This page is part of the FHIR Specification (v3.3.0: R4 Ballot 2). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2
Public Health and Emergency Response Work Group | Maturity Level: 1 | Trial Use | Compartments: Patient |
A patient's point-in-time set of recommendations (i.e. forecasting) according to a published schedule with optional supporting justification.
STU Note: The Public Health work group wants to draw the attention of reviewers and implementers to the following issues for feedback:
- ImmunizationRecommendation.recommendation is allowed to repeat, meaning that multiple recommendations for a given patient can be contained in a single resouce. This ensures that if the recommendations are interrelated, they are available in the same resource (for example, multiple doses of the same vaccine are recommended at different points in the future). Is the preference to allow repetitions of the recommendation backbone element or should the core resource constrain the cardinality to 1..1?
- The ImmunizationRecommendation resource can be thought of as a specialization of a generic recommendation (for a medication or a procedure, etc.). Is it better to have a single generic recommendation resource that is then profiled for use in specific domains (immunization recommendation, imaging recommendation, etc.) or individual, specific resources for each domain which require less profiling and may be easier for domain implementers to understand?
- Should the ImmunizationEvaluation resource be harmonized with the CDS Hooks project?
The ImmunizationRecommendation resource is intended to cover communication of a specified patient's immunization recommendations and status across all healthcare disciplines in all care settings and all regions. The set of customized (for the patient) recommendations is based on the comparison of the patient's immunization history with a set of published recommendations (protocols).
Additionally, the ImmunizationRecommendation resource is expected to cover key concepts related to the querying of a patient's immunization recommendations and status. This resource - through consultation with the Public Health 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.
This resource references the following resources:
This resource is referenced by DiagnosticReport and Observation
Structure
Name | Flags | Card. | Type | Description & Constraints |
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ImmunizationRecommendation | TU | DomainResource | Guidance or advice relating to an immunization Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension | |
identifier | Σ | 0..* | Identifier | Business identifier |
patient | Σ | 1..1 | Reference(Patient) | Who this profile is for |
date | Σ | 1..1 | dateTime | Date recommendation(s) created |
authority | 0..1 | Reference(Organization) | Who is responsible for protocol | |
recommendation | ΣI | 1..* | BackboneElement | Vaccine administration recommendations + One of vaccineCode or targetDisease SHALL be present |
vaccineCode | Σ | 0..* | CodeableConcept | Vaccine or vaccine group recommendation applies to Vaccine Administered Value Set (Example) |
targetDisease | Σ | 0..1 | CodeableConcept | Disease to be immunized against Immunization Recommendation Target Disease Codes (Example) |
contraindicatedVaccineCode | Σ | 0..* | CodeableConcept | Vaccine which is contraindicated to fulfill the recommendation Vaccine Administered Value Set (Example) |
forecastStatus | ?!Σ | 1..1 | CodeableConcept | Vaccine recommendation status Immunization Recommendation Status Codes (Example) |
forecastReason | Σ | 0..* | CodeableConcept | Vaccine administration status reason Immunization Recommendation Reason Codes (Example) |
dateCriterion | 0..* | BackboneElement | Dates governing proposed immunization | |
code | 1..1 | CodeableConcept | Type of date Immunization Recommendation Date Criterion Codes (Example) | |
value | 1..1 | dateTime | Recommended date | |
description | 0..1 | string | Protocol details | |
series | 0..1 | string | Name of vaccination series | |
doseNumber[x] | Σ | 0..1 | Recommended dose number within series | |
doseNumberPositiveInt | positiveInt | |||
doseNumberString | string | |||
