serious and debilitating injuries, including but not limited to autonomic, neurological and heterogenous autoimmune injuries and resulting sequalae; serious and debilitating injuries, including but not limited to autonomic, neurological and heterogenous autoimmune injuries and resulting sequalae; serious and debilitating injuries, including but not limited to autonomic, neurological and heterogenous autoimmune injuries and resulting sequalae; Injury; serious and debilitating injuries, including but not limited to autonomic, neurological and heterogenous autoimmune injuries and resulting sequalae; Adverse event; premature ovarian failure (menses continued to be irregular and ultimately stopped/post-vaccine amenorrhea); postural orthostatic tachycardia syndrome (POTS) (lightheadedness/nausea/headaches); Information has been received from a lawyer regarding a case in litigation and referred to 15-year-old (also reported as an adult) female patient (pt). No information was provided regarding medical history, concurrent conditions, or concomitant medications. Prior to receiving her vaccine, pt had no autoimmune diseases. On 22-JUL-2013, the 15-year-old pt was vaccinated with the first dose of Quadrivalent Human Papillomavirus (Types 6,11,16,18) Recomb. Vaccine (GARDASIL) intramuscular injection for preventing cervical cancer (strength, dose, route, lot#, and expiration date were not reported). In August 2013, pt's menses became irregular. During that time, she also developed headaches, lightheadedness, and nausea. On 23-OCT-2013, pt was vaccinated with the second dose of Quadrivalent Human Papillomavirus (Types 6,11,16,18) Recomb. Vaccine (GARDASIL). After that, pt's menses continued to be irregular and ultimately stopped. On 06-DEC-2013, pt was seen by her medical providers for post-vaccine amenorrhea. On 07-FEB-2014, pt was assessed for premature ovarian failure. On 14-MAY-2014, pt underwent a tilt table test which was abnormal. Based upon her chronic and severe post-vaccine symptoms, pt had been diagnosed with premature ovarian failure and postural orthostatic tachycardia syndrome (POTS). Pt contended that the vaccine also caused serious and debilitating injuries, including but not limited to autonomic disease, neurological and heterogenous autoimmune injuries (also reported as autoimmune disorder) and resulting sequalae (a constellation of adverse symptoms, complications, injuries, and other adverse events). 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. 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 vaccine-induced injuries, pt 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. The outcome of all events was not resolved. The causality was related.   All the events were considered to be disabling by the lawyer. Upon on internal review, the event autoimmune disorder was considered to be medically significant.