R6 Ballot (2nd Draft)

Publish-box (todo)

Example StructureDefinition/ImmunizationRecommendation (XML)

Public Health Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Patient

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

Jump past Narrative

StructureDefinition for immunizationrecommendation

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

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="ImmunizationRecommendation"/> 
  <meta> 
    <lastUpdated value="2024-08-12T16:52:12.437+08:00"/> 
  </meta> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">
      <table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align:
       top;">
        <tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align:
         top">
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="The logical name of the element">Name</a> 
          </th> 
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Information about the use of the element">Flags</a> 
          </th> 
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the element can appear in the instance">Card.</a> 
          </th> 
          <th class="hierarchy" style="width: 100px">
            <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Reference to the type of the element">Type</a> 
          </th> 
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description &amp; Constraints</a> 
            <span style="float: right">
              <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format">
                <img alt="doco" src="data:(snipped in html view)" style="background-color: inherit"/> 
              </a> 
            </span> 
          </th> 
        </tr> 
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAJUlEQVR4Xu3IIQEAAAgDsHd9/w4EQIOamFnaBgAA4M
          MKAACAKwNp30CqZFfFmwAAAABJRU5ErkJggg==)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Resource"/>  
            <span title="ImmunizationRecommendation : A patient's point-in-time set of recommendations (i.e.
             forecasting) according to a published schedule with optional supporting justification.">ImmunizationRecommendation</span> 
            <a name="ImmunizationRecommendation"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="versions.html#std-process" style="padding-left: 3px; padding-right: 3px; border: 1px grey solid; font-weight: bold;
             color: black; background-color: #fff5e6" title="Standards Status = Trial Use">TU</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="domainresource.html">DomainResource</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Guidance or advice relating to an immunization
            <br/>  
            <br/>  Elements defined in Ancestors: 
            <a href="resource.html#Resource" title="The logical id of the resource, as used in the URL for the resource. Once assigned,
             this value never changes.">id</a> , 
            <a href="resource.html#Resource" title="The metadata about the resource. This is content that is maintained by the infrastructure.
             Changes to the content might not always be associated with version changes to the
             resource.">meta</a> , 
            <a href="resource.html#Resource" title="A reference to a set of rules that were followed when the resource was constructed,
             and which must be understood when processing the content. Often, this is a reference
             to an implementation guide that defines the special rules along with other profiles
             etc.">implicitRules</a> , 
            <a href="resource.html#Resource" title="The base language in which the resource is written.">language</a> , 
            <a href="domainresource.html#DomainResource" title="A human-readable narrative that contains a summary of the resource and can be used
             to represent the content of the resource to a human. The narrative need not encode
             all the structured data, but is required to contain sufficient detail to make it
             &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions
             may define what content should be represented in the narrative to ensure clinical
             safety.">text</a> , 
            <a href="domainresource.html#DomainResource" title="These resources do not have an independent existence apart from the resource that
             contains them - they cannot be identified independently, nor can they have their
             own independent transaction scope. This is allowed to be a Parameters resource
             if and only if it is referenced by a resource that provides context/meaning.">contained</a> , 
            <a href="domainresource.html#DomainResource" title="May be used to represent additional information that is not part of the basic definition
             of the resource. To make the use of extensions safe and managable, there is a strict
             set of governance applied to the definition and use of extensions. Though any implementer
             can define an extension, there is a set of requirements that SHALL be met as part
             of the definition of the extension.">extension</a> , 
            <a href="domainresource.html#DomainResource" title="May be used to represent additional information that is not part of the basic definition
             of the resource and that modifies the understanding of the element that contains
             it and/or the understanding of the containing element's descendants. Usually modifier
             elements provide negation or qualification. To make the use of extensions safe
             and managable, there is a strict set of governance applied to the definition and
             use of extensions. Though any implementer is allowed to define an extension, there
             is a set of requirements that SHALL be met as part of the definition of the extension.
             Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or
             DomainResource (including cannot change the meaning of modifierExtension itself).">modifierExtension</a> 
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
          EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Data Type"/>  
            <span title="ImmunizationRecommendation.identifier : A unique identifier assigned to this particular
             recommendation record.">identifier</span> 
            <a name="ImmunizationRecommendation.identifier"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#Identifier">Identifier</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Business identifier
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="ImmunizationRecommendation.patient : The patient the recommendation(s) are for.">patient</span> 
            <a name="ImmunizationRecommendation.patient"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">1..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="patient.html">Patient</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Who this profile is for
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
          EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type"/>  
            <span title="ImmunizationRecommendation.date : The date the immunization recommendation(s) were
             created.">date</span> 
            <a name="ImmunizationRecommendation.date"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">1..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#dateTime">dateTime</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Date recommendation(s) created
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="ImmunizationRecommendation.authority : Indicates the authority who published the
             protocol (e.g. ACIP).">authority</span> 
            <a name="ImmunizationRecommendation.authority"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="organization.html">Organization</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Who is responsible for protocol
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAJUlEQVR4Xu3IIQEAAAg
          DsHd9/w4EQIOamFnaBgAA4MMKAACAKwNp30CqZFfFmwAAAABJRU5ErkJggg==)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Element"/>  