seriesDoses[x] | 0..1 | Recommended number of doses for immunity | ||
seriesDosesPositiveInt | positiveInt | |||
seriesDosesString | string | |||
supportingImmunization | 0..* | Reference(Immunization | ImmunizationEvaluation) | Past immunizations supporting recommendation | |
supportingPatientInformation | 0..* | Reference(Any) | Patient observations supporting recommendation | |
Documentation for this format |
UML Diagram (Legend)
XML Template
<ImmunizationRecommendation 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> <patient><!-- 1..1 Reference(Patient) Who this profile is for --></patient> <date value="[dateTime]"/><!-- 1..1 Date recommendation(s) created --> <authority><!-- 0..1 Reference(Organization) Who is responsible for protocol --></authority> <recommendation> <!-- 1..* Vaccine administration recommendations --> <vaccineCode><!-- 0..* CodeableConcept Vaccine or vaccine group recommendation applies to --></vaccineCode> <targetDisease><!-- 0..1 CodeableConcept Disease to be immunized against --></targetDisease> <contraindicatedVaccineCode><!-- 0..* CodeableConcept Vaccine which is contraindicated to fulfill the recommendation --></contraindicatedVaccineCode> <forecastStatus><!-- 1..1 CodeableConcept Vaccine recommendation status --></forecastStatus> <forecastReason><!-- 0..* CodeableConcept Vaccine administration status reason --></forecastReason> <dateCriterion> <!-- 0..* Dates governing proposed immunization --> <code><!-- 1..1 CodeableConcept Type of date --></code> <value value="[dateTime]"/><!-- 1..1 Recommended date --> </dateCriterion> <description value="[string]"/><!-- 0..1 Protocol details --> <series value="[string]"/><!-- 0..1 Name of vaccination series --> <doseNumber[x]><!-- 0..1 positiveInt|string Recommended dose number within series --></doseNumber[x]> <seriesDoses[x]><!-- 0..1 positiveInt|string Recommended number of doses for immunity --></seriesDoses[x]> <supportingImmunization><!-- 0..* Reference(Immunization|ImmunizationEvaluation) Past immunizations supporting recommendation --></supportingImmunization> <supportingPatientInformation><!-- 0..* Reference(Any) Patient observations supporting recommendation --></supportingPatientInformation> </recommendation> </ImmunizationRecommendation>
JSON Template
{ "resourceType" : "ImmunizationRecommendation", // from Resource: id, meta, implicitRules, and language // from DomainResource: text, contained, extension, and modifierExtension "identifier" : [{ Identifier }], // Business identifier "patient" : { Reference(Patient) }, // R! Who this profile is for "date" : "<dateTime>", // R! Date recommendation(s) created "authority" : { Reference(Organization) }, // Who is responsible for protocol "recommendation" : [{ // R! Vaccine administration recommendations "vaccineCode" : [{ CodeableConcept }], // Vaccine or vaccine group recommendation applies to "targetDisease" : { CodeableConcept }, // Disease to be immunized against "contraindicatedVaccineCode" : [{ CodeableConcept }], // Vaccine which is contraindicated to fulfill the recommendation "forecastStatus" : { CodeableConcept }, // R! Vaccine recommendation status "forecastReason" : [{ CodeableConcept }], // Vaccine administration status reason "dateCriterion" : [{ // Dates governing proposed immunization "code" : { CodeableConcept }, // R! Type of date "value" : "<dateTime>" // R! Recommended date }], "description" : "<string>", // Protocol details "series" : "<string>", // Name of vaccination series // doseNumber[x]: Recommended dose number within series. One of these 2: "doseNumberPositiveInt" : "<positiveInt>", "doseNumberString" : "<string>", // seriesDoses[x]: Recommended number of doses for immunity. One of these 2: "seriesDosesPositiveInt" : "<positiveInt>", "seriesDosesString" : "<string>", "supportingImmunization" : [{ Reference(Immunization|ImmunizationEvaluation) }], // Past immunizations supporting recommendation "supportingPatientInformation" : [{ Reference(Any) }] // Patient observations supporting recommendation }] }
