Release 5 Ballot

This page is part of the FHIR Specification (v5.0.0-ballot: R5 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

Example Immunization/protocol (JSON)

Public Health and Emergency Response Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Patient, Practitioner

Raw JSON (canonical form + also see JSON Format Specification)

Example where the provider indicates the protocol being followed

{
  "resourceType": "Immunization",
  "id": "protocol",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Immunization</b><a name=\"protocol\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Immunization &quot;protocol&quot; </p></div><p><b>identifier</b>: id: urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234</p><p><b>status</b>: completed</p><p><b>vaccineCode</b>: Twinrix (HepA/HepB) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v2-0292.html\">PH_VaccinesAdministeredCVX_CDC_NIP</a>#104)</span></p><h3>Manufacturers</h3><table class=\"grid\"><tr><td>-</td><td><b>Reference</b></td></tr><tr><td>*</td><td><a href=\"organization-example.html\">Organization/hl7</a> &quot;Health Level Seven International&quot;</td></tr></table><p><b>lotNumber</b>: PT123F</p><p><b>expirationDate</b>: 2018-12-15</p><p><b>patient</b>: <a href=\"patient-example.html\">Patient/example</a> &quot;Peter CHALMERS&quot;</p><p><b>encounter</b>: <a href=\"encounter-example.html\">Encounter/example</a></p><p><b>occurrence</b>: 2018-06-18</p><p><b>primarySource</b>: true</p><p><b>location</b>: <a href=\"location-example.html\">Location/1</a> &quot;South Wing, second floor&quot;</p><p><b>site</b>: left arm <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-ActSite.html\">ActSite</a>#LA)</span></p><p><b>route</b>: Injection, intramuscular <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-RouteOfAdministration.html\">RouteOfAdministration</a>#IM)</span></p><p><b>doseQuantity</b>: 5 mg<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code mg = 'mg')</span></p><blockquote><p><b>performer</b></p><p><b>function</b>: Ordering Provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v2-0443.html\">providerRole</a>#OP)</span></p><p><b>actor</b>: <a href=\"practitioner-example.html\">Practitioner/example</a> &quot;Adam CAREFUL&quot;</p></blockquote><blockquote><p><b>performer</b></p><p><b>function</b>: Administering Provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v2-0443.html\">providerRole</a>#AP)</span></p><p><b>actor</b>: <a href=\"practitioner-example.html\">Practitioner/example</a> &quot;Adam CAREFUL&quot;</p></blockquote><p><b>isSubpotent</b>: false</p><h3>ProgramEligibilities</h3><table class=\"grid\"><tr><td>-</td><td><b>Program</b></td><td><b>ProgramStatus</b></td></tr><tr><td>*</td><td>VFC <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></td><td>Not Eligible <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-immunization-program-eligibility.html\">Immunization Program Eligibility</a>#ineligible)</span></td></tr></table><p><b>fundingSource</b>: Private <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-immunization-funding-source.html\">Immunization Funding Source</a>#private)</span></p><blockquote><p><b>protocolApplied</b></p><p><b>series</b>: 2-dose</p><p><b>targetDisease</b>: Viral hepatitis, type A <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#40468003)</span></p><p><b>doseNumber</b>: 1</p></blockquote><blockquote><p><b>protocolApplied</b></p><p><b>series</b>: 3-dose</p><p><b>targetDisease</b>: Type B viral hepatitis <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#66071002)</span></p><p><b>doseNumber</b>: 2</p><p><b>seriesDoses</b>: 3</p></blockquote></div>"
  },
  "identifier": [
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234"
    }
  ],
  "status": "completed",
  "vaccineCode": {
    "coding": [
      {
        "system": "http://hl7.org/fhir/sid/cvx",
        "code": "104"
      }
    ],
    "text": "Twinrix (HepA/HepB)"
  },
  "manufacturer": {
    "reference": {
      "reference": "Organization/hl7"
    }
  },
  "lotNumber": "PT123F",
  "expirationDate": "2018-12-15",
  "patient": {
    "reference": "Patient/example"
  },
  "encounter": {
    "reference": "Encounter/example"
  },
  "occurrenceDateTime": "2018-06-18",
  "primarySource": true,
  "location": {
    "reference": "Location/1"
  },
  "site": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActSite",
        "code": "LA",
        "display": "left arm"
      }
    ]
  },
  "route": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-RouteOfAdministration",
        "code": "IM",
        "display": "Injection, intramuscular"
      }
    ]
  },
  "doseQuantity": {
    "value": 5,
    "system": "http://unitsofmeasure.org",
    "code": "mg"
  },
  "performer": [
    {
      "function": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0443",
            "code": "OP"
          }
        ]
      },
      "actor": {
        "reference": "Practitioner/example"
      }
    },
    {
      "function": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0443",
            "code": "AP"
          }
        ]
      },
      "actor": {
        "reference": "Practitioner/example"
      }
    }
  ],
  "isSubpotent": false,
  "programEligibility": [
    {
      "program": {
        "text": "VFC"
      },
      "programStatus": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/immunization-program-eligibility",
            "code": "ineligible"
          }
        ]
      }
    }
  ],
  "fundingSource": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/immunization-funding-source",
        "code": "private"
      }
    ]
  },
  "protocolApplied": [
    {
      "series": "2-dose",
      "targetDisease": [
        {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "40468003"
            }
          ]
        }
      ],
      "doseNumber": "1"
    },
    {
      "series": "3-dose",
      "targetDisease": [
        {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "66071002"
            }
          ]
        }
      ],
      "doseNumber": "2",
      "seriesDoses": "3"
    }
  ]
}

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.