This page is part of the FHIR Specification v6.0.0-ballot1: Release 6 Ballot (1st Draft) (see Ballot Notes). The current version is 5.0.0. For a full list of available versions, see the Directory of published versions
Public Health Work Group | Maturity Level: 5 | Trial Use | Security 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.
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 immunization implementation guide, HL7 v3 POIZ domain and Immunization Domain Analysis Model.
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.
Structure
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Immunization | TU | DomainResource | Immunization event information Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension | |
identifier | 0..* | Identifier | Business identifier | |
basedOn | Σ | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | Authority that the immunization event is based on |
status | ?!Σ | 1..1 | code | completed | entered-in-error | not-done Binding: Immunization Status Codes (Required) |
statusReason | 0..1 | CodeableConcept | Reason for current status Binding: Immunization Status Reason Codes (Example) | |
vaccineCode | Σ | 1..1 | CodeableConcept | Vaccine administered Binding: Vaccine Administered Value Set (Example) |
administeredProduct | 0..1 | CodeableReference(Medication) | Product that was administered | |
manufacturer | 0..1 | CodeableReference(Organization) | Vaccine manufacturer | |
lotNumber | 0..1 | string | Vaccine lot number | |
expirationDate | 0..1 | date | Vaccine expiration date | |
patient | Σ | 1..1 | Reference(Patient) | Who was immunized |
encounter | 0..1 | Reference(Encounter) | Encounter immunization was part of | |
supportingInformation | 0..* | Reference(Any) | Additional information in support of the immunization | |
occurrence[x] | Σ | 1..1 | Vaccine administration date | |
occurrenceDateTime | dateTime | |||
occurrenceString | string | |||
primarySource | Σ | 0..1 | boolean | Indicates context the data was captured in |
informationSource | 0..1 | CodeableReference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) | Indicates the source of a reported record Binding: Immunization Origin Codes (Example) | |
location | 0..1 | Reference(Location) | Where immunization occurred | |
site | 0..1 | CodeableConcept | Body site vaccine was administered Binding: Codes for Immunization Site of Administration (Example) | |
route | 0..1 | CodeableConcept | How vaccine entered body Binding: Immunization Route Codes (Example) | |
doseQuantity | 0..1 | SimpleQuantity | Amount of vaccine administered | |
performer | Σ | 0..* | BackboneElement | Who performed event |
function | Σ | 0..1 | CodeableConcept | What type of performance was done Binding: Immunization Function Codes (Extensible) |
actor | Σ | 1..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson) | Individual or organization who was performing |
note | Σ | 0..* | Annotation | Additional immunization notes |
reason | 0..* | CodeableReference(Condition | Observation | DiagnosticReport) | Why immunization occurred Binding: Immunization Reason Codes (Example) | |
isSubpotent | ?!Σ | 0..1 | boolean | Dose potency |
subpotentReason | 0..* | CodeableConcept | Reason for being subpotent Binding: Immunization Subpotent Reason (Example) | |
programEligibility | 0..* | BackboneElement | Patient eligibility for a specific vaccination program | |
program | 1..1 | CodeableConcept | The program that eligibility is declared for Binding: Vaccine Funding Programs (Example) | |
programStatus | 1..1 | CodeableConcept | The patient's eligibility status for the program Binding: Immunization Program Eligibility (Example) | |
fundingSource | 0..1 | CodeableConcept | Funding source for the vaccine Binding: Immunization Funding Source (Example) | |
reaction | 0..* | BackboneElement | Details of a reaction that follows immunization | |
date | 0..1 | dateTime | When reaction started | |
manifestation | 0..1 | CodeableReference(Observation) | Additional information on reaction | |
reported | 0..1 | boolean | Indicates self-reported reaction | |
protocolApplied | 0..* | BackboneElement | Protocol followed by the provider | |
series | 0..1 | string | Name of vaccine series | |
authority | 0..1 | Reference(Organization) | Who is responsible for publishing the recommendations | |
targetDisease | 0..* | CodeableConcept | Vaccine preventatable disease being targeted Binding: Immunization Target Disease Codes (Example) | |
doseNumber | 1..1 | string | Dose number within series | |
seriesDoses | 0..1 | string | Recommended number of doses for immunity | |
Documentation for this format |
See the Extensions for this resource
UML Diagram (Legend)
XML Template
<Immunization xmlns="http://hl7.org/fhir"> <!-- 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
