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11.6 Resource Immunization - Content

Public Health and Emergency Response

Work Group

Maturity Level: 1

Compartments: Patient, Practitioner

Describes the event of a patient being administered a vaccination or a record of a vaccination as reported by a patient, a clinician or another party and may include vaccine reaction information and what vaccination protocol was followed.

11.6.1 Scope and Usage

The Immunization resource is intended to cover the recording of current and historical administration of vaccines to patients across all healthcare disciplines in all care settings and all regions. This includes immunization of both humans and animals, but does not include the administration of non-vaccine agents, even those that may have or claim to have immunological effects.

Additionally, the Immunization resource is expected to cover key concepts related to the creation, revision and querying of a patient's immunization history. 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 v2 immunization implementation guide, HL7 v3 POIZ domain and Immunization Domain Analysis Model.

11.6.2 Boundaries and Relationships

This resource references the following resources:

Patient
Practitioner
Organization
Location
Observation
Encounter

Administration of vaccines is intended to be handled using the Immunization resource. MedicationAdministration is intended for tracking the administration of non-vaccine medications. Some systems treat immunizations in the same way as any other medication administration. Such systems SHOULD use an immunization resource to represent these. If systems need to use a MedicationAdministration resource to capture vaccinations for workflow or other reasons, they SHOULD also expose an equivalent Immunization instance.

AllergyIntolerance and Immunization.reaction

Immunization.reaction may be an indication of an allergy or intolerance. If this is deemed to be the case, a separate AllergyIntolerance resource instance should be created to indicate it, as most systems will not query against past Immunization.reaction.

This resource is referenced by immunizationrecommendation

Structure

Name	Flags	Card.	Type	Description & Constraints
Immunization	I		DomainResource	Immunization event information If immunization was administered (wasNotGiven=false) then explanation.reasonNotGiven SHALL be absent. If immunization was not administered (wasNotGiven=true) then there SHALL be no reaction nor explanation.reason present
identifier		0..*	Identifier	Business identifier
status	?!Σ	1..1	code	completed \| entered-in-error Immunization Status Codes (Required)
date		0..1	dateTime	Vaccination administration date
vaccineCode		1..1	CodeableConcept	Vaccine product administered Vaccine Administered Value Set (Example)
patient		1..1	Reference(Patient)	Who was immunized
wasNotGiven	?!Σ	1..1	boolean	Flag for whether immunization was given
primarySource		1..1	boolean	Indicates context the data was recorded in
reportOrigin		0..1	CodeableConcept	Indicates the source of a secondarily reported record ImmunizationOrigin (Example)
performer		0..1	Reference(Practitioner)	Who administered vaccine
requester		0..1	Reference(Practitioner)	Who ordered vaccination
encounter		0..1	Reference(Encounter)	Encounter administered as part of
manufacturer		0..1	Reference(Organization)	Vaccine manufacturer
location		0..1	Reference(Location)	Where vaccination occurred
lotNumber		0..1	string	Vaccine lot number
expirationDate		0..1	date	Vaccine expiration date
site		0..1	CodeableConcept	Body site vaccine was administered Codes for Immunization Site of Administration (Example)
route		0..1	CodeableConcept	How vaccine entered body Immunization Route Codes (Example)
doseQuantity		0..1	SimpleQuantity	Amount of vaccine administered
note	Σ	0..*	Annotation	Vaccination notes
explanation		0..1	BackboneElement	Administration/non-administration reasons
reason		0..*	CodeableConcept	Why immunization occurred Immunization Reason Codes (Example)
reasonNotGiven		0..*	CodeableConcept	Why immunization did not occur Immunization Reasons for Not Immunizing Codes (Example)
reaction		0..*	BackboneElement	Details of a reaction that follows immunization
date		0..1	dateTime	When reaction started
detail		0..1	Reference(Observation)	Additional information on reaction
reported		0..1	boolean	Indicates self-reported reaction
vaccinationProtocol		0..*	BackboneElement	What protocol was followed
doseSequence		0..1	positiveInt	Dose number within series
description		0..1	string	Details of vaccine protocol
authority		0..1	Reference(Organization)	Who is responsible for protocol
series		0..1	string	Name of vaccine series
seriesDoses		0..1	positiveInt	Recommended number of doses for immunity
targetDisease		1..*	CodeableConcept	Disease immunized against Vaccination Protocol Dose Target Codes (Example)
doseStatus		1..1	CodeableConcept	Indicates if dose counts towards immunity Vaccination Protocol Dose Status codes (Example)
doseStatusReason		0..1	CodeableConcept	Why dose does (not) count Vaccination Protocol Dose Status Reason codes (Example)
Documentation for this format

