Snapshot 3: Connectathon 32 Base

This page is part of the FHIR Specification (v5.0.0-snapshot3: R5 Snapshot #3, to support Connectathon 32). 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

11.7 Resource Immunization - Content

Public Health and Emergency Response icon Work GroupMaturity Level: 3 Trial UseSecurity Category: Patient Compartments: Patient, Practitioner

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.

11.7.1 Scope and Usage

The Immunization resource is intended to cover the recording of current and historical administration of vaccines to patients across all healthcare disciplines in all care settings and all regions. This includes immunization of both humans and animals but does not include the administration of non-vaccine agents, even those that may have or claim to have immunological effects. While the terms "immunization" and "vaccination" are not clinically identical, for the purposes of the FHIR resources, the terms are used synonymously.

Additionally, the Immunization resource is expected to cover key concepts related to the creation, revision and querying of a patient's immunization history. 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 v2 icon immunization implementation guide, HL7 v3 icon POIZ domain and Immunization Domain Analysis Model.

11.7.2 Boundaries and Relationships

Administration of vaccines is intended to be handled using the Immunization resource. MedicationAdministration is intended for tracking the administration of non-vaccine medications. Some systems treat immunizations in the same way as any other medication administration. Such systems SHOULD use an immunization resource to represent these. If systems need to use a MedicationAdministration resource to capture vaccinations for workflow or other reasons, they SHOULD also expose an equivalent Immunization instance.

While the Immunization and MedicationAdministration resources are distinct, they are both able to capture specific details of the administered product. The Immunization resource uses Immunization.vaccineCode to indicate the nature of the vaccine administered to the patient. The Immunization.administeredProduct may additionally be used to identify the specific product used (either as a coded value or as a reference to a Medication resource). The Immunization resource also contains data about the administered vaccine including the manufacturer, lot number and expiration date. However, the data elements contained within Immunization are expected to only be used when Immunization.administeredProduct does not reference a Medication resource which contains the same information about the product.

Similarly, MedicationAdministrative.medication references a Medication resource which is used to identify the administered product. Medication.marketingAuthorizationHolder, Medication.batch.lotNumber and Medication.batch.expirationDate are all analogous to the Immunization resource elements and are similarly used to capture details of the administered product.

Immunization.reaction may be an indication of an allergy or intolerance. If this is deemed to be the case, a separate AllergyIntolerance resource instance should be created to indicate it, as most systems will not query against past Immunization.reaction.

Some workflows may require documenting that specific educational materials were presented to the patient (or other responsible party) at the time of or before the immunization event. Conveyance of this information should be accomplished using the Communication resource. This resource can be linked to an Immunization resource and indicate the timing and nature of the educational material provided. The Communication resource may be a standalone resource or may be contained within the Immunization resource as appropriate. Feedback on this approach is welcome.

11.7.3 References to this Resource

11.7.4 Resource Content

Structure

Name iconFlags iconCard. iconType iconDescription & Constraints icondoco icon
.. Immunization TUDomainResourceImmunization event information

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier 0..*IdentifierBusiness identifier

... basedOn Σ0..*Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)Authority that the immunization event is based on

... status ?!Σ1..1codecompleted | entered-in-error | not-done
Immunization Status Codes (Required)
... statusReason 0..1CodeableConceptReason for current status
Immunization Status Reason Codes (Example)
... vaccineCode Σ1..1CodeableConceptVaccine administered
Vaccine Administered Value Set (Example)
... administeredProduct 0..1CodeableReference(Medication)Product that was administered
... manufacturer 0..1CodeableReference(Organization)Vaccine manufacturer
... lotNumber 0..1stringVaccine lot number
... expirationDate 0..1dateVaccine expiration date
... patient Σ1..1Reference(Patient)Who was immunized
... encounter 0..1Reference(Encounter)Encounter immunization was part of
... supportingInformation 0..*Reference(Any)Additional information in support of the immunization

... occurrence[x] Σ1..1Vaccine administration date
.... occurrenceDateTimedateTime
.... occurrenceStringstring
... primarySource Σ0..1booleanIndicates context the data was captured in
... informationSource 0..1CodeableReference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)Indicates the source of a reported record
Immunization Origin Codes (Example)
... location 0..1Reference(Location)Where immunization occurred
... site 0..1CodeableConceptBody site vaccine was administered
Codes for Immunization Site of Administration (Example)
... route 0..1CodeableConceptHow vaccine entered body
Immunization Route Codes (Example)
... doseQuantity 0..1SimpleQuantityAmount of vaccine administered
... performer Σ0..*BackboneElementWho performed event

.... function Σ0..1CodeableConceptWhat type of performance was done
Immunization Function Codes (Extensible)
.... actor Σ1..1Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson)Individual or organization who was performing
... note Σ0..*AnnotationAdditional immunization notes

... reason 0..*CodeableReference(Condition | Observation | DiagnosticReport)Why immunization occurred
Immunization Reason Codes (Example)

... isSubpotent ?!Σ0..1booleanDose potency
... subpotentReason 0..*CodeableConceptReason for being subpotent
Immunization Subpotent Reason (Example)

... programEligibility 0..*BackboneElementPatient eligibility for a specific vaccination program

.... program 1..1CodeableConceptThe program that eligibility is declared for
Vaccine Funding Programs (Example)
.... programStatus 1..1CodeableConceptThe patient's eligibility status for the program
Immunization Program Eligibility (Example)
... fundingSource 0..1CodeableConceptFunding source for the vaccine
Immunization Funding Source (Example)
... reaction 0..*BackboneElementDetails of a reaction that follows immunization

.... date 0..1dateTimeWhen reaction started
.... manifestation 0..1CodeableReference(Observation)Additional information on reaction
.... reported 0..1booleanIndicates self-reported reaction
... protocolApplied 0..*BackboneElementProtocol followed by the provider

.... series 0..1stringName of vaccine series
.... authority 0..1Reference(Organization)Who is responsible for publishing the recommendations
.... targetDisease 0..*CodeableConceptVaccine preventatable disease being targeted
Immunization Target Disease Codes (Example)

.... doseNumber 1..1stringDose number within series
.... seriesDoses 0..1stringRecommended number of doses for immunity

doco Documentation for this format icon

See the Extensions for this resource

UML Diagram (Legend)