{ "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/> . [ 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:identifier ( [ Identifier ] ... ) ; # 0..* Business identifier fhir:basedOn ( [ Reference(CarePlan|ImmunizationRecommendation|MedicationRequest|ServiceRequest) ] ... ) ; # 0..* Authority that the immunization event is based on fhir:status [ code ] ; # 1..1 completed | entered-in-error | not-done fhir:statusReason [ CodeableConcept ] ; # 0..1 Reason for current status fhir:vaccineCode [ CodeableConcept ] ; # 1..1 Vaccine administered fhir:administeredProduct [ CodeableReference(Medication) ] ; # 0..1 Product that was administered fhir:manufacturer [ CodeableReference(Organization) ] ; # 0..1 Vaccine manufacturer fhir:lotNumber [ string ] ; # 0..1 Vaccine lot number fhir:expirationDate [ date ] ; # 0..1 Vaccine expiration date fhir:patient [ Reference(Patient) ] ; # 1..1 Who was immunized fhir:encounter [ Reference(Encounter) ] ; # 0..1 Encounter immunization was part of fhir:supportingInformation ( [ Reference(Any) ] ... ) ; # 0..* Additional information in support of the immunization # occurrence[x] : 1..1 Vaccine administration date. One of these 2 fhir:occurrence [ a fhir:dateTime ; dateTime ] fhir:occurrence [ a fhir:string ; string ] fhir:primarySource [ boolean ] ; # 0..1 Indicates context the data was captured in fhir:informationSource [ CodeableReference(Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 Indicates the source of a reported record fhir:location [ Reference(Location) ] ; # 0..1 Where immunization occurred fhir:site [ CodeableConcept ] ; # 0..1 Body site vaccine was administered fhir:route [ CodeableConcept ] ; # 0..1 How vaccine entered body fhir:doseQuantity [ Quantity(SimpleQuantity) ] ; # 0..1 Amount of vaccine administered fhir:performer ( [ # 0..* Who performed event fhir:function [ CodeableConcept ] ; # 0..1 What type of performance was done fhir:actor [ Reference(Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 1..1 Individual or organization who was performing ] ... ) ; fhir:note ( [ Annotation ] ... ) ; # 0..* Additional immunization notes fhir:reason ( [ CodeableReference(Condition|DiagnosticReport|Observation) ] ... ) ; # 0..* Why immunization occurred fhir:isSubpotent [ boolean ] ; # 0..1 Dose potency fhir:subpotentReason ( [ CodeableConcept ] ... ) ; # 0..* Reason for being subpotent fhir:programEligibility ( [ # 0..* Patient eligibility for a specific vaccination program fhir:program [ CodeableConcept ] ; # 1..1 The program that eligibility is declared for fhir:programStatus [ CodeableConcept ] ; # 1..1 The patient's eligibility status for the program ] ... ) ; fhir:fundingSource [ CodeableConcept ] ; # 0..1 Funding source for the vaccine fhir:reaction ( [ # 0..* Details of a reaction that follows immunization fhir:date [ dateTime ] ; # 0..1 When reaction started fhir:manifestation [ CodeableReference(Observation) ] ; # 0..1 Additional information on reaction fhir:reported [ boolean ] ; # 0..1 Indicates self-reported reaction ] ... ) ; fhir:protocolApplied ( [ # 0..* Protocol followed by the provider fhir:series [ string ] ; # 0..1 Name of vaccine series fhir:authority [ Reference(Organization) ] ; # 0..1 Who is responsible for publishing the recommendations fhir:targetDisease ( [ CodeableConcept ] ... ) ; # 0..* Vaccine preventatable disease being targeted fhir:doseNumber [ string ] ; # 1..1 Dose number within series fhir:seriesDoses [ string ] ; # 0..1 Recommended number of doses for immunity ] ... ) ; ]
Changes from both R4 and R4B
Immunization | |
Immunization.basedOn |
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Immunization.administeredProduct |
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Immunization.manufacturer |
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Immunization.supportingInformation |
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Immunization.informationSource |
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Immunization.performer.actor |
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Immunization.reason |
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Immunization.programEligibility |
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Immunization.programEligibility.program |
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Immunization.programEligibility.programStatus |
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Immunization.reaction.manifestation |
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Immunization.protocolApplied.doseNumber |
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Immunization.protocolApplied.seriesDoses |
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Immunization.recorded |
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Immunization.reportOrigin |
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Immunization.reasonCode |
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Immunization.reasonReference |
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Immunization.education |
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Immunization.reaction.detail |
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See the Full Difference for further information
This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.
