Postural Orthostatic Tachycardia Syndrome: fatigue/fainting and dizziness/axiety/cognitive issues with foccus and memory/ chronic nausea/vomiting/sharp chest pain/headaches-cluster/heart palpitations/brain fog/ shortness of breath/ hearing loss; Gardasil -induced autonomic disease/dysautonomia: joint pain/hypersomnia/depression/constipation/diarrhea/migraine/reflux/chronic dehydration/indigestion/urinary incontinence/chronic UTI/tinnitus/presyncope; Gardasil-induced autoimmune disorder; allodynia; small fiber neuropathy: ankle, feet and leg pain; Ankle, feet, and leg pain and swelling; Bruising; Severe vaginal bleeding; Irregular and excessive menstrual pain; Irregular and excessive menstrual pain; painful sex; nose bleeds; arthritis like symptoms in hands, wrist, fingers; chronic pain: pelvic pain, neck and shoulder pain, back pain; hives/itching; fever; gland swelling; This initial spontaneous report was received from a lawyer regarding a case in litigation, concerning a an adult (age not specified) female patient. Patient's current conditions, medical history and  concomitant therapy was not reported. On 19-DEC-2018, (at 18 years old), the patient was vaccinated with the first dose of quadrivalent human papillomavirus (types 6,11,16,18) recomb. Vaccine (GARDASIL) (strength, dose, lot number, expiration date, route of administration and anatomical location were not provided) administered for prevention cervical cancer. On an unknown date, following her vaccination, pt sustained serious autoimmune, autonomic, and neurological injuries as a result of her injection; she developed symptoms of dysautonomia (Autonomic nervous system imbalance), including joint pain, fatigue, fainting and dizziness, hypersomnia, anxiety and depression, cognitive issues with focus and memory, allodynia, and small fiber neuropathy. She was formally diagnosed with postural orthostatic tachycardia syndrome (POTS). At least one of her medical providers has attributed her POTS condition to quadrivalent human papillomavirus (types 6,11,16,18) recomb. Vaccine (GARDASIL). As the months have progressed, so have pt's symptoms. She has been seen by multiple physicians and specialists for her complaints which now include: dizziness, fatigue, fainting, chronic nausea, vomiting, anxiety, depression, abdominal pain, sharp chest pain, constipation, diarrhea, migraine/headaches/cluster, ankle, feet and leg pain and swelling (periphereal swelling), heart palpitations, reflux, motion sickness, bruising (contusion), chronic pain, chronic dehydration, vertigo, brain fog, severe vaginal bleeding (Vaginal haemorrhage), irregular and excessive menstrual pain (menstruation irregular, dysmenorrhoea), bloating and indigestion, hives, pelvic pain, itching (urticaria), fever, painful sex (dyspauremia), shortness of breath, back pain, hearing loss, urinary incontinence, chronic urinary tract infections (UTI's), neck and shoulder pain, nose bleeds (epistaxis), gland swelling (lymphadenopathy), tinnitus, arthritis-like symptoms in hands, wrist, fingers, and presyncope. As a result of her symptoms, pt had been unable to engage in activities that a normal young person would enjoy. Pt had been accepted and was going to attend culinary school abroad. She had plans to go into the baking business with her "self-adopted" mom, but when she became so dizzy and collapsed into a cake, she realized she would not be able to fulfil her dreams and attend culinary school. Despite two years of treatment with albumin infusion therapy, while pt has made some improvement related to fatigue and brain fog, her neurological and mobility issues continue. Pt now uses an wheelchair due to her immobility issues. 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, POTS. She had been referred to see a qualified obstetrics and gynecology (OB/GYN) specialist who was aware of POTS and autonomic issues at another state to try to resolve her gynecological issues. As a proximate result of the company's alleged wrongful acts and omissions and its negligent and fraudulent testing, labeling, manufacturing, marketing and promotion of quadrivalent human papillomavirus (types 6,11,16,18) recomb. Vaccine (GARDASIL), the pt suffered and continued to suffer severe and permanent physical injuries, and associated symptomology and 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 injuries caused by quadrivalent human papillomavirus (types 6,11,16,18) recomb. Vaccine (GARDASIL). As a direct and proximate result, Plaintiff has 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. At the time of reporting, plaintiff had not recovered from the events. The reporter considered all the aforementioned events to be related to quadrivalent human papillomavirus (types 6,11,16,18) recomb. Vaccine (GARDASIL).  All the events were considered as disabling by reporter.  Upon internal review, the event of autoimmune disorder was determined to be medically significant.