Immunization (DomainResource)A unique identifier assigned to this immunization recordidentifier : Identifier [0..*]A plan, order or recommendation fulfilled in whole or in part by this immunizationbasedOn : Reference [0..*] « CarePlan|MedicationRequest| ServiceRequest|ImmunizationRecommendation »Indicates the current status of the immunization event (this element modifies the meaning of other elements)status : code [1..1] « null (Strength=Required)ImmunizationStatusCodes! »Indicates the reason the immunization event was not performedstatusReason : CodeableConcept [0..1] « null (Strength=Example) ImmunizationStatusReasonCodes?? »Vaccine that was administered or was to be administeredvaccineCode : CodeableConcept [1..1] « null (Strength=Example)VaccineAdministeredValueSet?? »An indication of which product was administered to the patient. This is typically a more detailed representation of the concept conveyed by the vaccineCode data element. If a Medication resource is referenced, it may be to a stand-alone resource or a contained resource within the Immunization resourceadministeredProduct : CodeableReference [0..1] « Medication »Name of vaccine manufacturermanufacturer : CodeableReference [0..1] « Organization »Lot number of the vaccine productlotNumber : string [0..1]Date vaccine batch expiresexpirationDate : date [0..1]The patient who either received or did not receive the immunizationpatient : Reference [1..1] « Patient »The visit or admission or other contact between patient and health care provider the immunization was performed as part ofencounter : Reference [0..1] « Encounter »Additional information that is relevant to the immunization (e.g. for a vaccine recipient who is pregnant, the gestational age of the fetus). The reason why a vaccine was given (e.g. occupation, underlying medical condition) should be conveyed in Immunization.reason, not as supporting information. The reason why a vaccine was not given (e.g. contraindication) should be conveyed in Immunization.statusReason, not as supporting informationsupportingInformation : Reference [0..*] « Any »Date vaccine administered or was to be administeredoccurrence[x] : PrimitiveType [1..1] « dateTime|string »Indicates whether the data contained in the resource was captured by the individual/organization which was responsible for the administration of the vaccine rather than as 'secondary reported' data documented by a third party. A value of 'true' means this data originated with the individual/organization which was responsible for the administration of the vaccineprimarySource : boolean [0..1]Typically the source of the data when the report of the immunization event is not based on information from the person who administered the vaccineinformationSource : CodeableReference [0..1] « Patient|Practitioner| PractitionerRole|RelatedPerson|Organization; null (Strength=Example) ImmunizationOriginCodes?? »The service delivery location where the vaccine administration occurredlocation : Reference [0..1] « Location »Body site where vaccine was administeredsite : CodeableConcept [0..1] « null (Strength=Example)CodesForImmunizationSiteOfAdm...?? »The path by which the vaccine product is taken into the bodyroute : CodeableConcept [0..1] « null (Strength=Example)ImmunizationRouteCodes?? »The quantity of vaccine product that was administereddoseQuantity : Quantity(SimpleQuantity) [0..1]Extra information about the immunization that is not conveyed by the other attributesnote : Annotation [0..*]Describes why the immunization occurred in coded or textual form, or Indicates another resource (Condition, Observation or DiagnosticReport) whose existence justifies this immunizationreason : CodeableReference [0..*] « Condition|Observation| DiagnosticReport; null (Strength=Example)ImmunizationReasonCodes?? »Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent (this element modifies the meaning of other elements)isSubpotent : boolean [0..1]Reason why a dose is considered to be subpotentsubpotentReason : CodeableConcept [0..*] « null (Strength=Example) ImmunizationSubpotentReason?? »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)fundingSource : CodeableConcept [0..1] « null (Strength=Example)ImmunizationFundingSource?? »PerformerDescribes the type of performance (e.g. ordering provider, administering provider, etc.)function : CodeableConcept [0..1] « null (Strength=Extensible)ImmunizationFunctionCodes+ »The practitioner or organization who performed the actionactor : Reference [1..1] « Practitioner|PractitionerRole| Organization|Patient|RelatedPerson »ProgramEligibilityIndicates which program the patient had their eligility evaluated forprogram : CodeableConcept [1..1] « null (Strength=Example)CodesForVaccineFundingPrograms?? »Indicates the patient's eligility status for for a specific payment programprogramStatus : CodeableConcept [1..1] « null (Strength=Example) ImmunizationProgramEligibility?? »ReactionDate of reaction to the immunizationdate : dateTime [0..1]Details of the reactionmanifestation : CodeableReference [0..1] « Observation »Self-reported indicatorreported : boolean [0..1]ProtocolAppliedOne possible path to achieve presumed immunity against a disease - within the context of an authorityseries : string [0..1]Indicates the authority who published the protocol (e.g. ACIP) that is being followedauthority : Reference [0..1] « Organization »The vaccine preventable disease the dose is being administered againsttargetDisease : CodeableConcept [0..*] « null (Strength=Example) ImmunizationTargetDiseaseCodes?? »Nominal position in a series as intended by the practitioner administering the dosedoseNumber : string [1..1]The recommended number of doses to achieve immunity as intended by the practitioner administering the doseseriesDoses : string [0..1]Indicates who performed the immunization eventperformer[0..*]Indicates a patient's eligibility for a funding programprogramEligibility[0..*]Categorical data indicating that an adverse event is associated in time to an immunizationreaction[0..*]The protocol (set of recommendations) being followed by the provider who administered the doseprotocolApplied[0..*]

