This page is part of the FHIR Specification (v0.4.0: DSTU 2 Draft). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions
This is an example form generated from the questionnaire. See also the XML or JSON format.
This is an example form generated from the questionnaire. See also the XML or JSON format
Logical id of this artefact |
Metadata about the resource
A set of rules under which this content was created |
language |
Text summary of the resource, for human interpretation
Contained, inline Resources
Business identifier
label: | |
system: | |
value: |
Vaccination administration date |
Vaccine product administered
code: | |
text: |
Who was immunized? |
|
Was immunization given? |
Is this a self-reported record? |
Who administered vaccine? |
|
Who ordered vaccination? |
|
Encounter administered as part of |
|
Vaccine manufacturer |
|
Where did vaccination occur? |
|
Vaccine lot number |
Vaccine expiration date |
Body site vaccine was administered
code: | |
text: |
How vaccine entered body
code: | |
text: |
Amount of vaccine administered
comp: | |
value: | |
units: | |
coded units: | |
units system: |
xml:id (or equivalent in JSON) |
Why immunization occurred
code: | |
text: |
Why immunization did not occur
code: | |
text: |
xml:id (or equivalent in JSON) |
When did reaction start? |
Additional information on reaction |
|
Was reaction self-reported? |
xml:id (or equivalent in JSON) |
What dose number within series? |
Details of vaccine protocol |
Who is responsible for protocol |
|
Name of vaccine series |
Recommended number of doses for immunity |
Disease immunized against
code: | |
text: |
Does dose count towards immunity?
code: | |
text: |
Why does does count/not count?
code: | |
text: |