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4.19 Resource ImmunizationRecommendation - Content

Public Health and Emergency Response Work GroupMaturity Level: 1Compartments: Patient

A patient’s point-in-time immunization and recommendation (i.e. forecasting a patient’s immunization eligibility according to a published schedule) with optional supporting justification.

4.19.1 Scope and Usage

The ImmunizationRecommendation resource is intended to cover communication of a specified patient's immunization recommendation and status across all healthcare disciplines in all care settings and all regions.

Additionally, the ImmunizationRecommendation resource is expected to cover key concepts related to the querying of a patient's immunization recommendation and status. This resource - through consultation with the PHER work group - is believed to meet key use cases and information requirements as defined in the existing HL7 v3 POIZ domain and Immunization Domain Analysis Model.

4.19.2 Boundaries and Relationships

This resource references the following resources:

  • Allergy/Intolerance
  • Patient
  • Organization
  • Immunization
  • Observation

One of the considerations for this resource is if it is better for this resource to be a profile of the CarePlan resource or if it is more appropriate for this to be a separate resource due to the number of immunization profile-specific data elements. Please consider this when submitting your ballot comments.

4.19.3 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. ImmunizationRecommendation DomainResourceGuidance or advice relating to an immunization
... identifier Σ0..*IdentifierBusiness identifier
... patient Σ1..1Reference(Patient)Who this profile is for
... recommendation Σ1..*BackboneElementVaccine administration recommendations
.... date Σ1..1dateTimeDate recommendation created
.... vaccineCode Σ1..1CodeableConceptVaccine recommendation applies to
Vaccine Administered Value Set (Example)
.... doseNumber Σ0..1positiveIntRecommended dose number
.... forecastStatus Σ1..1CodeableConceptVaccine administration status
Immunization Recommendation Status Codes (Example)
.... dateCriterion 0..*BackboneElementDates governing proposed immunization
..... code 1..1CodeableConceptType of date
Immunization Recommendation Date Criterion Codes (Example)
..... value 1..1dateTimeRecommended date
.... protocol 0..1BackboneElementProtocol used by recommendation
..... doseSequence 0..1integerNumber of dose within sequence
..... description 0..1stringProtocol details
..... authority 0..1Reference(Organization)Who is responsible for protocol
..... series 0..1stringName of vaccination series
.... supportingImmunization 0..*Reference(Immunization)Past immunizations supporting recommendation
.... supportingPatientInformation 0..*Reference(Observation | AllergyIntolerance)Patient observations supporting recommendation

doco Documentation for this format

UML Diagram

ImmunizationRecommendation (DomainResource)A unique identifier assigned to this particular recommendation recordidentifier : Identifier [0..*]The patient for whom the recommendations are forpatient : Reference [1..1] « Patient »RecommendationThe date the immunization recommendation was createddate : dateTime [1..1]Vaccine that pertains to the recommendationvaccineCode : CodeableConcept [1..1] « The type of vaccine administered (Strength=Example)Vaccine Administered Value Set?? »This indicates the next recommended dose number (e.g. dose 2 is the next recommended dose)doseNumber : positiveInt [0..1]Vaccine administration statusforecastStatus : CodeableConcept [1..1] « The patient's status with respect to a vaccination protocol (Strength=Example)Immunization Recommendation S...?? »Immunization event history that supports the status and recommendationsupportingImmunization : Reference [0..*] « Immunization »Patient Information that supports the status and recommendation. This includes patient observations, adverse reactions and allergy/intolerance informationsupportingPatientInformation : Reference [0..*] « Observation| AllergyIntolerance »DateCriterionDate classification of recommendation - e.g. earliest date to give, latest date to give, etccode : CodeableConcept [1..1] « Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.) (Strength=Example)Immunization Recommendation D...?? »Date recommendationvalue : dateTime [1..1]ProtocolIndicates the nominal position in a series of the next dose. This is the recommended dose number as per a specified protocoldoseSequence : integer [0..1]Contains the description about the protocol under which the vaccine was administereddescription : string [0..1]Indicates the authority who published the protocol? E.g. ACIPauthority : Reference [0..1] « Organization »One possible path to achieve presumed immunity against a disease - within the context of an authorityseries : string [0..1]Vaccine date recommendations - e.g. earliest date to administer, latest date to administer, etcdateCriterion[0..*]Contains information about the protocol under which the vaccine was administeredprotocol[0..1]Vaccine administration recommendationsrecommendation[1..*]

