R4 Ballot #1 (Mixed Normative/Trial use)

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

11.15 Resource ImmunizationRecommendation - Content

Public Health and Emergency Response Work GroupMaturity 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:

  1. 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?
  2. 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?
  3. 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:

  • Patient
  • Organization
  • Immunization
  • ImmunizationEvaluation

This resource is referenced by DiagnosticReport and Observation

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. ImmunizationRecommendation TUDomainResourceGuidance or advice relating to an immunization
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierBusiness identifier
... patient Σ1..1Reference(Patient)Who this profile is for
... date Σ1..1dateTimeDate recommendation(s) created
... authority 0..1Reference(Organization)Who is responsible for protocol
... recommendation ΣI1..*BackboneElementVaccine administration recommendations
+ One of vaccineCode or targetDisease SHALL be present
.... vaccineCode Σ0..*CodeableConceptVaccine or vaccine group recommendation applies to
Vaccine Administered Value Set (Example)
.... targetDisease Σ0..1CodeableConceptDisease to be immunized against
Immunization Recommendation Target Disease Codes (Example)
.... contraindicatedVaccineCode Σ0..*CodeableConceptVaccine which is contraindicated to fulfill the recommendation
Vaccine Administered Value Set (Example)
.... forecastStatus ?!Σ1..1CodeableConceptVaccine recommendation status
Immunization Recommendation Status Codes (Example)
.... forecastReason Σ0..*CodeableConceptVaccine administration status reason
Immunization Recommendation Reason Codes (Example)
.... dateCriterion 0..*BackboneElementDates governing proposed immunization
..... code 1..1CodeableConceptType of date
Immunization Recommendation Date Criterion Codes (Example)
..... value 1..1dateTimeRecommended date
.... description 0..1stringProtocol details
.... series 0..1stringName of vaccination series
.... doseNumber[x] Σ0..1Recommended dose number within series
..... doseNumberPositiveIntpositiveInt
..... doseNumberStringstring
.... seriesDoses[x] 0..1Recommended number of doses for immunity
..... seriesDosesPositiveIntpositiveInt
..... seriesDosesStringstring
.... supportingImmunization 0..*Reference(Immunization | ImmunizationEvaluation)Past immunizations supporting recommendation
.... supportingPatientInformation 0..*Reference(Any)Patient observations supporting recommendation

doco Documentation for this format

UML Diagram (Legend)

ImmunizationRecommendation (DomainResource)A unique identifier assigned to this particular recommendation recordidentifier : Identifier [0..*]The patient the recommendation(s) are forpatient : Reference [1..1] « Patient »The date the immunization recommendation(s) were createddate : dateTime [1..1]Indicates the authority who published the protocol (e.g. ACIP)authority : Reference [0..1] « Organization »RecommendationVaccine(s) or vaccine group that pertain to the recommendationvaccineCode : CodeableConcept [0..*] « The type of vaccine administered (Strength=Example)Vaccine Administered Value Set?? »The targeted disease for the recommendationtargetDisease : CodeableConcept [0..1] « The disease that the recommended vaccination targets (Strength=Example)Immunization Recommendation T...?? »Vaccine(s) which should not be used to fulfill the recommendationcontraindicatedVaccineCode : CodeableConcept [0..*] « The type of vaccine administered (Strength=Example)Vaccine Administered Value Set?? »Indicates the patient status with respect to the path to immunity for the target disease (this element modifies the meaning of other elements)forecastStatus : CodeableConcept [1..1] « The patient's status with respect to a vaccination protocol (Strength=Example)Immunization Recommendation S...?? »The reason for the assigned forecast statusforecastReason : CodeableConcept [0..*] « The reason for the patient's status with respect to a vaccination protocol (Strength=Example)Immunization Recommendation R...?? »Contains the description about the protocol under which the vaccine was administereddescription : string [0..1]One possible path to achieve presumed immunity against a disease - within the context of an authorityseries : string [0..1]Nominal position of the recommended dose in a series (e.g. dose 2 is the next recommended dose)doseNumber[x] : Type [0..1] « positiveInt|string »The recommended number of doses to achieve immunityseriesDoses[x] : Type [0..1] « positiveInt|string »Immunization event history and/or evaluation that supports the status and recommendationsupportingImmunization : Reference [0..*] « Immunization| ImmunizationEvaluation »Patient Information that supports the status and recommendation. This includes patient observations, adverse reactions and allergy/intolerance informationsupportingPatientInformation : Reference [0..*] « Any »DateCriterionDate classification of recommendation. For example, 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...?? »The date whose meaning is specified by dateCriterion.codevalue : dateTime [1..1]Vaccine date recommendations. For example, earliest date to administer, latest date to administer, etcdateCriterion[0..*]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>
 <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

