This page is part of the FHIR Specification (v4.6.0: R5 Draft Ballot - see ballot notes). 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: 3 | Trial Use | Security Category: Patient | Compartments: Patient, Practitioner |
Detailed Descriptions for the elements in the Immunization resource.
Immunization | |||||||||
Element Id | Immunization | ||||||||
Definition | Describes the event of a patient being administered a vaccine or a record of an immunization as reported by a patient, a clinician or another party. | ||||||||
Cardinality | 0..* | ||||||||
Type | DomainResource | ||||||||
Summary | false | ||||||||
Immunization.identifier | |||||||||
Element Id | Immunization.identifier | ||||||||
Definition | A unique identifier assigned to this immunization record. | ||||||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||||||
Cardinality | 0..* | ||||||||
Type | Identifier | ||||||||
Summary | false | ||||||||
Immunization.instantiatesCanonical | |||||||||
Element Id | Immunization.instantiatesCanonical | ||||||||
Definition | The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Immunization. | ||||||||
Cardinality | 0..* | ||||||||
Type | canonical(Definition[ActivityDefinition, EventDefinition, EvidenceVariable, Measure, OperationDefinition, PlanDefinition, Questionnaire, SubscriptionTopic]) | ||||||||
Summary | true | ||||||||
Immunization.instantiatesUri | |||||||||
Element Id | Immunization.instantiatesUri | ||||||||
Definition | The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Immunization. | ||||||||
Cardinality | 0..* | ||||||||
Type | uri | ||||||||
Summary | true | ||||||||
Comments | This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier. | ||||||||
Immunization.basedOn | |||||||||
Element Id | Immunization.basedOn | ||||||||
Definition | A plan, order or recommendation fulfilled in whole or in part by this immunization. | ||||||||
Cardinality | 0..* | ||||||||
Type | Reference(CarePlan | MedicationRequest | ImmunizationRecommendation) | ||||||||
Patterns | Reference(CarePlan,MedicationRequest,ImmunizationRecommendation): Common patterns = Request | ||||||||
Summary | true | ||||||||
Comments | Allows tracing of an authorization for the Immunization. | ||||||||
Immunization.status | |||||||||
Element Id | Immunization.status | ||||||||
Definition | Indicates the current status of the immunization event. | ||||||||
Cardinality | 1..1 | ||||||||
Terminology Binding | Immunization Status Codes (Required) | ||||||||
Type | code | ||||||||
Is Modifier | true (Reason: This element is labeled as a modifier because it is a status element that contains statuses entered-in-error and not-done which means that the resource should not be treated as valid) | ||||||||
Summary | true | ||||||||
Comments | Will generally be set to show that the immunization has been completed or not done. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. | ||||||||
Immunization.statusReason | |||||||||
Element Id | Immunization.statusReason | ||||||||
Definition | Indicates the reason the immunization event was not performed. | ||||||||
Cardinality | 0..1 | ||||||||
Terminology Binding | Immunization Status Reason Codes (Example) | ||||||||
Type | CodeableConcept | ||||||||
Summary | false | ||||||||
Comments | This is generally only used for the status of "not-done". The reason for performing the immunization event is captured in reasonCode, not here. | ||||||||
Immunization.vaccineCode | |||||||||
Element Id | Immunization.vaccineCode | ||||||||
Definition | Vaccine that was administered or was to be administered. | ||||||||
Cardinality | 1..1 | ||||||||
Terminology Binding | Vaccine Administered Value Set (Example) | ||||||||
Type | CodeableConcept | ||||||||
Summary | true | ||||||||
Comments | The code for the administered vaccine may be reported at various levels of granularity from a very generic code for a general type of vaccine (e.g. the SNOMED or CVX code for the flu vaccine) to a very discrete code for a specific product including the form and packaging (e.g. an NDC code). Because vaccineCode uses the CodeableConcept data type, multiple codes at different levels of granularity may be reported for a single immunization event provided that all codes are appropriate for the same vaccine. For example, both NDC and CVX codes may be provided for a given immunization event by repeating the coding element within vaccineCode. | ||||||||
Immunization.manufacturer | |||||||||
Element Id | Immunization.manufacturer | ||||||||
