Premature Ovarian Failure (POF)/Premature Ovarian Insufficiency; heart palpitations; Postural orthostatic tachycardia syndrome like symptoms; serious and debilitating injuries, including but not limited to autonomic, autoimmune, and neurological injuries and resulting sequalae; serious and debilitating injuries, including but not limited to autonomic, autoimmune, and neurological injuries and resulting sequalae; dehydrated; light and noise sensitivity; restlessness; limited attention span; brain fog; light and noise sensitivity; hair loss; cold hands and feet,; anxiety; heat sensitivity,; serious and debilitating injuries, including but not limited to autonomic, autoimmune, and neurological injuries and resulting sequalae; serious and debilitating injuries, including but not limited to autonomic, autoimmune, and neurological injuries and resulting sequalae; tingling in legs and feet/sensations of pins and needles; insomnia; non-refreshing sleep; shooting pains in her chest; headaches; dizzy; weakness; fatigue; shoulder started to hurt.; vomiting constantly to the point that she was only vomiting bile; profusely nauseous; Information has been received from a lawyer regarding a case in litigation and referred to an adult female patient (pt). No information was provided regarding medical history, concurrent conditions, or concomitant medications. On an unknown date, pt was vaccinated with the first and only dose of Quadrivalent Human Papillomavirus (Types 6,11,16,18) Recomb. Vaccine (GARDASIL) intramuscular injection for preventing cancer (strength, dose, route, lot#, and expiration date were not reported). Her shoulder started to hurt, she was profusely nauseous and was vomiting constantly to the point that she was only vomiting bile. She became so dizzy and dehydrated that her roommates had to take her to the emergency room (ER). She began having very heavy, painful periods which would last up to 11 days. She underwent testing which determined her hormone levels were completely out of range for her age and were consistent with premature ovarian failure (POF) or premature ovarian insufficiency (POI). As time passed, her symptoms progressed. Due to the severity of her symptoms, she had an endometrial ablation to reduce the pain during her periods. As a result, her uterine lining was no longer viable and she was told that, if she were to become pregnant, the pregnancy would kill her. For this reason, she had her fallopian tubes tied and a section of them removed. In the years following her vaccination, she also began to experience postural orthostatic tachycardia syndrome (POTS)-like symptoms, including heart palpitations and shooting pains in her chest. She had been to the ER at least a few times because her heart was beating so fast. She had been seen by multiple physicians and specialists for her complaints, which included heart palpitations, severe fatigue, nausea, vomiting, dizziness, weakness, tingling in legs and feet, cold hands and feet, sensations of pins and needles, heat sensitivity, light and noise sensitivity, headaches, insomnia, restlessness and non-refreshing sleep, brain fog, limited attention span, hair loss, and anxiety (date for all events was not reported). Pt had serious, chronic, severe and debilitating injuries, including but not limited to autonomic, autoimmune, neurological injuries and resulting sequalae. Pt began to suspect that the vaccine was the cause of her symptoms and injuries. As a result of her post-vaccine symptoms, she had been unable to engage in activities that a normal young person would enjoy, bear her own children, hold down a full-time job, and she had been forced to work from her home, which has negatively affected her finances. As a direct and proximate result of her vaccine-induced injuries, she had suffered and 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. She had suffered and continued to suffer severe and permanent physical injuries, and associated symptomology and has suffered severe and permanent emotional injuries. She 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 injuries. The outcome of events was not resolved.   All the events were considered to be disabling by the lawyer. Upon on internal review, the events POF/POI (treatment: endometrial ablation, fallopian tubes tied and a section of them removed) and autoimmune disorder were considered to be medically significant.