See R4 <--> R5 Conversion Maps (status = See Conversions Summary.)
Structure
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Immunization | TU | DomainResource | Immunization event information Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension | |
identifier | 0..* | Identifier | Business identifier | |
basedOn | Σ | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | Authority that the immunization event is based on |
status | ?!Σ | 1..1 | code | completed | entered-in-error | not-done Binding: Immunization Status Codes (Required) |
statusReason | 0..1 | CodeableConcept | Reason for current status Binding: Immunization Status Reason Codes (Example) | |
vaccineCode | Σ | 1..1 | CodeableConcept | Vaccine administered Binding: Vaccine Administered Value Set (Example) |
administeredProduct | 0..1 | CodeableReference(Medication) | Product that was administered | |
manufacturer | 0..1 | CodeableReference(Organization) | Vaccine manufacturer | |
lotNumber | 0..1 | string | Vaccine lot number | |
expirationDate | 0..1 | date | Vaccine expiration date | |
patient | Σ | 1..1 | Reference(Patient) | Who was immunized |
encounter | 0..1 | Reference(Encounter) | Encounter immunization was part of | |
supportingInformation | 0..* | Reference(Any) | Additional information in support of the immunization | |
occurrence[x] | Σ | 1..1 | Vaccine administration date | |
occurrenceDateTime | dateTime | |||
occurrenceString | string | |||
primarySource | Σ | 0..1 | boolean | Indicates context the data was captured in |
informationSource | 0..1 | CodeableReference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) | Indicates the source of a reported record Binding: Immunization Origin Codes (Example) | |
location | 0..1 | Reference(Location) | Where immunization occurred | |
site | 0..1 | CodeableConcept | Body site vaccine was administered Binding: Codes for Immunization Site of Administration (Example) | |
route | 0..1 | CodeableConcept | How vaccine entered body Binding: Immunization Route Codes (Example) | |
doseQuantity | 0..1 | SimpleQuantity | Amount of vaccine administered | |
performer | Σ | 0..* | BackboneElement | Who performed event |
function | Σ | 0..1 | CodeableConcept | What type of performance was done Binding: Immunization Function Codes (Extensible) |
actor | Σ | 1..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson) | Individual or organization who was performing |
note | Σ | 0..* | Annotation | Additional immunization notes |
reason | 0..* | CodeableReference(Condition | Observation | DiagnosticReport) | Why immunization occurred Binding: Immunization Reason Codes (Example) | |
isSubpotent | ?!Σ | 0..1 | boolean | Dose potency |
subpotentReason | 0..* | CodeableConcept | Reason for being subpotent Binding: Immunization Subpotent Reason (Example) | |
programEligibility | 0..* | BackboneElement | Patient eligibility for a specific vaccination program | |
program | 1..1 | CodeableConcept | The program that eligibility is declared for Binding: Vaccine Funding Programs (Example) | |
programStatus | 1..1 | CodeableConcept | The patient's eligibility status for the program Binding: Immunization Program Eligibility (Example) | |
fundingSource | 0..1 | CodeableConcept | Funding source for the vaccine Binding: Immunization Funding Source (Example) | |
reaction | 0..* | BackboneElement | Details of a reaction that follows immunization | |
date | 0..1 | dateTime | When reaction started | |
manifestation | 0..1 | CodeableReference(Observation) | Additional information on reaction | |
reported | 0..1 | boolean | Indicates self-reported reaction | |
protocolApplied | 0..* | BackboneElement | Protocol followed by the provider | |
series | 0..1 | string | Name of vaccine series | |
authority | 0..1 | Reference(Organization) | Who is responsible for publishing the recommendations | |
targetDisease | 0..* | CodeableConcept | Vaccine preventatable disease being targeted Binding: Immunization Target Disease Codes (Example) | |
doseNumber | 1..1 | string | Dose number within series | |
seriesDoses | 0..1 | string | Recommended number of doses for immunity | |
Documentation for this format |
See the Extensions for this resource
XML Template
<Immunization xmlns="http://hl7.org/fhir"> <!-- 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
