Example of a Historical Example

{
  "resourceType" : "Immunization",
  "id" : "historical",
  "identifier" : [{
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234"
  }],
  "status" : "completed",
  "vaccineCode" : {
    "coding" : [{
      "system" : "urn:oid:1.2.36.1.2001.1005.17",
      "code" : "GNFLU"
    }],
    "text" : "Influenza"
  },
  "patient" : {
    "reference" : "Patient/example"
  },
  "occurrenceString" : "January 2012",
  "primarySource" : false,
  "informationSource" : {
    "concept" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/immunization-origin",
        "code" : "record"
      }],
      "text" : "Written Record"
    }
  },
  "location" : {
    "reference" : "Location/1"
  },
  "note" : [{
    "text" : "Notes on adminstration of a historical vaccine"
  }]
}