XML Template

<ImmunizationRecommendation xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business identifier --></identifier>
 <patient><!-- 1..1 Reference(Patient) Who this profile is for --></patient>
 <recommendation>  <!-- 1..* Vaccine administration recommendations -->
  <date value="[dateTime]"/><!-- 1..1 Date recommendation created -->
  <vaccineCode><!-- 1..1 CodeableConcept Vaccine recommendation applies to --></vaccineCode>
  <doseNumber value="[positiveInt]"/><!-- 0..1 Recommended dose number -->
  <forecastStatus><!-- 1..1 CodeableConcept Vaccine administration status --></forecastStatus>
  <dateCriterion>  <!-- 0..* Dates governing proposed immunization -->
   <code><!-- 1..1 CodeableConcept Type of date --></code>
   <value value="[dateTime]"/><!-- 1..1 Recommended date -->
  </dateCriterion>
  <protocol>  <!-- 0..1 Protocol used by recommendation -->
   <doseSequence value="[integer]"/><!-- 0..1 Number of dose within sequence -->
   <description value="[string]"/><!-- 0..1 Protocol details -->
   <authority><!-- 0..1 Reference(Organization) Who is responsible for protocol --></authority>
   <series value="[string]"/><!-- 0..1 Name of vaccination series -->
  </protocol>
  <supportingImmunization><!-- 0..* Reference(Immunization) Past immunizations supporting recommendation --></supportingImmunization>
  <supportingPatientInformation><!-- 0..* Reference(Observation|
    AllergyIntolerance) Patient observations supporting recommendation --></supportingPatientInformation>
 </recommendation>
</ImmunizationRecommendation>

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. ImmunizationRecommendation DomainResourceGuidance or advice relating to an immunization
... identifier Σ0..*IdentifierBusiness identifier
... patient Σ1..1Reference(Patient)Who this profile is for
... recommendation Σ1..*BackboneElementVaccine administration recommendations
.... date Σ1..1dateTimeDate recommendation created
.... vaccineCode Σ1..1CodeableConceptVaccine recommendation applies to
Vaccine Administered Value Set (Example)
.... doseNumber Σ0..1positiveIntRecommended dose number
.... forecastStatus Σ1..1CodeableConceptVaccine administration status
Immunization Recommendation Status Codes (Example)
.... dateCriterion 0..*BackboneElementDates governing proposed immunization
..... code 1..1CodeableConceptType of date
Immunization Recommendation Date Criterion Codes (Example)
..... value 1..1dateTimeRecommended date
.... protocol 0..1BackboneElementProtocol used by recommendation
..... doseSequence 0..1integerNumber of dose within sequence
..... description 0..1stringProtocol details
..... authority 0..1Reference(Organization)Who is responsible for protocol
..... series 0..1stringName of vaccination series
.... supportingImmunization 0..*Reference(Immunization)Past immunizations supporting recommendation
.... supportingPatientInformation 0..*Reference(Observation | AllergyIntolerance)Patient observations supporting recommendation

