnormal weight loss; normocytic anemia; TSH elevation; polyarthritis; immune-suppressed status; h-pylori infection; uncoordinated gate; systemic lupus erythematosus, extreme fatigue, rash developed on his ears; rash persisted and spread across his entire body/positive ANA/sedimentation rate elevation/leukopenia; nasal congestion; early satiety, loss of appetite; Information has been received from a lawyer, regarding a case in litigation and concerning a minor male patient (pt) of an unknown age. No other information concerning the pt's medical history, concurrent conditions or concomitant medications was provided. On 29-JUL-2019, at the age of 11 years old, the pt received his 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 prophylaxis. On 29-JUL-2020, the pt received his 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). The pt sustained serious and debilitating injuries, including but not limited to autonomic, autoimmune, and neurological injuries and resulting sequalae (also reported as serious autoimmune injuries) as a result of his quadrivalent human papillomavirus (HPV) (types 6,11,16,18) recomb. vaccine (GARDASIL) injections. On 29-JUL-2020, immediately after receiving his second Gardasil vaccination, pt began to experience fatigue. Over the next few days, he experienced loss of appetite, nasal congestion and a rash developed on his ears. As the months progressed, so did the pt's symptoms. The rash persisted and spread across his entire body, he experienced extreme fatigue, loss of appetite, uncoordinated gate, and his hair began falling out. He was seen by multiple physicians and specialists for his complaints, including being admitted to the hospital. Based upon the pt's chronic and severe post-quadrivalent human papillomavirus (HPV) (types 6,11,16,18) recomb. vaccine (GARDASIL) symptoms, pt has been diagnosed with various medical conditions, including but not limited to systemic lupus erythematosus, lupus nephritis class IV & V, alopecia, cutaneous vasculitis, leukopenia, transaminitis, abnormal weight loss, positive ANA, normocytic anemia, sedimentation rate elevation, TSH elevation, polyarthritis, early satiety, immune-suppressed status, and h-pylori infection. The pt continues to see specialists, gets regular testing, and receives treatments for his myriad symptoms. 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. He 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 his injuries caused by quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL). As a direct and proximate result of his 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 he would continue to incur these losses and expenses in the future. The outcome of the events was considered to be not recovered. The lawyer 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 events of systemic lupus erythematosus, lupus nephritis, cutaneous vasculitis, immunodeficiency and polyarthritis were considered to be medically significant.