Release 5 Ballot

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

Example Immunization/example (XML)

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

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

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Example of Immunization (id = "example")

<?xml version="1.0" encoding="UTF-8"?>

<Immunization xmlns="http://hl7.org/fhir">
  <id value="example"/> 
  <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative: Immunization</b> <a name="example"> </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;example&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> : Flucelvax (Influenza) <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (unknown#FLUCEL VAX)</span> </p> <h3> AdministeredProducts</h3> <table class="grid"><tr> <td> -</td> <td> <b> Concept</b> </td> </tr> <tr> <td> *</td> <td> Flucelvax (Influenza, injectable, MDCK, preservative free, quadrivalent) <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (unknown#70461-0321-03)</span> </td> </tr> </table> <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> : AAJN11K</p> <p> <b> expirationDate</b> : 2015-02-15</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> : 2013-01-10</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> note</b> : Notes on adminstration of vaccine</p> <h3> Reasons</h3> <table class="grid"><tr> <td> -</td> <td> <b> Concept</b> </td> </tr> <tr> <td> *</td> <td> Procedure to meet occupational requirement <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #429060002)</span> </td> </tr> </table> <p> <b> isSubpotent</b> : true</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> Uninsured <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> #uninsured)</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> </div> </text> <identifier> 
    <system value="urn:ietf:rfc:3986"/> 
    <value value="urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234"/> 
  </identifier> 
  <status value="completed"/> 
  <vaccineCode> 
    <coding> 
      <system value="urn:oid:1.2.36.1.2001.1005.17"/> 
      <code value="FLUCEL VAX"/> 
    </coding> 
    <text value="Flucelvax (Influenza)"/> 
  </vaccineCode> 
  <administeredProduct> 
    <concept> 
      <coding> 
        <system value="urn:oid:2.16.840.1.113883.6.69"/> 
        <code value="70461-0321-03"/> 
      </coding> 
      <text value="Flucelvax (Influenza, injectable, MDCK, preservative free, quadrivalent)"/> 
    </concept> 
  </administeredProduct> 
  <manufacturer> 
    <reference> 
      <reference value="Organization/hl7"/> 
    </reference> 
  </manufacturer> 
  <lotNumber value="AAJN11K"/> 
  <expirationDate value="2015-02-15"/> 
  <patient> 
    <reference value="Patient/example"/> 
  </patient> 
  <encounter> 
    <reference value="Encounter/example"/> 
  </encounter> 
  <occurrenceDateTime value="2013-01-10"/> 
  <primarySource value="true"/> 
  <location> 
    <reference value="Location/1"/> 
  </location> 
  <site> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActSite"/> 
      <code value="LA"/> 
      <display value="left arm"/> 
    </coding> 
  </site> 
  <route> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/v3-RouteOfAdministration"/> 
      <code value="IM"/> 
      <display value="Injection, intramuscular"/> 
    </coding> 
  </route> 
  <doseQuantity> 
    <value value="5"/> 
    <system value="http://unitsofmeasure.org"/> 
    <code value="mg"/> 
  </doseQuantity> 
  <performer> 
    <function> 
      <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/v2-0443"/> 
        <code value="OP"/> 
      </coding> 
    </function> 
      <actor> 
         <reference value="Practitioner/example"/> 
      </actor> 
  </performer> 
  <performer> 
    <function> 
      <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/v2-0443"/> 
        <code value="AP"/> 
      </coding> 
    </function> 
      <actor> 
         <reference value="Practitioner/example"/> 
      </actor> 
  </performer> 
  <note> 
    <text value="Notes on adminstration of vaccine"/> 
  </note> 
  <reason> 
    <concept> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="429060002"/> 
      </coding> 
    </concept> 
  </reason> 
  <isSubpotent value="true"/> 
  <programEligibility> 
    <program> 
      <text value="VFC"/> 
    </program> 
    <programStatus> 
      <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/immunization-program-eligibility"/> 
        <code value="uninsured"/> 
      </coding> 
    </programStatus> 
  </programEligibility> 
  <fundingSource> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/immunization-funding-source"/> 
      <code value="private"/> 
    </coding> 
  </fundingSource> 
</Immunization> 

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.