doco Documentation for this format

UML Diagram

ImmunizationRecommendation (DomainResource)A unique identifier assigned to this particular recommendation recordidentifier : Identifier [0..*]The patient for whom the recommendations are forpatient : Reference [1..1] « Patient »RecommendationThe date the immunization recommendation was createddate : dateTime [1..1]Vaccine that pertains to the recommendationvaccineCode : CodeableConcept [1..1] « The type of vaccine administered (Strength=Example)Vaccine Administered Value Set?? »This indicates the next recommended dose number (e.g. dose 2 is the next recommended dose)doseNumber : positiveInt [0..1]Vaccine administration statusforecastStatus : CodeableConcept [1..1] « The patient's status with respect to a vaccination protocol (Strength=Example)Immunization Recommendation S...?? »Immunization event history that supports the status and recommendationsupportingImmunization : Reference [0..*] « Immunization »Patient Information that supports the status and recommendation. This includes patient observations, adverse reactions and allergy/intolerance informationsupportingPatientInformation : Reference [0..*] « Observation| AllergyIntolerance »DateCriterionDate classification of recommendation - e.g. earliest date to give, latest date to give, etccode : CodeableConcept [1..1] « Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.) (Strength=Example)Immunization Recommendation D...?? »Date recommendationvalue : dateTime [1..1]ProtocolIndicates the nominal position in a series of the next dose. This is the recommended dose number as per a specified protocoldoseSequence : integer [0..1]Contains the description about the protocol under which the vaccine was administereddescription : string [0..1]Indicates the authority who published the protocol? E.g. ACIPauthority : Reference [0..1] « Organization »One possible path to achieve presumed immunity against a disease - within the context of an authorityseries : string [0..1]Vaccine date recommendations - e.g. earliest date to administer, latest date to administer, etcdateCriterion[0..*]Contains information about the protocol under which the vaccine was administeredprotocol[0..1]Vaccine administration recommendationsrecommendation[1..*]

XML Template

<ImmunizationRecommendation xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business identifier --></identifier>
 <patient><!-- 1..1 Reference(Patient) Who this profile is for --></patient>
 <recommendation>  <!-- 1..* Vaccine administration recommendations -->
  <date value="[dateTime]"/><!-- 1..1 Date recommendation created -->
  <vaccineCode><!-- 1..1 CodeableConcept Vaccine recommendation applies to --></vaccineCode>
  <doseNumber value="[positiveInt]"/><!-- 0..1 Recommended dose number -->
  <forecastStatus><!-- 1..1 CodeableConcept Vaccine administration status --></forecastStatus>
  <dateCriterion>  <!-- 0..* Dates governing proposed immunization -->
   <code><!-- 1..1 CodeableConcept Type of date --></code>
   <value value="[dateTime]"/><!-- 1..1 Recommended date -->
  </dateCriterion>
  <protocol>  <!-- 0..1 Protocol used by recommendation -->
   <doseSequence value="[integer]"/><!-- 0..1 Number of dose within sequence -->
   <description value="[string]"/><!-- 0..1 Protocol details -->
   <authority><!-- 0..1 Reference(Organization) Who is responsible for protocol --></authority>
   <series value="[string]"/><!-- 0..1 Name of vaccination series -->
  </protocol>
  <supportingImmunization><!-- 0..* Reference(Immunization) Past immunizations supporting recommendation --></supportingImmunization>
  <supportingPatientInformation><!-- 0..* Reference(Observation|
    AllergyIntolerance) Patient observations supporting recommendation --></supportingPatientInformation>
 </recommendation>
</ImmunizationRecommendation>

 

Alternate definitions: Schema/Schematron, Resource Profile (XML, JSON), Questionnaire

4.19.3.1 Terminology Bindings

PathDefinitionTypeReference
ImmunizationRecommendation.recommendation.vaccineCode The type of vaccine administeredExampleVaccine Administered Value Set
ImmunizationRecommendation.recommendation.forecastStatus The patient's status with respect to a vaccination protocolExampleImmunization Recommendation Status Codes
ImmunizationRecommendation.recommendation.dateCriterion.code Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.)ExampleImmunization Recommendation Date Criterion Codes

4.19.4 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

NameTypeDescriptionPaths
datedateDate recommendation createdImmunizationRecommendation.recommendation.date
dose-numbernumberRecommended dose numberImmunizationRecommendation.recommendation.doseNumber
dose-sequencenumberNumber of dose within sequenceImmunizationRecommendation.recommendation.protocol.doseSequence
identifiertokenBusiness identifierImmunizationRecommendation.identifier
informationreferencePatient observations supporting recommendationImmunizationRecommendation.recommendation.supportingPatientInformation
(AllergyIntolerance, Observation)
patientreferenceWho this profile is forImmunizationRecommendation.patient
(Patient)
statustokenVaccine administration statusImmunizationRecommendation.recommendation.forecastStatus
supportreferencePast immunizations supporting recommendationImmunizationRecommendation.recommendation.supportingImmunization
(Immunization)
vaccine-typetokenVaccine recommendation applies toImmunizationRecommendation.recommendation.vaccineCode