XML Template

<Immunization 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>
 <basedOn><!-- 0..* Reference(CarePlan|ImmunizationRecommendation|
   MedicationRequest|ServiceRequest) Authority that the immunization event is based on --></basedOn>
 <status value="[code]"/><!-- 1..1 completed | entered-in-error | not-done -->
 <statusReason><!-- 0..1 CodeableConcept Reason for current status --></statusReason>
 <vaccineCode><!-- 1..1 CodeableConcept Vaccine administered --></vaccineCode>
 <administeredProduct><!-- 0..1 CodeableReference(Medication) Product that was administered --></administeredProduct>
 <manufacturer><!-- 0..1 CodeableReference(Organization) Vaccine manufacturer --></manufacturer>
 <lotNumber value="[string]"/><!-- 0..1 Vaccine lot number -->
 <expirationDate value="[date]"/><!-- 0..1 Vaccine expiration date -->
 <patient><!-- 1..1 Reference(Patient) Who was immunized --></patient>
 <encounter><!-- 0..1 Reference(Encounter) Encounter immunization was part of --></encounter>
 <supportingInformation><!-- 0..* Reference(Any) Additional information in support of the immunization --></supportingInformation>
 <occurrence[x]><!-- 1..1 dateTime|string Vaccine administration date --></occurrence[x]>
 <primarySource value="[boolean]"/><!-- 0..1 Indicates context the data was captured in -->
 <informationSource><!-- 0..1 CodeableReference(Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Indicates the source of a  reported record --></informationSource>
 <location><!-- 0..1 Reference(Location) Where immunization occurred --></location>
 <site><!-- 0..1 CodeableConcept Body site vaccine  was administered --></site>
 <route><!-- 0..1 CodeableConcept How vaccine entered body --></route>
 <doseQuantity><!-- 0..1 Quantity(SimpleQuantity) Amount of vaccine administered --></doseQuantity>
 <performer>  <!-- 0..* Who performed event -->
  <function><!-- 0..1 CodeableConcept What type of performance was done --></function>
  <actor><!-- 1..1 Reference(Organization|Patient|Practitioner|PractitionerRole|
    RelatedPerson) Individual or organization who was performing --></actor>
 </performer>
 <note><!-- 0..* Annotation Additional immunization notes --></note>
 <reason><!-- 0..* CodeableReference(Condition|DiagnosticReport|Observation) Why immunization occurred --></reason>
 <isSubpotent value="[boolean]"/><!-- 0..1 Dose potency -->
 <subpotentReason><!-- 0..* CodeableConcept Reason for being subpotent --></subpotentReason>
 <programEligibility>  <!-- 0..* Patient eligibility for a specific vaccination program -->
  <program><!-- 1..1 CodeableConcept The program that eligibility is declared for --></program>
  <programStatus><!-- 1..1 CodeableConcept The patient's eligibility status for the program --></programStatus>
 </programEligibility>
 <fundingSource><!-- 0..1 CodeableConcept Funding source for the vaccine --></fundingSource>
 <reaction>  <!-- 0..* Details of a reaction that follows immunization -->
  <date value="[dateTime]"/><!-- 0..1 When reaction started -->
  <manifestation><!-- 0..1 CodeableReference(Observation) Additional information on reaction --></manifestation>
  <reported value="[boolean]"/><!-- 0..1 Indicates self-reported reaction -->
 </reaction>
 <protocolApplied>  <!-- 0..* Protocol followed by the provider -->
  <series value="[string]"/><!-- 0..1 Name of vaccine series -->
  <authority><!-- 0..1 Reference(Organization) Who is responsible for publishing the recommendations --></authority>
  <targetDisease><!-- 0..* CodeableConcept Vaccine preventatable disease being targeted --></targetDisease>
  <doseNumber value="[string]"/><!-- 1..1 Dose number within series -->
  <seriesDoses value="[string]"/><!-- 0..1 Recommended number of doses for immunity -->
 </protocolApplied>
</Immunization>