UML Diagram (Legend)

XML Template

<Immunization xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business identifier --></identifier>
 <status value="[code]"/><!-- 1..1 completed | entered-in-error -->
 <date value="[dateTime]"/><!-- 0..1 Vaccination administration date -->
 <vaccineCode><!-- 1..1 CodeableConcept Vaccine product administered --></vaccineCode>
 <patient><!-- 1..1 Reference(Patient) Who was immunized --></patient>
 <wasNotGiven value="[boolean]"/><!-- 1..1 Flag for whether immunization was given -->
 <primarySource value="[boolean]"/><!-- 1..1 Indicates context the data was recorded in -->
 <reportOrigin><!-- 0..1 CodeableConcept Indicates the source of a secondarily reported record --></reportOrigin>
 <performer><!-- 0..1 Reference(Practitioner) Who administered vaccine --></performer>
 <requester><!-- 0..1 Reference(Practitioner) Who ordered vaccination --></requester>
 <encounter><!-- 0..1 Reference(Encounter) Encounter administered as part of --></encounter>
 <manufacturer><!-- 0..1 Reference(Organization) Vaccine manufacturer --></manufacturer>
 <location><!-- 0..1 Reference(Location) Where vaccination occurred --></location>
 <lotNumber value="[string]"/><!-- 0..1 Vaccine lot number -->
 <expirationDate value="[date]"/><!-- 0..1 Vaccine expiration date -->
 <site><!-- 0..1 CodeableConcept Body site vaccine  was administered --></site>
 <route><!-- 0..1 CodeableConcept How vaccine entered body --></route>
 <doseQuantity><!-- 0..1 Quantity(SimpleQuantity) Amount of vaccine administered --></doseQuantity>
 <note><!-- 0..* Annotation Vaccination notes --></note>
 <explanation>  <!-- 0..1 Administration/non-administration reasons -->
  <reason><!-- 0..* CodeableConcept Why immunization occurred --></reason>
  <reasonNotGiven><!-- 0..* CodeableConcept Why immunization did not occur --></reasonNotGiven>
 </explanation>
 <reaction>  <!-- 0..* Details of a reaction that follows immunization -->
  <date value="[dateTime]"/><!-- 0..1 When reaction started -->
  <detail><!-- 0..1 Reference(Observation) Additional information on reaction --></detail>
  <reported value="[boolean]"/><!-- 0..1 Indicates self-reported reaction -->
 </reaction>
 <vaccinationProtocol>  <!-- 0..* What protocol was followed -->
  <doseSequence value="[positiveInt]"/><!-- 0..1 Dose number within series -->
  <description value="[string]"/><!-- 0..1 Details of vaccine protocol -->
  <authority><!-- 0..1 Reference(Organization) Who is responsible for protocol --></authority>
  <series value="[string]"/><!-- 0..1 Name of vaccine series -->
  <seriesDoses value="[positiveInt]"/><!-- 0..1 Recommended number of doses for immunity -->
  <targetDisease><!-- 1..* CodeableConcept Disease immunized against --></targetDisease>
  <doseStatus><!-- 1..1 CodeableConcept Indicates if dose counts towards immunity --></doseStatus>
  <doseStatusReason><!-- 0..1 CodeableConcept Why dose does (not) count --></doseStatusReason>
 </vaccinationProtocol>
</Immunization>

