inability to walk/barely walk /could not walk; complex regional pain syndrome; chronic fatigue syndrome; Irlen syndrome; feel unwell; struggling to stand; dehydrated; blood pressure was going up and down; Patient was finally diagnosed with POTS/fainting/chest and stomach pain/shortness of breath/chronic pain, dizziness, extreme brain fog/faint/lightheadedness/headache; she had previously had strep throat; This initial spontaneous report was received from a lawyer and patient's mother regarding a case in litigation and refers to a 12-year-old female patient. No information was provided regarding medical history, concurrent conditions, or concomitant medications. On 08-FEB-2019, patient was vaccinated with a first dose of quadrivalent human papillomavirus (types 6,11,16,18) recomb. Vaccine (GARDASIL) for prevention of cervical cancer (lot#, expiration date, dose, and route not specified).  On 09-JAN-2020, during the physician's office visit, the pt.  was vaccinated with second dosage of human papillomavirus (types 6,11,16,18) recomb. Vaccine (GARDASIL) for prevention of cervical cancer (lot#, expiration date, dose, and route not specified) and it was reported that the pt. returned to the doctor's office on this day, because she had previously had strep throat, in December 2019, and her mother wanted to make sure it wasn't coming back.  Immediately after receiving the shot, pt. began to feel unwell (Malaise). She left the office with her mother, and by the time they got to the elevator, she could barely walk (Walking disability) and had to sit down. Over the next two hours, pt. started having chest and stomach pains, could not walk or stand at all, and was having trouble breathing.  Pt.'s mother took her to the Emergency Room, where they ran tests and did bloodwork (data not showed). She was still struggling to breathe, her blood pressure was going up and down (blood pressure abnormal), and she was struggling to stand(dysstasia). It was thought that she might be dehydrated so she was given IV fluids. After six hours in the ER, pt. was sent home with no answers.  A few weeks went by, and pt. was still unable to stand for longer than a few minutes without almost fainting, and she was struggling to walk from one end of the house to the other. On 07-FEB-2020, pt. went to the Emergency Room for a second opinion and hopefully to get some answers. After extensive testing, it was suggested that pt. had POTS, and she was referred to a pediatric cardiologist for a tilt table test.On 21-FEB-2020, pt.  had a tilt table test which confirmed her POTS Diagnosis.  As the months progressed, so did pt.'s symptoms. She was seen by multiple physicians and specialists for her complaints which now included: chronic pain, dizziness, lightheadedness, heart rate fluctuations, severe stomach pain, headaches, inability to walk, and extreme brain fog (Postural orthostatic tachycardia syndrome). Pt. had had at least four Erector Spinal Nerve blocks to try to alleviate her intense pain.  As a result of her post- quadrivalent human papillomavirus (types 6,11,16,18) recomb. Vaccine (GARDASIL) symptoms, pt. had been unable to engage in activities that a normal young person would enjoy. Everyday activities, such as walking up the stairs, going to the store, or even sitting in a chair without a back, are very difficult for her.  Pt. could no longer play sports, which she previously enjoyed, or even go to school. Pt. was currently not able to attend school due to her severe symptoms. Based upon her chronic and severe post- quadrivalent human papillomavirus (types 6,11,16,18) recomb. Vaccine (GARDASIL) symptoms, pt. had been diagnosed with various medical conditions, including but not limited to, postural orthostatic tachycardia syndrome ("POTS"), complex regional pain syndrome ("CRPS"), chronic fatigue syndrome ("CFS"), and Irlen syndrome.  As a direct and proximate result of her quadrivalent human papillomavirus (types 6,11,16,18) recomb. Vaccine (GARDASIL) -induced injuries, pt. had suffered and continues to suffer economic losses, including considerable financial expenses for medical care and treatment, and diminished income capacity and she will continue to incur these losses and expenses in the future. The outcome of pharyngitis streptococcal was reported as recovered, on an unknown date. The outcome of the remaining events were not recovered.  The events were considered serious and disabling by the reporter.  The events were considered to be related to Quadrivalent Human Papillomavirus (Types 6,11,16,18) Recomb. Vaccine (GARDASIL).