JSON Template

{doco
  "resourceType" : "Immunization",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business identifier
  "basedOn" : [{ Reference(CarePlan|ImmunizationRecommendation|
   MedicationRequest|ServiceRequest) }], // Authority that the immunization event is based on
  "status" : "<code>", // R!  completed | entered-in-error | not-done
  "statusReason" : { CodeableConcept }, // Reason for current status
  "vaccineCode" : { CodeableConcept }, // R!  Vaccine administered
  "administeredProduct" : { CodeableReference(Medication) }, // Product that was administered
  "manufacturer" : { CodeableReference(Organization) }, // Vaccine manufacturer
  "lotNumber" : "<string>", // Vaccine lot number
  "expirationDate" : "<date>", // Vaccine expiration date
  "patient" : { Reference(Patient) }, // R!  Who was immunized
  "encounter" : { Reference(Encounter) }, // Encounter immunization was part of
  "supportingInformation" : [{ Reference(Any) }], // Additional information in support of the immunization
  // occurrence[x]: Vaccine administration date. One of these 2:
  "occurrenceDateTime" : "<dateTime>",
  "occurrenceString" : "<string>",
  "primarySource" : <boolean>, // Indicates context the data was captured in
  "informationSource" : { CodeableReference(Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }, // Indicates the source of a  reported record
  "location" : { Reference(Location) }, // Where immunization occurred
  "site" : { CodeableConcept }, // Body site vaccine  was administered
  "route" : { CodeableConcept }, // How vaccine entered body
  "doseQuantity" : { Quantity(SimpleQuantity) }, // Amount of vaccine administered
  "performer" : [{ // Who performed event
    "function" : { CodeableConcept }, // What type of performance was done
    "actor" : { Reference(Organization|Patient|Practitioner|PractitionerRole|
    RelatedPerson) } // R!  Individual or organization who was performing
  }],
  "note" : [{ Annotation }], // Additional immunization notes
  "reason" : [{ CodeableReference(Condition|DiagnosticReport|Observation) }], // Why immunization occurred
  "isSubpotent" : <boolean>, // Dose potency
  "subpotentReason" : [{ CodeableConcept }], // Reason for being subpotent
  "programEligibility" : [{ // Patient eligibility for a specific vaccination program
    "program" : { CodeableConcept }, // R!  The program that eligibility is declared for
    "programStatus" : { CodeableConcept } // R!  The patient's eligibility status for the program
  }],
  "fundingSource" : { CodeableConcept }, // Funding source for the vaccine
  "reaction" : [{ // Details of a reaction that follows immunization
    "date" : "<dateTime>", // When reaction started
    "manifestation" : { CodeableReference(Observation) }, // Additional information on reaction
    "reported" : <boolean> // Indicates self-reported reaction
  }],
  "protocolApplied" : [{ // Protocol followed by the provider
    "series" : "<string>", // Name of vaccine series
    "authority" : { Reference(Organization) }, // Who is responsible for publishing the recommendations
    "targetDisease" : [{ CodeableConcept }], // Vaccine preventatable disease being targeted
    "doseNumber" : "<string>", // R!  Dose number within series
    "seriesDoses" : "<string>" // Recommended number of doses for immunity
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Immunization;
  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:Immunization.identifier [ Identifier ], ... ; # 0..* Business identifier
  fhir:Immunization.basedOn [ Reference(CarePlan|ImmunizationRecommendation|MedicationRequest|ServiceRequest) ], ... ; # 0..* Authority that the immunization event is based on
  fhir:Immunization.status [ code ]; # 1..1 completed | entered-in-error | not-done
  fhir:Immunization.statusReason [ CodeableConcept ]; # 0..1 Reason for current status
  fhir:Immunization.vaccineCode [ CodeableConcept ]; # 1..1 Vaccine administered
  fhir:Immunization.administeredProduct [ CodeableReference(Medication) ]; # 0..1 Product that was administered
  fhir:Immunization.manufacturer [ CodeableReference(Organization) ]; # 0..1 Vaccine manufacturer
  fhir:Immunization.lotNumber [ string ]; # 0..1 Vaccine lot number
  fhir:Immunization.expirationDate [ date ]; # 0..1 Vaccine expiration date
  fhir:Immunization.patient [ Reference(Patient) ]; # 1..1 Who was immunized
  fhir:Immunization.encounter [ Reference(Encounter) ]; # 0..1 Encounter immunization was part of
  fhir:Immunization.supportingInformation [ Reference(Any) ], ... ; # 0..* Additional information in support of the immunization
  # Immunization.occurrence[x] : 1..1 Vaccine administration date. One of these 2
    fhir:Immunization.occurrenceDateTime [ dateTime ]
    fhir:Immunization.occurrenceString [ string ]
  fhir:Immunization.primarySource [ boolean ]; # 0..1 Indicates context the data was captured in
  fhir:Immunization.informationSource [ CodeableReference(Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 Indicates the source of a  reported record
  fhir:Immunization.location [ Reference(Location) ]; # 0..1 Where immunization occurred
  fhir:Immunization.site [ CodeableConcept ]; # 0..1 Body site vaccine  was administered
  fhir:Immunization.route [ CodeableConcept ]; # 0..1 How vaccine entered body
  fhir:Immunization.doseQuantity [ Quantity(SimpleQuantity) ]; # 0..1 Amount of vaccine administered
  fhir:Immunization.performer [ # 0..* Who performed event
    fhir:Immunization.performer.function [ CodeableConcept ]; # 0..1 What type of performance was done
    fhir:Immunization.performer.actor [ Reference(Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 1..1 Individual or organization who was performing
  ], ...;
  fhir:Immunization.note [ Annotation ], ... ; # 0..* Additional immunization notes
  fhir:Immunization.reason [ CodeableReference(Condition|DiagnosticReport|Observation) ], ... ; # 0..* Why immunization occurred
  fhir:Immunization.isSubpotent [ boolean ]; # 0..1 Dose potency
  fhir:Immunization.subpotentReason [ CodeableConcept ], ... ; # 0..* Reason for being subpotent
  fhir:Immunization.programEligibility [ # 0..* Patient eligibility for a specific vaccination program
    fhir:Immunization.programEligibility.program [ CodeableConcept ]; # 1..1 The program that eligibility is declared for
    fhir:Immunization.programEligibility.programStatus [ CodeableConcept ]; # 1..1 The patient's eligibility status for the program
  ], ...;
  fhir:Immunization.fundingSource [ CodeableConcept ]; # 0..1 Funding source for the vaccine
  fhir:Immunization.reaction [ # 0..* Details of a reaction that follows immunization
    fhir:Immunization.reaction.date [ dateTime ]; # 0..1 When reaction started
    fhir:Immunization.reaction.manifestation [ CodeableReference(Observation) ]; # 0..1 Additional information on reaction
    fhir:Immunization.reaction.reported [ boolean ]; # 0..1 Indicates self-reported reaction
  ], ...;
  fhir:Immunization.protocolApplied [ # 0..* Protocol followed by the provider
    fhir:Immunization.protocolApplied.series [ string ]; # 0..1 Name of vaccine series
    fhir:Immunization.protocolApplied.authority [ Reference(Organization) ]; # 0..1 Who is responsible for publishing the recommendations
    fhir:Immunization.protocolApplied.targetDisease [ CodeableConcept ], ... ; # 0..* Vaccine preventatable disease being targeted
    fhir:Immunization.protocolApplied.doseNumber [ string ]; # 1..1 Dose number within series
    fhir:Immunization.protocolApplied.seriesDoses [ string ]; # 0..1 Recommended number of doses for immunity
  ], ...;
]

Changes since R4

Immunization
Immunization.basedOn
  • Added Element
Immunization.administeredProduct
  • Added Element
Immunization.manufacturer
  • Type changed from Reference(Organization) to CodeableReference
  • Type changed from Reference(Organization) to CodeableReference
Immunization.supportingInformation
  • Added Element
Immunization.informationSource
  • Added Element
Immunization.performer.actor
  • Type Reference: Added Target Types Patient, RelatedPerson
  • Type Reference: Added Target Types Patient, RelatedPerson
Immunization.reason
  • Added Element
Immunization.programEligibility
  • Type changed from CodeableConcept to BackboneElement
  • Type changed from CodeableConcept to BackboneElement
Immunization.programEligibility.program
  • Added Mandatory Element
Immunization.programEligibility.programStatus
  • Added Mandatory Element
Immunization.reaction.manifestation
  • Added Element
Immunization.protocolApplied.doseNumber
  • Added Mandatory Element
Immunization.protocolApplied.seriesDoses
  • Added Element
Immunization.recorded
  • deleted
Immunization.reportOrigin
  • deleted
Immunization.reasonCode
  • deleted
Immunization.reasonReference
  • deleted
Immunization.education
  • deleted
Immunization.reaction.detail
  • deleted
Immunization.protocolApplied.doseNumber[x]
  • deleted
Immunization.protocolApplied.seriesDoses[x]
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 3 tests that all execute ok. All tests pass round-trip testing and 3 r3 resources are invalid (0 errors).)