JSON Template

{
  "resourceType" : "Immunization",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business identifier
  "status" : "<code>", // R!  completed | entered-in-error
  "date" : "<dateTime>", // Vaccination administration date
  "vaccineCode" : { CodeableConcept }, // R!  Vaccine product administered
  "patient" : { Reference(Patient) }, // R!  Who was immunized
  "wasNotGiven" : <boolean>, // R!  Flag for whether immunization was given
  "primarySource" : <boolean>, // R!  Indicates context the data was recorded in
  "reportOrigin" : { CodeableConcept }, // Indicates the source of a secondarily reported record
  "performer" : { Reference(Practitioner) }, // Who administered vaccine
  "requester" : { Reference(Practitioner) }, // Who ordered vaccination
  "encounter" : { Reference(Encounter) }, // Encounter administered as part of
  "manufacturer" : { Reference(Organization) }, // Vaccine manufacturer
  "location" : { Reference(Location) }, // Where vaccination occurred
  "lotNumber" : "<string>", // Vaccine lot number
  "expirationDate" : "<date>", // Vaccine expiration date
  "site" : { CodeableConcept }, // Body site vaccine  was administered
  "route" : { CodeableConcept }, // How vaccine entered body
  "doseQuantity" : { Quantity(SimpleQuantity) }, // Amount of vaccine administered
  "note" : [{ Annotation }], // Vaccination notes
  "explanation" : { // Administration/non-administration reasons
    "reason" : [{ CodeableConcept }], // Why immunization occurred
    "reasonNotGiven" : [{ CodeableConcept }] // Why immunization did not occur
  },
  "reaction" : [{ // Details of a reaction that follows immunization
    "date" : "<dateTime>", // When reaction started
    "detail" : { Reference(Observation) }, // Additional information on reaction
    "reported" : <boolean> // Indicates self-reported reaction
  }],
  "vaccinationProtocol" : [{ // What protocol was followed
    "doseSequence" : "<positiveInt>", // Dose number within series
    "description" : "<string>", // Details of vaccine protocol
    "authority" : { Reference(Organization) }, // Who is responsible for protocol
    "series" : "<string>", // Name of vaccine series
    "seriesDoses" : "<positiveInt>", // Recommended number of doses for immunity
    "targetDisease" : [{ CodeableConcept }], // R!  Disease immunized against
    "doseStatus" : { CodeableConcept }, // R!  Indicates if dose counts towards immunity
    "doseStatusReason" : { CodeableConcept } // Why dose does (not) count
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:Immunization;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Immunization.identifier [ Identifier ], ... ; # 0..* Business identifier
  fhir:Immunization.status [ code ]; # 1..1 completed | entered-in-error
  fhir:Immunization.date [ dateTime ]; # 0..1 Vaccination administration date
  fhir:Immunization.vaccineCode [ CodeableConcept ]; # 1..1 Vaccine product administered
  fhir:Immunization.patient [ Reference(Patient) ]; # 1..1 Who was immunized
  fhir:Immunization.wasNotGiven [ boolean ]; # 1..1 Flag for whether immunization was given
  fhir:Immunization.primarySource [ boolean ]; # 1..1 Indicates context the data was recorded in
  fhir:Immunization.reportOrigin [ CodeableConcept ]; # 0..1 Indicates the source of a secondarily reported record
  fhir:Immunization.performer [ Reference(Practitioner) ]; # 0..1 Who administered vaccine
  fhir:Immunization.requester [ Reference(Practitioner) ]; # 0..1 Who ordered vaccination
  fhir:Immunization.encounter [ Reference(Encounter) ]; # 0..1 Encounter administered as part of
  fhir:Immunization.manufacturer [ Reference(Organization) ]; # 0..1 Vaccine manufacturer
  fhir:Immunization.location [ Reference(Location) ]; # 0..1 Where vaccination occurred
  fhir:Immunization.lotNumber [ string ]; # 0..1 Vaccine lot number
  fhir:Immunization.expirationDate [ date ]; # 0..1 Vaccine expiration date
  fhir:Immunization.site [ CodeableConcept ]; # 0..1 Body site vaccine  was administered
  fhir:Immunization.route [ CodeableConcept ]; # 0..1 How vaccine entered body
  fhir:Immunization.doseQuantity [ Quantity(SimpleQuantity) ]; # 0..1 Amount of vaccine administered
  fhir:Immunization.note [ Annotation ], ... ; # 0..* Vaccination notes
  fhir:Immunization.explanation [ # 0..1 Administration/non-administration reasons
    fhir:Immunization.explanation.reason [ CodeableConcept ], ... ; # 0..* Why immunization occurred
    fhir:Immunization.explanation.reasonNotGiven [ CodeableConcept ], ... ; # 0..* Why immunization did not occur
  ];
  fhir:Immunization.reaction [ # 0..* Details of a reaction that follows immunization
    fhir:Immunization.reaction.date [ dateTime ]; # 0..1 When reaction started
    fhir:Immunization.reaction.detail [ Reference(Observation) ]; # 0..1 Additional information on reaction
    fhir:Immunization.reaction.reported [ boolean ]; # 0..1 Indicates self-reported reaction
  ], ...;
  fhir:Immunization.vaccinationProtocol [ # 0..* What protocol was followed
    fhir:Immunization.vaccinationProtocol.doseSequence [ positiveInt ]; # 0..1 Dose number within series
    fhir:Immunization.vaccinationProtocol.description [ string ]; # 0..1 Details of vaccine protocol
    fhir:Immunization.vaccinationProtocol.authority [ Reference(Organization) ]; # 0..1 Who is responsible for protocol
    fhir:Immunization.vaccinationProtocol.series [ string ]; # 0..1 Name of vaccine series
    fhir:Immunization.vaccinationProtocol.seriesDoses [ positiveInt ]; # 0..1 Recommended number of doses for immunity
    fhir:Immunization.vaccinationProtocol.targetDisease [ CodeableConcept ], ... ; # 1..* Disease immunized against
    fhir:Immunization.vaccinationProtocol.doseStatus [ CodeableConcept ]; # 1..1 Indicates if dose counts towards immunity
    fhir:Immunization.vaccinationProtocol.doseStatusReason [ CodeableConcept ]; # 0..1 Why dose does (not) count
  ], ...;
]