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> . [ a fhir:ImmunizationRecommendation; 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:ImmunizationRecommendation.identifier [ Identifier ], ... ; # 0..* Business identifier fhir:ImmunizationRecommendation.patient [ Reference(Patient) ]; # 1..1 Who this profile is for fhir:ImmunizationRecommendation.date [ dateTime ]; # 1..1 Date recommendation(s) created fhir:ImmunizationRecommendation.authority [ Reference(Organization) ]; # 0..1 Who is responsible for protocol fhir:ImmunizationRecommendation.recommendation [ # 1..* Vaccine administration recommendations fhir:ImmunizationRecommendation.recommendation.vaccineCode [ CodeableConcept ], ... ; # 0..* Vaccine or vaccine group recommendation applies to fhir:ImmunizationRecommendation.recommendation.targetDisease [ CodeableConcept ]; # 0..1 Disease to be immunized against fhir:ImmunizationRecommendation.recommendation.contraindicatedVaccineCode [ CodeableConcept ], ... ; # 0..* Vaccine which is contraindicated to fulfill the recommendation fhir:ImmunizationRecommendation.recommendation.forecastStatus [ CodeableConcept ]; # 1..1 Vaccine recommendation status fhir:ImmunizationRecommendation.recommendation.forecastReason [ CodeableConcept ], ... ; # 0..* Vaccine administration status reason fhir:ImmunizationRecommendation.recommendation.dateCriterion [ # 0..* Dates governing proposed immunization fhir:ImmunizationRecommendation.recommendation.dateCriterion.code [ CodeableConcept ]; # 1..1 Type of date fhir:ImmunizationRecommendation.recommendation.dateCriterion.value [ dateTime ]; # 1..1 Recommended date ], ...; fhir:ImmunizationRecommendation.recommendation.description [ string ]; # 0..1 Protocol details fhir:ImmunizationRecommendation.recommendation.series [ string ]; # 0..1 Name of vaccination series # ImmunizationRecommendation.recommendation.doseNumber[x] : 0..1 Recommended dose number within series. One of these 2 fhir:ImmunizationRecommendation.recommendation.doseNumberPositiveInt [ positiveInt ] fhir:ImmunizationRecommendation.recommendation.doseNumberString [ string ] # ImmunizationRecommendation.recommendation.seriesDoses[x] : 0..1 Recommended number of doses for immunity. One of these 2 fhir:ImmunizationRecommendation.recommendation.seriesDosesPositiveInt [ positiveInt ] fhir:ImmunizationRecommendation.recommendation.seriesDosesString [ string ] fhir:ImmunizationRecommendation.recommendation.supportingImmunization [ Reference(Immunization|ImmunizationEvaluation) ], ... ; # 0..* Past immunizations supporting recommendation fhir:ImmunizationRecommendation.recommendation.supportingPatientInformation [ Reference(Any) ], ... ; # 0..* Patient observations supporting recommendation ], ...; ]
Changes since R3
ImmunizationRecommendation | |
ImmunizationRecommendation.date |
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ImmunizationRecommendation.authority |
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ImmunizationRecommendation.recommendation.vaccineCode |
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ImmunizationRecommendation.recommendation.contraindicatedVaccineCode |
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ImmunizationRecommendation.recommendation.forecastStatus |
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ImmunizationRecommendation.recommendation.forecastReason |
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ImmunizationRecommendation.recommendation.description |
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ImmunizationRecommendation.recommendation.series |
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ImmunizationRecommendation.recommendation.doseNumber[x] |
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ImmunizationRecommendation.recommendation.seriesDoses[x] |
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ImmunizationRecommendation.recommendation.supportingImmunization |
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ImmunizationRecommendation.recommendation.supportingPatientInformation |
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ImmunizationRecommendation.recommendation.date |
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ImmunizationRecommendation.recommendation.protocol |
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See the Full Difference for further information
This analysis is available as XML or JSON.