Definition | Name of vaccine manufacturer. | ||||||||
Cardinality | 0..1 | ||||||||
Type | Reference(Organization) | ||||||||
Summary | false | ||||||||
Immunization.lotNumber | |||||||||
Element Id | Immunization.lotNumber | ||||||||
Definition | Lot number of the vaccine product. | ||||||||
Cardinality | 0..1 | ||||||||
Type | string | ||||||||
Summary | false | ||||||||
Immunization.expirationDate | |||||||||
Element Id | Immunization.expirationDate | ||||||||
Definition | Date vaccine batch expires. | ||||||||
Cardinality | 0..1 | ||||||||
Type | date | ||||||||
Summary | false | ||||||||
Immunization.patient | |||||||||
Element Id | Immunization.patient | ||||||||
Definition | The patient who either received or did not receive the immunization. | ||||||||
Cardinality | 1..1 | ||||||||
Type | Reference(Patient) | ||||||||
Summary | true | ||||||||
Immunization.encounter | |||||||||
Element Id | Immunization.encounter | ||||||||
Definition | The visit or admission or other contact between patient and health care provider the immunization was performed as part of. | ||||||||
Cardinality | 0..1 | ||||||||
Type | Reference(Encounter) | ||||||||
Summary | false | ||||||||
Immunization.occurrence[x] | |||||||||
Element Id | Immunization.occurrence[x] | ||||||||
Definition | Date vaccine administered or was to be administered. | ||||||||
Cardinality | 1..1 | ||||||||
Type | dateTime|string | ||||||||
[x] Note | See Choice of Data Types for further information about how to use [x] | ||||||||
Summary | true | ||||||||
Comments | When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given. An exact date is always preferable, but the use of the String data type is acceptable when an exact date is not known. A small number of vaccines (e.g. live oral typhoid vaccine) are given as a series of patient self-administered dose over a span of time. In cases like this, often, only the first dose (typically a provider supervised dose) is recorded with the occurrence indicating the date/time of the first dose. | ||||||||
Immunization.recorded | |||||||||
Element Id | Immunization.recorded | ||||||||
Definition | The date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event. | ||||||||
Cardinality | 0..1 | ||||||||
Type | dateTime | ||||||||
Summary | false | ||||||||
Immunization.primarySource | |||||||||
Element Id | Immunization.primarySource | ||||||||
Definition | Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. | ||||||||
Cardinality | 0..1 | ||||||||
Type | boolean | ||||||||
Summary | true | ||||||||
Comments | Reflects the “reliability” of the content. | ||||||||
Immunization.informationSource[x] | |||||||||
Element Id | Immunization.informationSource[x] | ||||||||
Definition | Typically the source of the data when the report of the immunization event is not based on information from the person who administered the vaccine. | ||||||||
Cardinality | 0..1 | ||||||||
Terminology Binding | Immunization Origin Codes (Example) | ||||||||
Type | CodeableConcept|Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) | ||||||||
Patterns | Reference(Patient,Practitioner,PractitionerRole,RelatedPerson,Organization): Common patterns = Participant | ||||||||
[x] Note | See Choice of Data Types for further information about how to use [x] | ||||||||
Summary | false | ||||||||
Comments | Typically will not be populated if primarySource = True, not required even if primarySource = False. | ||||||||
Immunization.location | |||||||||
Element Id | Immunization.location | ||||||||
Definition | The service delivery location where the vaccine administration occurred. | ||||||||
Cardinality | 0..1 | ||||||||
Type | Reference(Location) | ||||||||
Summary | false | ||||||||
Immunization.site | |||||||||
Element Id | Immunization.site | ||||||||
Definition | Body site where vaccine was administered. | ||||||||
Cardinality | 0..1 | ||||||||
Terminology Binding | Codes for Immunization Site of Administration (Example) | ||||||||
Type | CodeableConcept | ||||||||
Summary | false | ||||||||
Immunization.route | |||||||||
Element Id | Immunization.route | ||||||||
Definition | The path by which the vaccine product is taken into the body. | ||||||||
Cardinality | 0..1 | ||||||||
Terminology Binding | Immunization Route Codes (Example) | ||||||||
Type | CodeableConcept | ||||||||
Summary | false | ||||||||
Immunization.doseQuantity | |||||||||
Element Id | Immunization.doseQuantity | ||||||||
Definition | The quantity of vaccine product that was administered. | ||||||||