Changes since DSTU2

Immunization

Immunization.status

Change value set from http://hl7.org/fhir/ValueSet/medication-admin-status to http://hl7.org/fhir/ValueSet/immunization-status

Immunization.primarySource

added Element

Immunization.reportOrigin

added Element

Immunization.vaccinationProtocol.doseSequence

Min Cardinality changed from 1 to 0

Immunization.reported

deleted

See the Full Difference for further information

Structure

Name	Flags	Card.	Type	Description & Constraints
Immunization	I		DomainResource	Immunization event information If immunization was administered (wasNotGiven=false) then explanation.reasonNotGiven SHALL be absent. If immunization was not administered (wasNotGiven=true) then there SHALL be no reaction nor explanation.reason present
identifier		0..*	Identifier	Business identifier
status	?!Σ	1..1	code	completed \| entered-in-error Immunization Status Codes (Required)
date		0..1	dateTime	Vaccination administration date
vaccineCode		1..1	CodeableConcept	Vaccine product administered Vaccine Administered Value Set (Example)
patient		1..1	Reference(Patient)	Who was immunized
wasNotGiven	?!Σ	1..1	boolean	Flag for whether immunization was given
primarySource		1..1	boolean	Indicates context the data was recorded in
reportOrigin		0..1	CodeableConcept	Indicates the source of a secondarily reported record ImmunizationOrigin (Example)
performer		0..1	Reference(Practitioner)	Who administered vaccine
requester		0..1	Reference(Practitioner)	Who ordered vaccination
encounter		0..1	Reference(Encounter)	Encounter administered as part of
manufacturer		0..1	Reference(Organization)	Vaccine manufacturer
location		0..1	Reference(Location)	Where vaccination occurred
lotNumber		0..1	string	Vaccine lot number
expirationDate		0..1	date	Vaccine expiration date
site		0..1	CodeableConcept	Body site vaccine was administered Codes for Immunization Site of Administration (Example)
route		0..1	CodeableConcept	How vaccine entered body Immunization Route Codes (Example)
doseQuantity		0..1	SimpleQuantity	Amount of vaccine administered
note	Σ	0..*	Annotation	Vaccination notes
explanation		0..1	BackboneElement	Administration/non-administration reasons
reason		0..*	CodeableConcept	Why immunization occurred Immunization Reason Codes (Example)
reasonNotGiven		0..*	CodeableConcept	Why immunization did not occur Immunization Reasons for Not Immunizing Codes (Example)
reaction		0..*	BackboneElement	Details of a reaction that follows immunization
date		0..1	dateTime	When reaction started
detail		0..1	Reference(Observation)	Additional information on reaction
reported		0..1	boolean	Indicates self-reported reaction
vaccinationProtocol		0..*	BackboneElement	What protocol was followed
doseSequence		0..1	positiveInt	Dose number within series
description		0..1	string	Details of vaccine protocol
authority		0..1	Reference(Organization)	Who is responsible for protocol
series		0..1	string	Name of vaccine series
seriesDoses		0..1	positiveInt	Recommended number of doses for immunity
targetDisease		1..*	CodeableConcept	Disease immunized against Vaccination Protocol Dose Target Codes (Example)
doseStatus		1..1	CodeableConcept	Indicates if dose counts towards immunity Vaccination Protocol Dose Status codes (Example)
