anxiety; depression; as well as a constellation of adverse symptoms; Autoimmune Disease/heterogenous autoimmune disease; Autonomic Dysfunction/autonomic/Dysautonomia; POTS; Information has been received regarding a case in litigation from a lawyer and referred to a 11 years old female patient (pt). Prior to receiving her quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) injections, the pt had no autoimmune diseases, and no autonomic issues. In fact, she was a busy, energetic, and healthy child who engaged in many activities and sports. Her favorite extracurricular activity was competitive swimming, in which she dedicated much effort and time. Prior to the quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) injections, the pt had no significant medical history. In fact, she was the picture of health. She had had only minor colds and flu on a few occasions, strep throat one time, and never vomited or had diarrhea. The pt's health care provider recommended she received the quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) vaccine, which was stated as a safe and effective vaccine for preventing cervical cancer. The pt had her third dosage of the quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) vaccine (dose, strength, route, lot number and expiration date were unknown) for prophylaxis on 01-FEB-2016. The pt's mother consented to her being injected with the "cervical cancer vaccine," quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL). Soon after receiving the third vaccination in 2016, her health dramatically declined at the outset, she was extremely tired and had excruciating leg pain. A few weeks after, she started having fevers, nausea, vomiting, daily diarrhea, headaches, stomachaches, and pain throughout her body. She began missing school and could no longer continue swimming or other sports. After the final shot, on 14-JUL-2016, her stomach hurt daily to the point where she could not engage in her daily activities. As the months progressed, so did her injuries. She was seen by multiple physicians and specialists and underwent multiple tests for her complaints which now included: extreme fatigue, extreme stomach pain, diarrhea, nausea, leg numbness and pain, dizziness, visual and sound sensitivities, insomnia, and loss of eyebrow hair. As a result of her post-quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) symptoms, she was unable to attend school regularly or engage in normal activities that a normal young person would enjoy. The pt was unable to continue her sports or attend school regularly. The pt had missed time with family and lost friends because she is too sick to participate. Based upon her chronic and severe post-quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) symptoms, she had been diagnosed with various medical conditions, including but not limited to, postural orthostatic tachycardia syndrome (POTS), dysautonomia, anxiety, and depression. The pt's quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) injections 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 are 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 quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL), the pt had suffered and continued to suffer severe and permanent physical injuries, including, but not limited to, her autoimmune disease and associated symptomology and had suffered severe and permanent emotional injuries, including pain and suffering. Her parents also had a substantial fear of the pt 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 quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL)-induced injuries, her parents had suffered and continue to suffer economic losses, including considerable financial expenses for medical care and treatment, and diminished income capacity and they will continue to incur these losses and expenses in the future. The outcome of the events was considered as not recovered. The reporter considered the events was related to the suspect vaccine.  Upon internal review, the autoimmune disorder was determined to be medically significant.  The reporter considered the events to be disability.