See R2 <--> R3 Conversion Maps (status = 1 test that all execute ok. All tests pass round-trip testing and all r3 resources are valid.). Note: these have note yet been updated to be R3 to R4
Structure
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
ImmunizationRecommendation | TU | DomainResource | Guidance or advice relating to an immunization Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension | |
identifier | Σ | 0..* | Identifier | Business identifier |
patient | Σ | 1..1 | Reference(Patient) | Who this profile is for |
date | Σ | 1..1 | dateTime | Date recommendation(s) created |
authority | 0..1 | Reference(Organization) | Who is responsible for protocol | |
recommendation | ΣI | 1..* | BackboneElement | Vaccine administration recommendations + One of vaccineCode or targetDisease SHALL be present |
vaccineCode | Σ | 0..* | CodeableConcept | Vaccine or vaccine group recommendation applies to Vaccine Administered Value Set (Example) |
targetDisease | Σ | 0..1 | CodeableConcept | Disease to be immunized against Immunization Recommendation Target Disease Codes (Example) |
contraindicatedVaccineCode | Σ | 0..* | CodeableConcept | Vaccine which is contraindicated to fulfill the recommendation Vaccine Administered Value Set (Example) |
forecastStatus | ?!Σ | 1..1 | CodeableConcept | Vaccine recommendation status Immunization Recommendation Status Codes (Example) |
forecastReason | Σ | 0..* | CodeableConcept | Vaccine administration status reason Immunization Recommendation Reason Codes (Example) |
dateCriterion | 0..* | BackboneElement | Dates governing proposed immunization | |
code | 1..1 | CodeableConcept | Type of date Immunization Recommendation Date Criterion Codes (Example) | |
value | 1..1 | dateTime | Recommended date | |
description | 0..1 | string | Protocol details | |
series | 0..1 | string | Name of vaccination series | |
doseNumber[x] | Σ | 0..1 | Recommended dose number within series | |
doseNumberPositiveInt | positiveInt | |||
doseNumberString | string | |||
seriesDoses[x] | 0..1 | Recommended number of doses for immunity | ||
seriesDosesPositiveInt | positiveInt | |||
seriesDosesString | string | |||
supportingImmunization | 0..* | Reference(Immunization | ImmunizationEvaluation) | Past immunizations supporting recommendation | |
supportingPatientInformation | 0..* | Reference(Any) | Patient observations supporting recommendation | |
Documentation for this format |
XML Template
<ImmunizationRecommendation 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> <patient><!-- 1..1 Reference(Patient) Who this profile is for --></patient> <date value="[dateTime]"/><!-- 1..1 Date recommendation(s) created --> <authority><!-- 0..1 Reference(Organization) Who is responsible for protocol --></authority> <recommendation> <!-- 1..* Vaccine administration recommendations --> <vaccineCode><!-- 0..* CodeableConcept Vaccine or vaccine group recommendation applies to --></vaccineCode> <targetDisease><!-- 0..1 CodeableConcept Disease to be immunized against --></targetDisease> <contraindicatedVaccineCode><!-- 0..* CodeableConcept Vaccine which is contraindicated to fulfill the recommendation --></contraindicatedVaccineCode> <forecastStatus><!-- 1..1 CodeableConcept Vaccine recommendation status --></forecastStatus> <forecastReason><!-- 0..* CodeableConcept Vaccine administration status reason --></forecastReason> <dateCriterion> <!-- 0..* Dates governing proposed immunization --> <code><!-- 1..1 CodeableConcept Type of date --></code> <value value="[dateTime]"/><!-- 1..1 Recommended date --> </dateCriterion> <description value="[string]"/><!-- 0..1 Protocol details --> <series value="[string]"/><!-- 0..1 Name of vaccination series --> <doseNumber[x]><!-- 0..1 positiveInt|string Recommended dose number within series --></doseNumber[x]> <seriesDoses[x]><!-- 0..1 positiveInt|string Recommended number of doses for immunity --></seriesDoses[x]> <supportingImmunization><!-- 0..* Reference(Immunization|ImmunizationEvaluation) Past immunizations supporting recommendation --></supportingImmunization> <supportingPatientInformation><!-- 0..* Reference(Any) Patient observations supporting recommendation --></supportingPatientInformation> </recommendation> </ImmunizationRecommendation>
JSON Template