doseStatusReason		0..1	CodeableConcept	Why dose does (not) count Vaccination Protocol Dose Status Reason codes (Example)
Documentation for this format

UML Diagram (Legend)

XML Template

<Immunization xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business identifier --></identifier>
 <status value="[code]"/><!-- 1..1 completed | entered-in-error -->
 <date value="[dateTime]"/><!-- 0..1 Vaccination administration date -->
 <vaccineCode><!-- 1..1 CodeableConcept Vaccine product administered --></vaccineCode>
 <patient><!-- 1..1 Reference(Patient) Who was immunized --></patient>
 <wasNotGiven value="[boolean]"/><!-- 1..1 Flag for whether immunization was given -->
 <primarySource value="[boolean]"/><!-- 1..1 Indicates context the data was recorded in -->
 <reportOrigin><!-- 0..1 CodeableConcept Indicates the source of a secondarily reported record --></reportOrigin>
 <performer><!-- 0..1 Reference(Practitioner) Who administered vaccine --></performer>
 <requester><!-- 0..1 Reference(Practitioner) Who ordered vaccination --></requester>
 <encounter><!-- 0..1 Reference(Encounter) Encounter administered as part of --></encounter>
 <manufacturer><!-- 0..1 Reference(Organization) Vaccine manufacturer --></manufacturer>
 <location><!-- 0..1 Reference(Location) Where vaccination occurred --></location>
 <lotNumber value="[string]"/><!-- 0..1 Vaccine lot number -->
 <expirationDate value="[date]"/><!-- 0..1 Vaccine expiration date -->
 <site><!-- 0..1 CodeableConcept Body site vaccine  was administered --></site>
 <route><!-- 0..1 CodeableConcept How vaccine entered body --></route>
 <doseQuantity><!-- 0..1 Quantity(SimpleQuantity) Amount of vaccine administered --></doseQuantity>
 <note><!-- 0..* Annotation Vaccination notes --></note>
 <explanation>  <!-- 0..1 Administration/non-administration reasons -->
  <reason><!-- 0..* CodeableConcept Why immunization occurred --></reason>
  <reasonNotGiven><!-- 0..* CodeableConcept Why immunization did not occur --></reasonNotGiven>
 </explanation>
 <reaction>  <!-- 0..* Details of a reaction that follows immunization -->
  <date value="[dateTime]"/><!-- 0..1 When reaction started -->
  <detail><!-- 0..1 Reference(Observation) Additional information on reaction --></detail>
  <reported value="[boolean]"/><!-- 0..1 Indicates self-reported reaction -->
 </reaction>
 <vaccinationProtocol>  <!-- 0..* What protocol was followed -->
  <doseSequence value="[positiveInt]"/><!-- 0..1 Dose number within series -->
  <description value="[string]"/><!-- 0..1 Details of vaccine protocol -->
  <authority><!-- 0..1 Reference(Organization) Who is responsible for protocol --></authority>
  <series value="[string]"/><!-- 0..1 Name of vaccine series -->
  <seriesDoses value="[positiveInt]"/><!-- 0..1 Recommended number of doses for immunity -->
  <targetDisease><!-- 1..* CodeableConcept Disease immunized against --></targetDisease>
  <doseStatus><!-- 1..1 CodeableConcept Indicates if dose counts towards immunity --></doseStatus>
  <doseStatusReason><!-- 0..1 CodeableConcept Why dose does (not) count --></doseStatusReason>
 </vaccinationProtocol>
</Immunization>