{ "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/> . [ 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:identifier ( [ Identifier ] ... ) ; # 0..* Business identifier fhir:basedOn ( [ Reference(CarePlan|ImmunizationRecommendation|MedicationRequest|ServiceRequest) ] ... ) ; # 0..* Authority that the immunization event is based on fhir:status [ code ] ; # 1..1 completed | entered-in-error | not-done fhir:statusReason [ CodeableConcept ] ; # 0..1 Reason for current status fhir:vaccineCode [ CodeableConcept ] ; # 1..1 Vaccine administered fhir:administeredProduct [ CodeableReference(Medication) ] ; # 0..1 Product that was administered fhir:manufacturer [ CodeableReference(Organization) ] ; # 0..1 Vaccine manufacturer fhir:lotNumber [ string ] ; # 0..1 Vaccine lot number fhir:expirationDate [ date ] ; # 0..1 Vaccine expiration date fhir:patient [ Reference(Patient) ] ; # 1..1 Who was immunized fhir:encounter [ Reference(Encounter) ] ; # 0..1 Encounter immunization was part of fhir:supportingInformation ( [ Reference(Any) ] ... ) ; # 0..* Additional information in support of the immunization # occurrence[x] : 1..1 Vaccine administration date. One of these 2 fhir:occurrence [ a fhir:dateTime ; dateTime ] fhir:occurrence [ a fhir:string ; string ] fhir:primarySource [ boolean ] ; # 0..1 Indicates context the data was captured in fhir:informationSource [ CodeableReference(Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 Indicates the source of a reported record fhir:location [ Reference(Location) ] ; # 0..1 Where immunization occurred fhir:site [ CodeableConcept ] ; # 0..1 Body site vaccine was administered fhir:route [ CodeableConcept ] ; # 0..1 How vaccine entered body fhir:doseQuantity [ Quantity(SimpleQuantity) ] ; # 0..1 Amount of vaccine administered fhir:performer ( [ # 0..* Who performed event fhir:function [ CodeableConcept ] ; # 0..1 What type of performance was done fhir:actor [ Reference(Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 1..1 Individual or organization who was performing ] ... ) ; fhir:note ( [ Annotation ] ... ) ; # 0..* Additional immunization notes fhir:reason ( [ CodeableReference(Condition|DiagnosticReport|Observation) ] ... ) ; # 0..* Why immunization occurred fhir:isSubpotent [ boolean ] ; # 0..1 Dose potency fhir:subpotentReason ( [ CodeableConcept ] ... ) ; # 0..* Reason for being subpotent fhir:programEligibility ( [ # 0..* Patient eligibility for a specific vaccination program fhir:program [ CodeableConcept ] ; # 1..1 The program that eligibility is declared for fhir:programStatus [ CodeableConcept ] ; # 1..1 The patient's eligibility status for the program ] ... ) ; fhir:fundingSource [ CodeableConcept ] ; # 0..1 Funding source for the vaccine fhir:reaction ( [ # 0..* Details of a reaction that follows immunization fhir:date [ dateTime ] ; # 0..1 When reaction started fhir:manifestation [ CodeableReference(Observation) ] ; # 0..1 Additional information on reaction fhir:reported [ boolean ] ; # 0..1 Indicates self-reported reaction ] ... ) ; fhir:protocolApplied ( [ # 0..* Protocol followed by the provider fhir:series [ string ] ; # 0..1 Name of vaccine series fhir:authority [ Reference(Organization) ] ; # 0..1 Who is responsible for publishing the recommendations fhir:targetDisease ( [ CodeableConcept ] ... ) ; # 0..* Vaccine preventatable disease being targeted fhir:doseNumber [ string ] ; # 1..1 Dose number within series fhir:seriesDoses [ string ] ; # 0..1 Recommended number of doses for immunity ] ... ) ; ]
Changes from both R4 and R4B
Immunization | |
Immunization.basedOn |
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Immunization.administeredProduct |
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Immunization.manufacturer |
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Immunization.supportingInformation |
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Immunization.informationSource |
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Immunization.performer.actor |
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Immunization.reason |
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Immunization.programEligibility |
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Immunization.programEligibility.program |
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Immunization.programEligibility.programStatus |
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Immunization.reaction.manifestation |
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Immunization.protocolApplied.doseNumber |
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Immunization.protocolApplied.seriesDoses |
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Immunization.recorded |
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Immunization.reportOrigin |
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Immunization.reasonCode |
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Immunization.reasonReference |
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Immunization.education |
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Immunization.reaction.detail |
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See the Full Difference for further information
This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.
