Merck will have to face multidistrict litigation (MDL) that centralizes personal injury cases relating to alleged adverse autoimmune reactions to the company’s human papillomavirus (HPV) vaccine Gardasil.

The complaints allege that the Merck vaccine has led to postural orthostatic tachycardia syndrome, a blood circulation disorder, but also other injuries. The plaintiffs are making claims of fraud, negligence and, in some cases, violations of state consumer protection laws.

Over the company’s protests, the U.S. Judicial Panel on Multidistrict Litigation has transferred the cases to the United States District Court for the Western District of North Carolina, to eliminate duplicative discovery and prevent inconsistent pretrial rulings.