JSON Template

{
  "resourceType" : "Immunization",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business identifier
  "status" : "<code>", // R!  completed | entered-in-error
  "date" : "<dateTime>", // Vaccination administration date
  "vaccineCode" : { CodeableConcept }, // R!  Vaccine product administered
  "patient" : { Reference(Patient) }, // R!  Who was immunized
  "wasNotGiven" : <boolean>, // R!  Flag for whether immunization was given
  "primarySource" : <boolean>, // R!  Indicates context the data was recorded in
  "reportOrigin" : { CodeableConcept }, // Indicates the source of a secondarily reported record
  "performer" : { Reference(Practitioner) }, // Who administered vaccine
  "requester" : { Reference(Practitioner) }, // Who ordered vaccination
  "encounter" : { Reference(Encounter) }, // Encounter administered as part of
  "manufacturer" : { Reference(Organization) }, // Vaccine manufacturer
  "location" : { Reference(Location) }, // Where vaccination occurred
  "lotNumber" : "<string>", // Vaccine lot number
  "expirationDate" : "<date>", // Vaccine expiration date
  "site" : { CodeableConcept }, // Body site vaccine  was administered
  "route" : { CodeableConcept }, // How vaccine entered body
  "doseQuantity" : { Quantity(SimpleQuantity) }, // Amount of vaccine administered
  "note" : [{ Annotation }], // Vaccination notes
  "explanation" : { // Administration/non-administration reasons
    "reason" : [{ CodeableConcept }], // Why immunization occurred
    "reasonNotGiven" : [{ CodeableConcept }] // Why immunization did not occur
  },
  "reaction" : [{ // Details of a reaction that follows immunization
    "date" : "<dateTime>", // When reaction started
    "detail" : { Reference(Observation) }, // Additional information on reaction
    "reported" : <boolean> // Indicates self-reported reaction
  }],
  "vaccinationProtocol" : [{ // What protocol was followed
    "doseSequence" : "<positiveInt>", // Dose number within series
    "description" : "<string>", // Details of vaccine protocol
    "authority" : { Reference(Organization) }, // Who is responsible for protocol
    "series" : "<string>", // Name of vaccine series
    "seriesDoses" : "<positiveInt>", // Recommended number of doses for immunity
    "targetDisease" : [{ CodeableConcept }], // R!  Disease immunized against
    "doseStatus" : { CodeableConcept }, // R!  Indicates if dose counts towards immunity
    "doseStatusReason" : { CodeableConcept } // Why dose does (not) count
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:Immunization;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Immunization.identifier [ Identifier ], ... ; # 0..* Business identifier
  fhir:Immunization.status [ code ]; # 1..1 completed | entered-in-error
  fhir:Immunization.date [ dateTime ]; # 0..1 Vaccination administration date
  fhir:Immunization.vaccineCode [ CodeableConcept ]; # 1..1 Vaccine product administered
  fhir:Immunization.patient [ Reference(Patient) ]; # 1..1 Who was immunized
  fhir:Immunization.wasNotGiven [ boolean ]; # 1..1 Flag for whether immunization was given
  fhir:Immunization.primarySource [ boolean ]; # 1..1 Indicates context the data was recorded in