Structure

Name iconFlags iconCard. iconType iconDescription & Constraints icondoco icon
.. Immunization TUDomainResourceImmunization event information

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier 0..*IdentifierBusiness identifier

... basedOn Σ0..*Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)Authority that the immunization event is based on

... status ?!Σ1..1codecompleted | entered-in-error | not-done
Immunization Status Codes (Required)
... statusReason 0..1CodeableConceptReason for current status
Immunization Status Reason Codes (Example)
... vaccineCode Σ1..1CodeableConceptVaccine administered
Vaccine Administered Value Set (Example)
... administeredProduct 0..1CodeableReference(Medication)Product that was administered
... manufacturer 0..1CodeableReference(Organization)Vaccine manufacturer
... lotNumber 0..1stringVaccine lot number
... expirationDate 0..1dateVaccine expiration date
... patient Σ1..1Reference(Patient)Who was immunized
... encounter 0..1Reference(Encounter)Encounter immunization was part of
... supportingInformation 0..*Reference(Any)Additional information in support of the immunization

... occurrence[x] Σ1..1Vaccine administration date
.... occurrenceDateTimedateTime
.... occurrenceStringstring
... primarySource Σ0..1booleanIndicates context the data was captured in
... informationSource 0..1CodeableReference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)Indicates the source of a reported record
Immunization Origin Codes (Example)
... location 0..1Reference(Location)Where immunization occurred
... site 0..1CodeableConceptBody site vaccine was administered
Codes for Immunization Site of Administration (Example)
... route 0..1CodeableConceptHow vaccine entered body
Immunization Route Codes (Example)
... doseQuantity 0..1SimpleQuantityAmount of vaccine administered
... performer Σ0..*BackboneElementWho performed event

.... function Σ0..1CodeableConceptWhat type of performance was done
Immunization Function Codes (Extensible)
.... actor Σ1..1Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson)Individual or organization who was performing
... note Σ0..*AnnotationAdditional immunization notes

... reason 0..*CodeableReference(Condition | Observation | DiagnosticReport)Why immunization occurred
Immunization Reason Codes (Example)

... isSubpotent ?!Σ0..1booleanDose potency
... subpotentReason 0..*CodeableConceptReason for being subpotent
Immunization Subpotent Reason (Example)

... programEligibility 0..*BackboneElementPatient eligibility for a specific vaccination program

.... program 1..1CodeableConceptThe program that eligibility is declared for
Vaccine Funding Programs (Example)
.... programStatus 1..1CodeableConceptThe patient's eligibility status for the program
Immunization Program Eligibility (Example)
... fundingSource 0..1CodeableConceptFunding source for the vaccine
Immunization Funding Source (Example)
... reaction 0..*BackboneElementDetails of a reaction that follows immunization

.... date 0..1dateTimeWhen reaction started
.... manifestation 0..1CodeableReference(Observation)Additional information on reaction
.... reported 0..1booleanIndicates self-reported reaction
... protocolApplied 0..*BackboneElementProtocol followed by the provider

.... series 0..1stringName of vaccine series
.... authority 0..1Reference(Organization)Who is responsible for publishing the recommendations
.... targetDisease 0..*CodeableConceptVaccine preventatable disease being targeted
Immunization Target Disease Codes (Example)

.... doseNumber 1..1stringDose number within series
.... seriesDoses 0..1stringRecommended number of doses for immunity

doco Documentation for this format icon

See the Extensions for this resource

UML Diagram (Legend)

Immunization (DomainResource)A unique identifier assigned to this immunization recordidentifier : Identifier [0..*]A plan, order or recommendation fulfilled in whole or in part by this immunizationbasedOn : Reference [0..*] « CarePlan|MedicationRequest| ServiceRequest|ImmunizationRecommendation »Indicates the current status of the immunization event (this element modifies the meaning of other elements)status : code [1..1] « null (Strength=Required)ImmunizationStatusCodes! »Indicates the reason the immunization event was not performedstatusReason : CodeableConcept [0..1] « null (Strength=Example) ImmunizationStatusReasonCodes?? »Vaccine that was administered or was to be administeredvaccineCode : CodeableConcept [1..1] « null (Strength=Example)VaccineAdministeredValueSet?? »An indication of which product was administered to the patient. This is typically a more detailed representation of the concept conveyed by the vaccineCode data element. If a Medication resource is referenced, it may be to a stand-alone resource or a contained resource within the Immunization resourceadministeredProduct : CodeableReference [0..1] « Medication »Name of vaccine manufacturermanufacturer : CodeableReference [0..1] « Organization »Lot number of the vaccine productlotNumber : string [0..1]Date vaccine batch expiresexpirationDate : date [0..1]The patient who either received or did not receive the immunizationpatient : Reference [1..1] « Patient »The visit or admission or other contact between patient and health care provider the immunization was performed as part ofencounter : Reference [0..1] « Encounter »Additional information that is relevant to the immunization (e.g. for a vaccine recipient who is pregnant, the gestational age of the fetus). The reason why a vaccine was given (e.g. occupation, underlying medical condition) should be conveyed in Immunization.reason, not as supporting information. The reason why a vaccine was not given (e.g. contraindication) should be conveyed in Immunization.statusReason, not as supporting informationsupportingInformation : Reference [0..*] « Any »Date vaccine administered or was to be administeredoccurrence[x] : PrimitiveType [1..1] « dateTime|string »Indicates whether the data contained in the resource was captured by the individual/organization which was responsible for the administration of the vaccine rather than as 'secondary reported' data documented by a third party. A value of 'true' means this data originated with the individual/organization which was responsible for the administration of the vaccineprimarySource : boolean [0..1]Typically the source of the data when the report of the immunization event is not based on information from the person who administered the vaccineinformationSource : CodeableReference [0..1] « Patient|Practitioner| PractitionerRole|RelatedPerson|Organization; null (Strength=Example) ImmunizationOriginCodes?? »The service delivery location where the vaccine administration occurredlocation : Reference [0..1] « Location »Body site where vaccine was administeredsite : CodeableConcept [0..1] « null (Strength=Example)CodesForImmunizationSiteOfAdm...?? »The path by which the vaccine product is taken into the bodyroute : CodeableConcept [0..1] « null (Strength=Example)ImmunizationRouteCodes?? »The quantity of vaccine product that was administereddoseQuantity : Quantity(SimpleQuantity) [0..1]Extra information about the immunization that is not conveyed by the other attributesnote : Annotation [0..*]Describes why the immunization occurred in coded or textual form, or Indicates another resource (Condition, Observation or DiagnosticReport) whose existence justifies this immunizationreason : CodeableReference [0..*] « Condition|Observation| DiagnosticReport; null (Strength=Example)ImmunizationReasonCodes?? »Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent (this element modifies the meaning of other elements)isSubpotent : boolean [0..1]Reason why a dose is considered to be subpotentsubpotentReason : CodeableConcept [0..*] « null (Strength=Example) ImmunizationSubpotentReason?? »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)fundingSource : CodeableConcept [0..1] « null (Strength=Example)ImmunizationFundingSource?? »PerformerDescribes the type of performance (e.g. ordering provider, administering provider, etc.)function : CodeableConcept [0..1] « null (Strength=Extensible)ImmunizationFunctionCodes+ »The practitioner or organization who performed the actionactor : Reference [1..1] « Practitioner|PractitionerRole| Organization|Patient|RelatedPerson »ProgramEligibilityIndicates which program the patient had their eligility evaluated forprogram : CodeableConcept [1..1] « null (Strength=Example)CodesForVaccineFundingPrograms?? »Indicates the patient's eligility status for for a specific payment programprogramStatus : CodeableConcept [1..1] « null (Strength=Example) ImmunizationProgramEligibility?? »ReactionDate of reaction to the immunizationdate : dateTime [0..1]Details of the reactionmanifestation : CodeableReference [0..1] « Observation »Self-reported indicatorreported : boolean [0..1]ProtocolAppliedOne possible path to achieve presumed immunity against a disease - within the context of an authorityseries : string [0..1]Indicates the authority who published the protocol (e.g. ACIP) that is being followedauthority : Reference [0..1] « Organization »The vaccine preventable disease the dose is being administered againsttargetDisease : CodeableConcept [0..*] « null (Strength=Example) ImmunizationTargetDiseaseCodes?? »Nominal position in a series as intended by the practitioner administering the dosedoseNumber : string [1..1]The recommended number of doses to achieve immunity as intended by the practitioner administering the doseseriesDoses : string [0..1]Indicates who performed the immunization eventperformer[0..*]Indicates a patient's eligibility for a funding programprogramEligibility[0..*]Categorical data indicating that an adverse event is associated in time to an immunizationreaction[0..*]The protocol (set of recommendations) being followed by the provider who administered the doseprotocolApplied[0..*]