{doco
  "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/> .doco


[ 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
  • Added Element
ImmunizationRecommendation.authority
  • Added Element
ImmunizationRecommendation.recommendation.vaccineCode
  • Max Cardinality changed from 1 to *
ImmunizationRecommendation.recommendation.contraindicatedVaccineCode
  • Added Element
ImmunizationRecommendation.recommendation.forecastStatus
  • Now marked as Modifier
ImmunizationRecommendation.recommendation.forecastReason
  • Added Element
ImmunizationRecommendation.recommendation.description
  • Added Element
ImmunizationRecommendation.recommendation.series
  • Added Element
ImmunizationRecommendation.recommendation.doseNumber[x]
  • Renamed from doseNumber to doseNumber[x]
  • Add string
ImmunizationRecommendation.recommendation.seriesDoses[x]
  • Added Element
ImmunizationRecommendation.recommendation.supportingImmunization
  • Type changed from Reference(Immunization) to Reference(Immunization|ImmunizationEvaluation)
ImmunizationRecommendation.recommendation.supportingPatientInformation
  • Type changed from Reference(Observation|AllergyIntolerance) to Reference(Resource)
ImmunizationRecommendation.recommendation.date
  • deleted
ImmunizationRecommendation.recommendation.protocol
  • deleted

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

NameFlagsCard.TypeDescription & Constraintsdoco
.. ImmunizationRecommendation TUDomainResourceGuidance or advice relating to an immunization
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierBusiness identifier
... patient Σ1..1Reference(Patient)Who this profile is for
... date Σ1..1dateTimeDate recommendation(s) created
... authority 0..1Reference(Organization)Who is responsible for protocol
... recommendation ΣI1..*BackboneElementVaccine administration recommendations
+ One of vaccineCode or targetDisease SHALL be present
.... vaccineCode Σ0..*CodeableConceptVaccine or vaccine group recommendation applies to
Vaccine Administered Value Set (Example)
.... targetDisease Σ0..1CodeableConceptDisease to be immunized against
Immunization Recommendation Target Disease Codes (Example)
.... contraindicatedVaccineCode Σ0..*CodeableConceptVaccine which is contraindicated to fulfill the recommendation
Vaccine Administered Value Set (Example)
.... forecastStatus ?!Σ1..1CodeableConceptVaccine recommendation status
Immunization Recommendation Status Codes (Example)
.... forecastReason Σ0..*CodeableConceptVaccine administration status reason
Immunization Recommendation Reason Codes (Example)
.... dateCriterion 0..*BackboneElementDates governing proposed immunization
..... code 1..1CodeableConceptType of date
Immunization Recommendation Date Criterion Codes (Example)
..... value 1..1dateTimeRecommended date
.... description 0..1stringProtocol details
.... series 0..1stringName of vaccination series
.... doseNumber[x] Σ0..1Recommended dose number within series
..... doseNumberPositiveIntpositiveInt
..... doseNumberStringstring
.... seriesDoses[x] 0..1Recommended number of doses for immunity
..... seriesDosesPositiveIntpositiveInt
..... seriesDosesStringstring
.... supportingImmunization 0..*Reference(Immunization | ImmunizationEvaluation)Past immunizations supporting recommendation
.... supportingPatientInformation 0..*Reference(Any)Patient observations supporting recommendation

doco Documentation for this format

UML Diagram (Legend)