See R4 <--> R5 Conversion Maps (status = See Conversions Summary.)
Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis
Path | ValueSet | Type | Documentation |
---|---|---|---|
Immunization.status | ImmunizationStatusCodes | Required | 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. |
Immunization.statusReason | ImmunizationStatusReasonCodes | Example | 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. |
Immunization.vaccineCode | VaccineAdministeredValueSet | Example | This identifies the vaccine substance administered - CVX codes. |
Immunization.informationSource | ImmunizationOriginCodes | Example | 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. |
Immunization.site | CodesForImmunizationSiteOfAdministration | Example | 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. |
Immunization.route | ImmunizationRouteCodes | Example | 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. |
Immunization.performer.function | ImmunizationFunctionCodes | Extensible | 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. |
Immunization.reason | ImmunizationReasonCodes | Example | 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. |
Immunization.subpotentReason | ImmunizationSubpotentReason | Example | 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. |
Immunization.programEligibility.program | CodesForVaccineFundingPrograms | Example | 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. |
Immunization.programEligibility.programStatus | ImmunizationProgramEligibility | Example | 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. |
Immunization.fundingSource | ImmunizationFundingSource | Example | 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. |
Immunization.protocolApplied.targetDisease | ImmunizationTargetDiseaseCodes | Example | 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. |
Search parameters for this resource. See also the full list of search parameters for this resource, and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.
Name | Type | Description | Expression | In Common |
date | date | Vaccination (non)-Administration Date | (Immunization.occurrence.ofType(dateTime)) | 26 Resources |
identifier | token | Business identifier | Immunization.identifier | 65 Resources |
location | reference | The service delivery location or facility in which the vaccine was / was to be administered | Immunization.location (Location) | |
lot-number | string | Vaccine Lot Number | Immunization.lotNumber | |
manufacturer | reference | Vaccine Manufacturer | Immunization.manufacturer.reference | |
patient | reference | The patient for the vaccination record | Immunization.patient (Patient) | 66 Resources |
performer | reference | The practitioner, individual or organization who played a role in the vaccination | Immunization.performer.actor (Practitioner, Organization, Patient, PractitionerRole, RelatedPerson) | |
reaction | reference | Additional information on reaction | Immunization.reaction.manifestation.reference | |
reaction-date | date | When reaction started | Immunization.reaction.date | |
reason-code | token | Reason why the vaccine was administered | Immunization.reason.concept | |
reason-reference | reference | Reference to a resource (by instance) | Immunization.reason.reference | |
series | string | The series being followed by the provider | Immunization.protocolApplied.series | |
status | token | Immunization event status | Immunization.status | |
status-reason | token | Reason why the vaccine was not administered | Immunization.statusReason | |
target-disease | token | The target disease the dose is being administered against | Immunization.protocolApplied.targetDisease | |
vaccine-code | token | Vaccine Product Administered | Immunization.vaccineCode |