XML Template

<Immunization 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>
 <basedOn><!-- 0..* Reference(CarePlan|ImmunizationRecommendation|
   MedicationRequest|ServiceRequest) Authority that the immunization event is based on --></basedOn>
 <status value="[code]"/><!-- 1..1 completed | entered-in-error | not-done -->
 <statusReason><!-- 0..1 CodeableConcept Reason for current status --></statusReason>
 <vaccineCode><!-- 1..1 CodeableConcept Vaccine administered --></vaccineCode>
 <administeredProduct><!-- 0..1 CodeableReference(Medication) Product that was administered --></administeredProduct>
 <manufacturer><!-- 0..1 CodeableReference(Organization) Vaccine manufacturer --></manufacturer>
 <lotNumber value="[string]"/><!-- 0..1 Vaccine lot number -->
 <expirationDate value="[date]"/><!-- 0..1 Vaccine expiration date -->
 <patient><!-- 1..1 Reference(Patient) Who was immunized --></patient>
 <encounter><!-- 0..1 Reference(Encounter) Encounter immunization was part of --></encounter>
 <supportingInformation><!-- 0..* Reference(Any) Additional information in support of the immunization --></supportingInformation>
 <occurrence[x]><!-- 1..1 dateTime|string Vaccine administration date --></occurrence[x]>
 <primarySource value="[boolean]"/><!-- 0..1 Indicates context the data was captured in -->
 <informationSource><!-- 0..1 CodeableReference(Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Indicates the source of a  reported record --></informationSource>
 <location><!-- 0..1 Reference(Location) Where immunization occurred --></location>
 <site><!-- 0..1 CodeableConcept Body site vaccine  was administered --></site>
 <route><!-- 0..1 CodeableConcept How vaccine entered body --></route>
 <doseQuantity><!-- 0..1 Quantity(SimpleQuantity) Amount of vaccine administered --></doseQuantity>
 <performer>  <!-- 0..* Who performed event -->
  <function><!-- 0..1 CodeableConcept What type of performance was done --></function>
  <actor><!-- 1..1 Reference(Organization|Patient|Practitioner|PractitionerRole|
    RelatedPerson) Individual or organization who was performing --></actor>
 </performer>
 <note><!-- 0..* Annotation Additional immunization notes --></note>
 <reason><!-- 0..* CodeableReference(Condition|DiagnosticReport|Observation) Why immunization occurred --></reason>
 <isSubpotent value="[boolean]"/><!-- 0..1 Dose potency -->
 <subpotentReason><!-- 0..* CodeableConcept Reason for being subpotent --></subpotentReason>
 <programEligibility>  <!-- 0..* Patient eligibility for a specific vaccination program -->
  <program><!-- 1..1 CodeableConcept The program that eligibility is declared for --></program>
  <programStatus><!-- 1..1 CodeableConcept The patient's eligibility status for the program --></programStatus>
 </programEligibility>
 <fundingSource><!-- 0..1 CodeableConcept Funding source for the vaccine --></fundingSource>
 <reaction>  <!-- 0..* Details of a reaction that follows immunization -->
  <date value="[dateTime]"/><!-- 0..1 When reaction started -->
  <manifestation><!-- 0..1 CodeableReference(Observation) Additional information on reaction --></manifestation>
  <reported value="[boolean]"/><!-- 0..1 Indicates self-reported reaction -->
 </reaction>
 <protocolApplied>  <!-- 0..* Protocol followed by the provider -->
  <series value="[string]"/><!-- 0..1 Name of vaccine series -->
  <authority><!-- 0..1 Reference(Organization) Who is responsible for publishing the recommendations --></authority>
  <targetDisease><!-- 0..* CodeableConcept Vaccine preventatable disease being targeted --></targetDisease>
  <doseNumber value="[string]"/><!-- 1..1 Dose number within series -->
  <seriesDoses value="[string]"/><!-- 0..1 Recommended number of doses for immunity -->
 </protocolApplied>
</Immunization>