  fhir:Immunization.reportOrigin [ CodeableConcept ]; # 0..1 Indicates the source of a secondarily reported record
  fhir:Immunization.performer [ Reference(Practitioner) ]; # 0..1 Who administered vaccine
  fhir:Immunization.requester [ Reference(Practitioner) ]; # 0..1 Who ordered vaccination
  fhir:Immunization.encounter [ Reference(Encounter) ]; # 0..1 Encounter administered as part of
  fhir:Immunization.manufacturer [ Reference(Organization) ]; # 0..1 Vaccine manufacturer
  fhir:Immunization.location [ Reference(Location) ]; # 0..1 Where vaccination occurred
  fhir:Immunization.lotNumber [ string ]; # 0..1 Vaccine lot number
  fhir:Immunization.expirationDate [ date ]; # 0..1 Vaccine expiration date
  fhir:Immunization.site [ CodeableConcept ]; # 0..1 Body site vaccine  was administered
  fhir:Immunization.route [ CodeableConcept ]; # 0..1 How vaccine entered body
  fhir:Immunization.doseQuantity [ Quantity(SimpleQuantity) ]; # 0..1 Amount of vaccine administered
  fhir:Immunization.note [ Annotation ], ... ; # 0..* Vaccination notes
  fhir:Immunization.explanation [ # 0..1 Administration/non-administration reasons
    fhir:Immunization.explanation.reason [ CodeableConcept ], ... ; # 0..* Why immunization occurred
    fhir:Immunization.explanation.reasonNotGiven [ CodeableConcept ], ... ; # 0..* Why immunization did not occur
  ];
  fhir:Immunization.reaction [ # 0..* Details of a reaction that follows immunization
    fhir:Immunization.reaction.date [ dateTime ]; # 0..1 When reaction started
    fhir:Immunization.reaction.detail [ Reference(Observation) ]; # 0..1 Additional information on reaction
    fhir:Immunization.reaction.reported [ boolean ]; # 0..1 Indicates self-reported reaction
  ], ...;
  fhir:Immunization.vaccinationProtocol [ # 0..* What protocol was followed
    fhir:Immunization.vaccinationProtocol.doseSequence [ positiveInt ]; # 0..1 Dose number within series
    fhir:Immunization.vaccinationProtocol.description [ string ]; # 0..1 Details of vaccine protocol
    fhir:Immunization.vaccinationProtocol.authority [ Reference(Organization) ]; # 0..1 Who is responsible for protocol
    fhir:Immunization.vaccinationProtocol.series [ string ]; # 0..1 Name of vaccine series
    fhir:Immunization.vaccinationProtocol.seriesDoses [ positiveInt ]; # 0..1 Recommended number of doses for immunity
    fhir:Immunization.vaccinationProtocol.targetDisease [ CodeableConcept ], ... ; # 1..* Disease immunized against
    fhir:Immunization.vaccinationProtocol.doseStatus [ CodeableConcept ]; # 1..1 Indicates if dose counts towards immunity
    fhir:Immunization.vaccinationProtocol.doseStatusReason [ CodeableConcept ]; # 0..1 Why dose does (not) count
  ], ...;
]

Changes since DSTU2

Immunization

Immunization.status

Change value set from http://hl7.org/fhir/ValueSet/medication-admin-status to http://hl7.org/fhir/ValueSet/immunization-status

Immunization.primarySource

added Element

Immunization.reportOrigin

added Element

Immunization.vaccinationProtocol.doseSequence

Min Cardinality changed from 1 to 0

Immunization.reported

deleted

See the Full Difference for further information

Alternate definitions: Master Definition (XML, JSON), XML Schema/Schematron (for ) + JSON Schema, ShEx (for Turtle), JSON-LD (for RDF as JSON-LD),