Cardinality | 0..1 | ||||||||
Type | SimpleQuantity | ||||||||
Summary | false | ||||||||
Immunization.performer | |||||||||
Element Id | Immunization.performer | ||||||||
Definition | Indicates who performed the immunization event. | ||||||||
Cardinality | 0..* | ||||||||
Summary | true | ||||||||
Immunization.performer.function | |||||||||
Element Id | Immunization.performer.function | ||||||||
Definition | Describes the type of performance (e.g. ordering provider, administering provider, etc.). | ||||||||
Cardinality | 0..1 | ||||||||
Terminology Binding | Immunization Function Codes (Extensible) | ||||||||
Type | CodeableConcept | ||||||||
Summary | true | ||||||||
Immunization.performer.actor | |||||||||
Element Id | Immunization.performer.actor | ||||||||
Definition | The practitioner or organization who performed the action. | ||||||||
Cardinality | 1..1 | ||||||||
Type | Reference(Practitioner | PractitionerRole | Organization) | ||||||||
Patterns | Reference(Practitioner,PractitionerRole,Organization): Common patterns = Participant | ||||||||
Summary | true | ||||||||
Comments | When the individual practitioner who performed the action is known, it is best to send. | ||||||||
Immunization.note | |||||||||
Element Id | Immunization.note | ||||||||
Definition | Extra information about the immunization that is not conveyed by the other attributes. | ||||||||
Cardinality | 0..* | ||||||||
Type | Annotation | ||||||||
Summary | true | ||||||||
Immunization.reason | |||||||||
Element Id | Immunization.reason | ||||||||
Definition | Describes why the immunization occurred in coded or textual form, or Indicates another resource (Condition, Observation or DiagnosticReport) whose existence justifies this immunization. | ||||||||
Cardinality | 0..* | ||||||||
Terminology Binding | Immunization Reason Codes (Example) | ||||||||
Type | CodeableReference(Condition | Observation | DiagnosticReport) | ||||||||
Patterns | CodeableReference(Condition,Observation,DiagnosticReport): Common patterns = Event | ||||||||
Summary | false | ||||||||
Immunization.isSubpotent | |||||||||
Element Id | Immunization.isSubpotent | ||||||||
Definition | Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent. | ||||||||
Cardinality | 0..1 | ||||||||
Type | boolean | ||||||||
Is Modifier | true (Reason: This element is labeled as a modifier because an immunization event with a subpotent vaccine doesn't protect the patient the same way as a potent dose.) | ||||||||
Meaning if Missing | By default, a dose should be considered to be potent. | ||||||||
Summary | true | ||||||||
Comments | Typically, the recognition of the dose being sub-potent is retrospective, after the administration (ex. notification of a manufacturer recall after administration). However, in the case of a partial administration (the patient moves unexpectedly and only some of the dose is actually administered), subpotency may be recognized immediately, but it is still important to record the event. | ||||||||
Immunization.subpotentReason | |||||||||
Element Id | Immunization.subpotentReason | ||||||||
Definition | Reason why a dose is considered to be subpotent. | ||||||||
Cardinality | 0..* | ||||||||
Terminology Binding | Immunization Subpotent Reason (Example) | ||||||||
Type | CodeableConcept | ||||||||
Summary | false | ||||||||
Immunization.education | |||||||||
Element Id | Immunization.education | ||||||||
Definition | Educational material presented to the patient (or guardian) at the time of vaccine administration. | ||||||||
Cardinality | 0..* | ||||||||
Summary | false | ||||||||
Invariants |
| ||||||||
Immunization.education.documentType | |||||||||
Element Id | Immunization.education.documentType | ||||||||
Definition | Identifier of the material presented to the patient. | ||||||||
Cardinality | 0..1 | ||||||||
Type | string | ||||||||
Summary | false | ||||||||
Immunization.education.reference | |||||||||
Element Id | Immunization.education.reference | ||||||||
Definition | Reference pointer to the educational material given to the patient if the information was on line. | ||||||||
Cardinality | 0..1 | ||||||||
Type | uri | ||||||||
Summary | false | ||||||||
Immunization.education.publicationDate | |||||||||
Element Id | Immunization.education.publicationDate | ||||||||
Definition | Date the educational material was published. | ||||||||
Cardinality | 0..1 | ||||||||
Type | dateTime | ||||||||
Summary | false | ||||||||
Immunization.education.presentationDate | |||||||||