JSON Template

{doco
  "resourceType" : "Immunization",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business identifier
  "basedOn" : [{ Reference(CarePlan|ImmunizationRecommendation|
   MedicationRequest|ServiceRequest) }], // Authority that the immunization event is based on
  "status" : "<code>", // R!  completed | entered-in-error | not-done
  "statusReason" : { CodeableConcept }, // Reason for current status
  "vaccineCode" : { CodeableConcept }, // R!  Vaccine administered
  "administeredProduct" : { CodeableReference(Medication) }, // Product that was administered
  "manufacturer" : { CodeableReference(Organization) }, // Vaccine manufacturer
  "lotNumber" : "<string>", // Vaccine lot number
  "expirationDate" : "<date>", // Vaccine expiration date
  "patient" : { Reference(Patient) }, // R!  Who was immunized
  "encounter" : { Reference(Encounter) }, // Encounter immunization was part of
  "supportingInformation" : [{ Reference(Any) }], // Additional information in support of the immunization
  // occurrence[x]: Vaccine administration date. One of these 2:
  "occurrenceDateTime" : "<dateTime>",
  "occurrenceString" : "<string>",
  "primarySource" : <boolean>, // Indicates context the data was captured in
  "informationSource" : { CodeableReference(Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }, // Indicates the source of a  reported record
  "location" : { Reference(Location) }, // Where immunization occurred
  "site" : { CodeableConcept }, // Body site vaccine  was administered
  "route" : { CodeableConcept }, // How vaccine entered body
  "doseQuantity" : { Quantity(SimpleQuantity) }, // Amount of vaccine administered
  "performer" : [{ // Who performed event
    "function" : { CodeableConcept }, // What type of performance was done
    "actor" : { Reference(Organization|Patient|Practitioner|PractitionerRole|
    RelatedPerson) } // R!  Individual or organization who was performing
  }],
  "note" : [{ Annotation }], // Additional immunization notes
  "reason" : [{ CodeableReference(Condition|DiagnosticReport|Observation) }], // Why immunization occurred
  "isSubpotent" : <boolean>, // Dose potency
  "subpotentReason" : [{ CodeableConcept }], // Reason for being subpotent
  "programEligibility" : [{ // Patient eligibility for a specific vaccination program
    "program" : { CodeableConcept }, // R!  The program that eligibility is declared for
    "programStatus" : { CodeableConcept } // R!  The patient's eligibility status for the program
  }],
  "fundingSource" : { CodeableConcept }, // Funding source for the vaccine
  "reaction" : [{ // Details of a reaction that follows immunization
    "date" : "<dateTime>", // When reaction started
    "manifestation" : { CodeableReference(Observation) }, // Additional information on reaction
    "reported" : <boolean> // Indicates self-reported reaction
  }],
  "protocolApplied" : [{ // Protocol followed by the provider
    "series" : "<string>", // Name of vaccine series
    "authority" : { Reference(Organization) }, // Who is responsible for publishing the recommendations
    "targetDisease" : [{ CodeableConcept }], // Vaccine preventatable disease being targeted
    "doseNumber" : "<string>", // R!  Dose number within series
    "seriesDoses" : "<string>" // Recommended number of doses for immunity
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Immunization;
  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:Immunization.identifier [ Identifier ], ... ; # 0..* Business identifier
  fhir:Immunization.basedOn [ Reference(CarePlan|ImmunizationRecommendation|MedicationRequest|ServiceRequest) ], ... ; # 0..* Authority that the immunization event is based on
  fhir:Immunization.status [ code ]; # 1..1 completed | entered-in-error | not-done
  fhir:Immunization.statusReason [ CodeableConcept ]; # 0..1 Reason for current status
  fhir:Immunization.vaccineCode [ CodeableConcept ]; # 1..1 Vaccine administered
  fhir:Immunization.administeredProduct [ CodeableReference(Medication) ]; # 0..1 Product that was administered
  fhir:Immunization.manufacturer [ CodeableReference(Organization) ]; # 0..1 Vaccine manufacturer
  fhir:Immunization.lotNumber [ string ]; # 0..1 Vaccine lot number
  fhir:Immunization.expirationDate [ date ]; # 0..1 Vaccine expiration date
  fhir:Immunization.patient [ Reference(Patient) ]; # 1..1 Who was immunized
  fhir:Immunization.encounter [ Reference(Encounter) ]; # 0..1 Encounter immunization was part of
  fhir:Immunization.supportingInformation [ Reference(Any) ], ... ; # 0..* Additional information in support of the immunization
  # Immunization.occurrence[x] : 1..1 Vaccine administration date. One of these 2
    fhir:Immunization.occurrenceDateTime [ dateTime ]
    fhir:Immunization.occurrenceString [ string ]
  fhir:Immunization.primarySource [ boolean ]; # 0..1 Indicates context the data was captured in
  fhir:Immunization.informationSource [ CodeableReference(Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 Indicates the source of a  reported record
  fhir:Immunization.location [ Reference(Location) ]; # 0..1 Where immunization occurred
  fhir:Immunization.site [ CodeableConcept ]; # 0..1 Body site vaccine  was administered
  fhir:Immunization.route [ CodeableConcept ]; # 0..1 How vaccine entered body
  fhir:Immunization.doseQuantity [ Quantity(SimpleQuantity) ]; # 0..1 Amount of vaccine administered
  fhir:Immunization.performer [ # 0..* Who performed event
    fhir:Immunization.performer.function [ CodeableConcept ]; # 0..1 What type of performance was done
    fhir:Immunization.performer.actor [ Reference(Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 1..1 Individual or organization who was performing
  ], ...;
  fhir:Immunization.note [ Annotation ], ... ; # 0..* Additional immunization notes
  fhir:Immunization.reason [ CodeableReference(Condition|DiagnosticReport|Observation) ], ... ; # 0..* Why immunization occurred
  fhir:Immunization.isSubpotent [ boolean ]; # 0..1 Dose potency
  fhir:Immunization.subpotentReason [ CodeableConcept ], ... ; # 0..* Reason for being subpotent
  fhir:Immunization.programEligibility [ # 0..* Patient eligibility for a specific vaccination program
    fhir:Immunization.programEligibility.program [ CodeableConcept ]; # 1..1 The program that eligibility is declared for
    fhir:Immunization.programEligibility.programStatus [ CodeableConcept ]; # 1..1 The patient's eligibility status for the program
  ], ...;
  fhir:Immunization.fundingSource [ CodeableConcept ]; # 0..1 Funding source for the vaccine
  fhir:Immunization.reaction [ # 0..* Details of a reaction that follows immunization
    fhir:Immunization.reaction.date [ dateTime ]; # 0..1 When reaction started
    fhir:Immunization.reaction.manifestation [ CodeableReference(Observation) ]; # 0..1 Additional information on reaction
    fhir:Immunization.reaction.reported [ boolean ]; # 0..1 Indicates self-reported reaction
  ], ...;
  fhir:Immunization.protocolApplied [ # 0..* Protocol followed by the provider
    fhir:Immunization.protocolApplied.series [ string ]; # 0..1 Name of vaccine series
    fhir:Immunization.protocolApplied.authority [ Reference(Organization) ]; # 0..1 Who is responsible for publishing the recommendations
    fhir:Immunization.protocolApplied.targetDisease [ CodeableConcept ], ... ; # 0..* Vaccine preventatable disease being targeted
    fhir:Immunization.protocolApplied.doseNumber [ string ]; # 1..1 Dose number within series
    fhir:Immunization.protocolApplied.seriesDoses [ string ]; # 0..1 Recommended number of doses for immunity
  ], ...;
]