ImmunizationRecommendation (DomainResource)A unique identifier assigned to this particular recommendation recordidentifier : Identifier [0..*]The patient the recommendation(s) are forpatient : Reference [1..1] « Patient »The date the immunization recommendation(s) were createddate : dateTime [1..1]Indicates the authority who published the protocol (e.g. ACIP)authority : Reference [0..1] « Organization »RecommendationVaccine(s) or vaccine group that pertain to the recommendationvaccineCode : CodeableConcept [0..*] « The type of vaccine administered (Strength=Example)Vaccine Administered Value Set?? »The targeted disease for the recommendationtargetDisease : CodeableConcept [0..1] « The disease that the recommended vaccination targets (Strength=Example)Immunization Recommendation T...?? »Vaccine(s) which should not be used to fulfill the recommendationcontraindicatedVaccineCode : CodeableConcept [0..*] « The type of vaccine administered (Strength=Example)Vaccine Administered Value Set?? »Indicates the patient status with respect to the path to immunity for the target disease (this element modifies the meaning of other elements)forecastStatus : CodeableConcept [1..1] « The patient's status with respect to a vaccination protocol (Strength=Example)Immunization Recommendation S...?? »The reason for the assigned forecast statusforecastReason : CodeableConcept [0..*] « The reason for the patient's status with respect to a vaccination protocol (Strength=Example)Immunization Recommendation R...?? »Contains the description about the protocol under which the vaccine was administereddescription : string [0..1]One possible path to achieve presumed immunity against a disease - within the context of an authorityseries : string [0..1]Nominal position of the recommended dose in a series (e.g. dose 2 is the next recommended dose)doseNumber[x] : Type [0..1] « positiveInt|string »The recommended number of doses to achieve immunityseriesDoses[x] : Type [0..1] « positiveInt|string »Immunization event history and/or evaluation that supports the status and recommendationsupportingImmunization : Reference [0..*] « Immunization| ImmunizationEvaluation »Patient Information that supports the status and recommendation. This includes patient observations, adverse reactions and allergy/intolerance informationsupportingPatientInformation : Reference [0..*] « Any »DateCriterionDate classification of recommendation. For example, 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...?? »The date whose meaning is specified by dateCriterion.codevalue : dateTime [1..1]Vaccine date recommendations. For example, earliest date to administer, latest date to administer, etcdateCriterion[0..*]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>
 <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

{doco
  "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/> .doco


[ 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
  • Added Element
ImmunizationRecommendation.authority
  • Added Element
ImmunizationRecommendation.recommendation.vaccineCode
  • Max Cardinality changed from 1 to *
ImmunizationRecommendation.recommendation.contraindicatedVaccineCode
  • Added Element
ImmunizationRecommendation.recommendation.forecastStatus
  • Now marked as Modifier
ImmunizationRecommendation.recommendation.forecastReason
  • Added Element
ImmunizationRecommendation.recommendation.description
  • Added Element
ImmunizationRecommendation.recommendation.series
  • Added Element
ImmunizationRecommendation.recommendation.doseNumber[x]
  • Renamed from doseNumber to doseNumber[x]
  • Add string
ImmunizationRecommendation.recommendation.seriesDoses[x]
  • Added Element
ImmunizationRecommendation.recommendation.supportingImmunization
  • Type changed from Reference(Immunization) to Reference(Immunization|ImmunizationEvaluation)
ImmunizationRecommendation.recommendation.supportingPatientInformation
  • Type changed from Reference(Observation|AllergyIntolerance) to Reference(Resource)
ImmunizationRecommendation.recommendation.date
  • deleted
ImmunizationRecommendation.recommendation.protocol
  • deleted

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

PathDefinitionTypeReference
ImmunizationRecommendation.recommendation.vaccineCode
ImmunizationRecommendation.recommendation.contraindicatedVaccineCode
The type of vaccine administeredExampleVaccine Administered Value Set
ImmunizationRecommendation.recommendation.targetDisease The disease that the recommended vaccination targetsExampleImmunization Recommendation Target Disease Codes
ImmunizationRecommendation.recommendation.forecastStatus The patient's status with respect to a vaccination protocolExampleImmunization Recommendation Status Codes
ImmunizationRecommendation.recommendation.forecastReason The reason for the patient's status with respect to a vaccination protocolExampleImmunization 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.)ExampleImmunization Recommendation Date Criterion Codes

  • imr-1: On ImmunizationRecommendation.recommendation: One of vaccineCode or targetDisease SHALL be present (expression on ImmunizationRecommendation.recommendation: vaccineCode.exists() or targetDisease.exists())

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

NameTypeDescriptionExpressionIn Common
datedateDate recommendation(s) createdImmunizationRecommendation.date
dose-numbernumberRecommended dose number within seriesImmunizationRecommendation.recommendation.doseNumber
dose-sequencenumberRecommended number of doses for immunityImmunizationRecommendation.recommendation.seriesDoses
identifiertokenBusiness identifierImmunizationRecommendation.identifier
informationreferencePatient observations supporting recommendationImmunizationRecommendation.recommendation.supportingPatientInformation
(Any)
patientreferenceWho this profile is forImmunizationRecommendation.patient
(Patient)
statustokenVaccine recommendation statusImmunizationRecommendation.recommendation.forecastStatus
supportreferencePast immunizations supporting recommendationImmunizationRecommendation.recommendation.supportingImmunization
(Immunization, ImmunizationEvaluation)
target-diseasetokenDisease to be immunized againstImmunizationRecommendation.recommendation.targetDisease
vaccine-typetokenVaccine or vaccine group recommendation applies toImmunizationRecommendation.recommendation.vaccineCode