{ "resourceType" : "ImmunizationRecommendation", // from Resource: id, meta, implicitRules, and language // from DomainResource: text, contained, extension, and modifierExtension "identifier" : [{ Identifier }], // Business identifier "patient" : { Reference(Patient) }, // R! Who this profile is for "date" : "<dateTime>", // R! Date recommendation(s) created "authority" : { Reference(Organization) }, // Who is responsible for protocol "recommendation" : [{ // R! Vaccine administration recommendations "vaccineCode" : [{ CodeableConcept }], // Vaccine or vaccine group recommendation applies to "targetDisease" : { CodeableConcept }, // Disease to be immunized against "contraindicatedVaccineCode" : [{ CodeableConcept }], // Vaccine which is contraindicated to fulfill the recommendation "forecastStatus" : { CodeableConcept }, // R! Vaccine recommendation status "forecastReason" : [{ CodeableConcept }], // Vaccine administration status reason "dateCriterion" : [{ // Dates governing proposed immunization "code" : { CodeableConcept }, // R! Type of date "value" : "<dateTime>" // R! Recommended date }], "description" : "<string>", // Protocol details "series" : "<string>", // Name of vaccination series // doseNumber[x]: Recommended dose number within series. One of these 2: "doseNumberPositiveInt" : "<positiveInt>", "doseNumberString" : "<string>", // seriesDoses[x]: Recommended number of doses for immunity. One of these 2: "seriesDosesPositiveInt" : "<positiveInt>", "seriesDosesString" : "<string>", "supportingImmunization" : [{ Reference(Immunization|ImmunizationEvaluation) }], // Past immunizations supporting recommendation "supportingPatientInformation" : [{ Reference(Any) }] // Patient observations supporting recommendation }] }
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> . [ a fhir:ImmunizationRecommendation; 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:ImmunizationRecommendation.identifier [ Identifier ], ... ; # 0..* Business identifier fhir:ImmunizationRecommendation.patient [ Reference(Patient) ]; # 1..1 Who this profile is for fhir:ImmunizationRecommendation.date [ dateTime ]; # 1..1 Date recommendation(s) created fhir:ImmunizationRecommendation.authority [ Reference(Organization) ]; # 0..1 Who is responsible for protocol fhir:ImmunizationRecommendation.recommendation [ # 1..* Vaccine administration recommendations fhir:ImmunizationRecommendation.recommendation.vaccineCode [ CodeableConcept ], ... ; # 0..* Vaccine or vaccine group recommendation applies to fhir:ImmunizationRecommendation.recommendation.targetDisease [ CodeableConcept ]; # 0..1 Disease to be immunized against fhir:ImmunizationRecommendation.recommendation.contraindicatedVaccineCode [ CodeableConcept ], ... ; # 0..* Vaccine which is contraindicated to fulfill the recommendation fhir:ImmunizationRecommendation.recommendation.forecastStatus [ CodeableConcept ]; # 1..1 Vaccine recommendation status fhir:ImmunizationRecommendation.recommendation.forecastReason [ CodeableConcept ], ... ; # 0..* Vaccine administration status reason fhir:ImmunizationRecommendation.recommendation.dateCriterion [ # 0..* Dates governing proposed immunization fhir:ImmunizationRecommendation.recommendation.dateCriterion.code [ CodeableConcept ]; # 1..1 Type of date fhir:ImmunizationRecommendation.recommendation.dateCriterion.value [ dateTime ]; # 1..1 Recommended date ], ...; fhir:ImmunizationRecommendation.recommendation.description [ string ]; # 0..1 Protocol details fhir:ImmunizationRecommendation.recommendation.series [ string ]; # 0..1 Name of vaccination series # ImmunizationRecommendation.recommendation.doseNumber[x] : 0..1 Recommended dose number within series. One of these 2 fhir:ImmunizationRecommendation.recommendation.doseNumberPositiveInt [ positiveInt ] fhir:ImmunizationRecommendation.recommendation.doseNumberString [ string ] # ImmunizationRecommendation.recommendation.seriesDoses[x] : 0..1 Recommended number of doses for immunity. One of these 2 fhir:ImmunizationRecommendation.recommendation.seriesDosesPositiveInt [ positiveInt ] fhir:ImmunizationRecommendation.recommendation.seriesDosesString [ string ] fhir:ImmunizationRecommendation.recommendation.supportingImmunization [ Reference(Immunization|ImmunizationEvaluation) ], ... ; # 0..* Past immunizations supporting recommendation fhir:ImmunizationRecommendation.recommendation.supportingPatientInformation [ Reference(Any) ], ... ; # 0..* Patient observations supporting recommendation ], ...; ]