Changes since Release 4

Immunization
Immunization.basedOn
  • Added Element
Immunization.administeredProduct
  • Added Element
Immunization.manufacturer
  • Type changed from Reference(Organization) to CodeableReference
  • Type changed from Reference(Organization) to CodeableReference
Immunization.supportingInformation
  • Added Element
Immunization.informationSource
  • Added Element
Immunization.performer.actor
  • Type Reference: Added Target Types Patient, RelatedPerson
  • Type Reference: Added Target Types Patient, RelatedPerson
Immunization.reason
  • Added Element
Immunization.programEligibility
  • Type changed from CodeableConcept to BackboneElement
  • Type changed from CodeableConcept to BackboneElement
Immunization.programEligibility.program
  • Added Mandatory Element
Immunization.programEligibility.programStatus
  • Added Mandatory Element
Immunization.reaction.manifestation
  • Added Element
Immunization.protocolApplied.doseNumber
  • Added Mandatory Element
Immunization.protocolApplied.seriesDoses
  • Added Element
Immunization.recorded
  • deleted
Immunization.reportOrigin
  • deleted
Immunization.reasonCode
  • deleted
Immunization.reasonReference
  • deleted
Immunization.education
  • deleted
Immunization.reaction.detail
  • deleted
Immunization.protocolApplied.doseNumber[x]
  • deleted
Immunization.protocolApplied.seriesDoses[x]
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 3 tests that all execute ok. All tests pass round-trip testing and 3 r3 resources are invalid (0 errors).)

 

Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis

11.7.4.1 Terminology Bindings

PathDefinitionTypeReference
Immunization.status

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the current status of the administered dose of vaccine.

RequiredImmunizationStatusCodes
Immunization.statusReason

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the reason why a dose of vaccine was not administered. This value set is provided as a suggestive example.

ExampleImmunizationStatusReasonCodes
Immunization.vaccineCode

This identifies the vaccine substance administered - CVX codes.

ExampleVaccineAdministeredValueSet
Immunization.informationSource

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the source of the data when the report of the immunization event is not based on information from the person, entity or organization who administered the vaccine. This value set is provided as a suggestive example.

ExampleImmunizationOriginCodes
Immunization.site

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the body site where the vaccination occurred. This value set is provided as a suggestive example.

ExampleCodesForImmunizationSiteOfAdministration
Immunization.route

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the administrative routes used during vaccination. This value set is provided as a suggestive example.

ExampleImmunizationRouteCodes
Immunization.performer.function

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the function a practitioner or organization may play in the immunization event. This value set is provided as a suggestive example.

ExtensibleImmunizationFunctionCodes
Immunization.reason

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the reason why a dose of vaccine was administered. This value set is provided as a suggestive example.

ExampleImmunizationReasonCodes
Immunization.subpotentReason

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the reason why a dose is considered to be subpotent. This value set is provided as a suggestive example.

ExampleImmunizationSubpotentReason
Immunization.programEligibility.program

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing programs that a patient may be eligible for to cover vaccine administration costs. This value set is provided as a suggestive example.

ExampleCodesForVaccineFundingPrograms
Immunization.programEligibility.programStatus

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the patient's eligibility for a vaccination program. This value set is provided as a suggestive example.

ExampleImmunizationProgramEligibility
Immunization.fundingSource

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the source of the vaccine administered. This value set is provided as a suggestive example.

ExampleImmunizationFundingSource
Immunization.protocolApplied.targetDisease

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the disease that the dose is being administered against. This value set is provided as a suggestive example and includes SNOMED CT concepts from the 64572001 (Disease) hierarchy.

ExampleImmunizationTargetDiseaseCodes

11.7.5 Search Parameters

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

NameTypeDescriptionExpressionIn Common
datedateVaccination (non)-Administration Date(Immunization.occurrence as dateTime)17 Resources
identifiertokenBusiness identifierImmunization.identifier30 Resources
locationreferenceThe service delivery location or facility in which the vaccine was / was to be administeredImmunization.location
(Location)
lot-numberstringVaccine Lot NumberImmunization.lotNumber
manufacturerreferenceVaccine ManufacturerImmunization.manufacturer.reference
patientreferenceThe patient for the vaccination recordImmunization.patient
(Patient)		33 Resources
performerreferenceThe practitioner, individual or organization who played a role in the vaccinationImmunization.performer.actor
(Practitioner, Organization, Patient, PractitionerRole, RelatedPerson)
reactionreferenceAdditional information on reactionImmunization.reaction.manifestation.reference
reaction-datedateWhen reaction startedImmunization.reaction.date
reason-codetokenReason why the vaccine was administeredImmunization.reason.concept
reason-referencereferenceReference to a resource (by instance)Immunization.reason.reference
seriesstringThe series being followed by the providerImmunization.protocolApplied.series
statustokenImmunization event statusImmunization.status
status-reasontokenReason why the vaccine was not administeredImmunization.statusReason
target-diseasetokenThe target disease the dose is being administered againstImmunization.protocolApplied.targetDisease
vaccine-codetokenVaccine Product AdministeredImmunization.vaccineCode