Element Id | Immunization.education.presentationDate | ||||||||
Definition | Date the educational material was given to the patient. | ||||||||
Cardinality | 0..1 | ||||||||
Type | dateTime | ||||||||
Summary | false | ||||||||
Immunization.programEligibility | |||||||||
Element Id | Immunization.programEligibility | ||||||||
Definition | Indicates a patient's eligibility for a funding program. | ||||||||
Cardinality | 0..* | ||||||||
Terminology Binding | Immunization Program Eligibility (Example) | ||||||||
Type | CodeableConcept | ||||||||
Summary | false | ||||||||
Immunization.fundingSource | |||||||||
Element Id | Immunization.fundingSource | ||||||||
Definition | Indicates the source of the vaccine actually administered. This may be different than the patient eligibility (e.g. the patient may be eligible for a publically purchased vaccine but due to inventory issues, vaccine purchased with private funds was actually administered). | ||||||||
Cardinality | 0..1 | ||||||||
Terminology Binding | Immunization Funding Source (Example) | ||||||||
Type | CodeableConcept | ||||||||
Summary | false | ||||||||
Immunization.reaction | |||||||||
Element Id | Immunization.reaction | ||||||||
Definition | Categorical data indicating that an adverse event is associated in time to an immunization. | ||||||||
Cardinality | 0..* | ||||||||
Summary | false | ||||||||
Comments | A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case, it should be recorded as a new AllergyIntolerance resource instance as most systems will not query against past Immunization.reaction elements. | ||||||||
Immunization.reaction.date | |||||||||
Element Id | Immunization.reaction.date | ||||||||
Definition | Date of reaction to the immunization. | ||||||||
Cardinality | 0..1 | ||||||||
Type | dateTime | ||||||||
Summary | false | ||||||||
Immunization.reaction.detail | |||||||||
Element Id | Immunization.reaction.detail | ||||||||
Definition | Details of the reaction. | ||||||||
Cardinality | 0..1 | ||||||||
Type | Reference(Observation) | ||||||||
Summary | false | ||||||||
Immunization.reaction.reported | |||||||||
Element Id | Immunization.reaction.reported | ||||||||
Definition | Self-reported indicator. | ||||||||
Cardinality | 0..1 | ||||||||
Type | boolean | ||||||||
Summary | false | ||||||||
Immunization.protocolApplied | |||||||||
Element Id | Immunization.protocolApplied | ||||||||
Definition | The protocol (set of recommendations) being followed by the provider who administered the dose. | ||||||||
Cardinality | 0..* | ||||||||
Summary | false | ||||||||
Immunization.protocolApplied.series | |||||||||
Element Id | Immunization.protocolApplied.series | ||||||||
Definition | One possible path to achieve presumed immunity against a disease - within the context of an authority. | ||||||||
Cardinality | 0..1 | ||||||||
Type | string | ||||||||
Summary | false | ||||||||
Immunization.protocolApplied.authority | |||||||||
Element Id | Immunization.protocolApplied.authority | ||||||||
Definition | Indicates the authority who published the protocol (e.g. ACIP) that is being followed. | ||||||||
Cardinality | 0..1 | ||||||||
Type | Reference(Organization) | ||||||||
Summary | false | ||||||||
Immunization.protocolApplied.targetDisease | |||||||||
Element Id | Immunization.protocolApplied.targetDisease | ||||||||
Definition | The vaccine preventable disease the dose is being administered against. | ||||||||
Cardinality | 0..* | ||||||||
Terminology Binding | Immunization Target Disease Codes (Example) | ||||||||
Type | CodeableConcept | ||||||||
Summary | false | ||||||||
Immunization.protocolApplied.doseNumber | |||||||||
Element Id | Immunization.protocolApplied.doseNumber | ||||||||
Definition | Nominal position in a series as intended by the practitioner administering the dose. | ||||||||
Cardinality | 1..1 | ||||||||
Type | string | ||||||||
Summary | false | ||||||||
Comments | The use of an integer is preferred if known. Text should only be used in cases where an integer is not available (such as when documenting a recurring booster dose). | ||||||||
Immunization.protocolApplied.seriesDoses | |||||||||
Element Id | Immunization.protocolApplied.seriesDoses | ||||||||
Definition | The recommended number of doses to achieve immunity as intended by the practitioner administering the dose. | ||||||||
Cardinality | 0..1 | ||||||||
Type | string | ||||||||
Summary | false | ||||||||
Comments | The use of an integer is preferred if known. |