11.6.3.1 Terminology Bindings

Path	Definition	Type	Reference
Immunization.status	A set of codes indicating the current status of an Immunization	Required	Immunization Status Codes
Immunization.vaccineCode	The code for vaccine product administered	Example	Vaccine Administered Value Set
Immunization.reportOrigin	The source of the data for a record which is not from a primary source.	Example	ImmunizationOrigin
Immunization.site	The site at which the vaccine was administered	Example	Codes for Immunization Site of Administration
Immunization.route	The route by which the vaccine was administered	Example	Immunization Route Codes
Immunization.explanation.reason	The reason why a vaccine was administered	Example	Immunization Reason Codes
Immunization.explanation.reasonNotGiven	The reason why a vaccine was not administered	Example	Immunization Reasons for Not Immunizing Codes
Immunization.vaccinationProtocol.targetDisease	The disease target of the vaccination protocol	Example	Vaccination Protocol Dose Target Codes
Immunization.vaccinationProtocol.doseStatus	The status of the vaccination protocol (i.e. should this count)	Example	Vaccination Protocol Dose Status codes
Immunization.vaccinationProtocol.doseStatusReason	The reason for the determining if a vaccination should count or why vaccination should not count.	Example	Vaccination Protocol Dose Status Reason codes

Path

Definition

Type

Reference

Immunization.status

A set of codes indicating the current status of an Immunization

Required

Immunization Status Codes

Immunization.vaccineCode

The code for vaccine product administered

Example

Vaccine Administered Value Set

Immunization.reportOrigin

The source of the data for a record which is not from a primary source.

Example

ImmunizationOrigin

Immunization.site

The site at which the vaccine was administered

Example

Codes for Immunization Site of Administration

Immunization.route

The route by which the vaccine was administered

Example

Immunization Route Codes

Immunization.explanation.reason

The reason why a vaccine was administered

Example

Immunization Reason Codes

Immunization.explanation.reasonNotGiven

The reason why a vaccine was not administered

Example

Immunization Reasons for Not Immunizing Codes

Immunization.vaccinationProtocol.targetDisease

The disease target of the vaccination protocol

Example

Vaccination Protocol Dose Target Codes

Immunization.vaccinationProtocol.doseStatus

The status of the vaccination protocol (i.e. should this count)

Example

Vaccination Protocol Dose Status codes

Immunization.vaccinationProtocol.doseStatusReason

The reason for the determining if a vaccination should count or why vaccination should not count.

Example

Vaccination Protocol Dose Status Reason codes

11.6.3.2 Constraints

imm-1: If immunization was not administered (wasNotGiven=true) then there SHALL be no reaction nor explanation.reason present (expression : (wasNotGiven = true).not() or (reaction.empty() and explanation.reason.empty()))
imm-2: If immunization was administered (wasNotGiven=false) then explanation.reasonNotGiven SHALL be absent. (expression : (wasNotGiven = true) or explanation.reasonNotGiven.empty())

11.6.4 Search Parameters

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

Name	Type	Description	Paths	In Common
date	date	Vaccination (non)-Administration Date	Immunization.date	18 Resources
dose-sequence	number	Dose number within series	Immunization.vaccinationProtocol.doseSequence
identifier	token	Business identifier	Immunization.identifier	26 Resources
location	reference	The service delivery location or facility in which the vaccine was / was to be administered	Immunization.location (Location)
lot-number	string	Vaccine Lot Number	Immunization.lotNumber
manufacturer	reference	Vaccine Manufacturer	Immunization.manufacturer (Organization)
notgiven	token	Administrations which were not given	Immunization.wasNotGiven
patient	reference	The patient for the vaccination record	Immunization.patient (Patient)	31 Resources
performer	reference	The practitioner who administered the vaccination	Immunization.performer (Practitioner)
reaction	reference	Additional information on reaction	Immunization.reaction.detail (Observation)
reaction-date	date	When reaction started	Immunization.reaction.date
reason	token	Why immunization occurred	Immunization.explanation.reason
reason-not-given	token	Explanation of reason vaccination was not administered	Immunization.explanation.reasonNotGiven
requester	reference	The practitioner who ordered the vaccination	Immunization.requester (Practitioner)
status	token	Immunization event status	Immunization.status
vaccine-code	token	Vaccine Product Administered	Immunization.vaccineCode