Changes since DSTU2
ImmunizationRecommendation | |
ImmunizationRecommendation.date |
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ImmunizationRecommendation.authority |
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ImmunizationRecommendation.recommendation.vaccineCode |
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ImmunizationRecommendation.recommendation.contraindicatedVaccineCode |
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ImmunizationRecommendation.recommendation.forecastStatus |
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ImmunizationRecommendation.recommendation.forecastReason |
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ImmunizationRecommendation.recommendation.description |
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ImmunizationRecommendation.recommendation.series |
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ImmunizationRecommendation.recommendation.doseNumber[x] |
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ImmunizationRecommendation.recommendation.seriesDoses[x] |
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ImmunizationRecommendation.recommendation.supportingImmunization |
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ImmunizationRecommendation.recommendation.supportingPatientInformation |
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ImmunizationRecommendation.recommendation.date |
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ImmunizationRecommendation.recommendation.protocol |
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See the Full Difference for further information
This analysis is available as XML or JSON.
See R2 <--> R3 Conversion Maps (status = 1 test that all execute ok. All tests pass round-trip testing and all r3 resources are valid.). Note: these have note yet been updated to be R3 to R4
Alternate definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions & the dependency analysis
Path | Definition | Type | Reference |
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ImmunizationRecommendation.recommendation.vaccineCode ImmunizationRecommendation.recommendation.contraindicatedVaccineCode | The type of vaccine administered | Example | Vaccine Administered Value Set |
ImmunizationRecommendation.recommendation.targetDisease | The disease that the recommended vaccination targets | Example | Immunization Recommendation Target Disease Codes |
ImmunizationRecommendation.recommendation.forecastStatus | The patient's status with respect to a vaccination protocol | Example | Immunization Recommendation Status Codes |
ImmunizationRecommendation.recommendation.forecastReason | The reason for the patient's status with respect to a vaccination protocol | Example | Immunization Recommendation Reason 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.) | Example | Immunization Recommendation Date Criterion Codes |
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 | Expression | In Common |
date | date | Date recommendation(s) created | ImmunizationRecommendation.date | |
dose-number | number | Recommended dose number within series | ImmunizationRecommendation.recommendation.doseNumber | |
dose-sequence | number | Recommended number of doses for immunity | ImmunizationRecommendation.recommendation.seriesDoses | |
identifier | token | Business identifier | ImmunizationRecommendation.identifier | |
information | reference | Patient observations supporting recommendation | ImmunizationRecommendation.recommendation.supportingPatientInformation (Any) | |
patient | reference | Who this profile is for | ImmunizationRecommendation.patient (Patient) | |
status | token | Vaccine recommendation status | ImmunizationRecommendation.recommendation.forecastStatus | |
support | reference | Past immunizations supporting recommendation | ImmunizationRecommendation.recommendation.supportingImmunization (Immunization, ImmunizationEvaluation) | |
target-disease | token | Disease to be immunized against | ImmunizationRecommendation.recommendation.targetDisease | |
vaccine-type | token | Vaccine or vaccine group recommendation applies to | ImmunizationRecommendation.recommendation.vaccineCode |