            <span title="ImmunizationRecommendation.recommendation : Vaccine administration recommendations.">recommendation</span> 
            <a name="ImmunizationRecommendation.recommendation"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
            <a href="conformance-rules.html#constraints" style="padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold;
             color: #301212; background-color: #fdf4f4;" title="This element has or is affected by some invariants">C</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">1..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="types.html#BackBoneElement">BackboneElement</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Vaccine administration recommendations
            <br/>  
            <span style="font-style: italic" title="imr-1">+ Rule: One of vaccineCode or targetDisease SHALL be present</span> 
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALElEQVR4Xu3IsQ0AIAwEsez6+89AqKGGJj7JzVWS+m
          m3zgcAAMxwDQAAgFcaYAVAgNGLTjgAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Data Type"/>  
            <span title="ImmunizationRecommendation.recommendation.vaccineCode : Vaccine(s) or vaccine group
             that pertain to the recommendation.">vaccineCode</span> 
            <a name="ImmunizationRecommendation.recommendation.vaccineCode"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
            <a href="conformance-rules.html#constraints" style="padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold;
             color: #301212; background-color: #fdf4f4;" title="This element has or is affected by some invariants">C</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Vaccine  or vaccine group recommendation applies to
            <br/>  Binding: 
            <a href="valueset-vaccine-code.html">Vaccine Administered Value Set</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value
             set.  The value set merely provides examples of the types of concepts intended
             to be included.">Example</a> )
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALElEQVR4Xu3IsQ0AIAw
          Esez6+89AqKGGJj7JzVWS+mm3zgcAAMxwDQAAgFcaYAVAgNGLTjgAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Data Type"/>  
            <span title="ImmunizationRecommendation.recommendation.targetDisease : The targeted disease
             for the recommendation.">targetDisease</span> 
            <a name="ImmunizationRecommendation.recommendation.targetDisease"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
            <a href="conformance-rules.html#constraints" style="padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold;
             color: #301212; background-color: #fdf4f4;" title="This element has or is affected by some invariants">C</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Disease to be immunized against
            <br/>  Binding: 
            <a href="valueset-immunization-target-disease.html">Immunization Target Disease Codes</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value
             set.  The value set merely provides examples of the types of concepts intended
             to be included.">Example</a> )
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALElEQVR4Xu3IsQ0AIAwEsez6+89AqKGGJj7JzVWS+m
          m3zgcAAMxwDQAAgFcaYAVAgNGLTjgAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Data Type"/>  
            <span title="ImmunizationRecommendation.recommendation.contraindicatedVaccineCode : Vaccine(s)
             which should not be used to fulfill the recommendation.">contraindicatedVaccineCode</span> 
            <a name="ImmunizationRecommendation.recommendation.contraindicatedVaccineCode"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Vaccine which is contraindicated to fulfill the recommendation
            <br/>  Binding: 
            <a href="valueset-vaccine-code.html">Vaccine Administered Value Set</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value
             set.  The value set merely provides examples of the types of concepts intended
             to be included.">Example</a> )
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALElEQVR4Xu3IsQ0AIAw
          Esez6+89AqKGGJj7JzVWS+mm3zgcAAMxwDQAAgFcaYAVAgNGLTjgAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Data Type"/>  
            <span title="ImmunizationRecommendation.recommendation.forecastStatus : Indicates the patient
             status with respect to the path to immunity for the target disease.">forecastStatus</span> 
            <a name="ImmunizationRecommendation.recommendation.forecastStatus"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="conformance-rules.html#isModifier" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is a modifier element">?!</a> 
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">1..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Vaccine recommendation status
            <br/>  Binding: 
            <a href="valueset-immunization-recommendation-status.html">Immunization Recommendation Status Codes</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value
             set.  The value set merely provides examples of the types of concepts intended
             to be included.">Example</a> )
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALElEQVR4Xu3IsQ0AIAwEsez6+89AqKGGJj7JzVWS+m
          m3zgcAAMxwDQAAgFcaYAVAgNGLTjgAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Data Type"/>  
            <span title="ImmunizationRecommendation.recommendation.forecastReason : The reason for the assigned
             forecast status.">forecastReason</span> 
            <a name="ImmunizationRecommendation.recommendation.forecastReason"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Vaccine administration status reason
            <br/>  Binding: 
            <a href="valueset-immunization-recommendation-reason.html">Immunization Recommendation Reason Codes</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value
             set.  The value set merely provides examples of the types of concepts intended
             to be included.">Example</a> )
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALElEQVR4Xu3IsQ0AIAw
          Esez6+89AqKGGJj7JzVWS+mm3zgcAAMxwDQAAgFcaYAVAgNGLTjgAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Element"/>  
            <span title="ImmunizationRecommendation.recommendation.dateCriterion : Vaccine date recommendations.
              For example, earliest date to administer, latest date to administer, etc.">dateCriterion</span> 
            <a name="ImmunizationRecommendation.recommendation.dateCriterion"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="types.html#BackBoneElement">BackboneElement</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Dates governing proposed immunization
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAMUlEQVR4Xu3LsQkAIBRDwb9r9p9BrbUSUZsLXPMgla
          ReGmtz23H6BwAA/lkCAADALR1gq0BWueJ34gAAAABJRU5ErkJggg==)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Data Type"/>  
            <span title="ImmunizationRecommendation.recommendation.dateCriterion.code : Date classification
             of recommendation.  For example, earliest date to give, latest date to give, etc.">code</span> 
            <a name="ImmunizationRecommendation.recommendation.dateCriterion.code"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">1..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Type of date
            <br/>  Binding: 
            <a href="valueset-immunization-recommendation-date-criterion.html">Immunization Recommendation Date Criterion Codes</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value
             set.  The value set merely provides examples of the types of concepts intended
             to be included.">Example</a> )
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALElEQVR4Xu3IsQ0AIAw
          Esez6+89AqKGGJj7JzVWS+mm3zgcAAMxwDQAAgFcaYAVAgNGLTjgAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type"/>  
            <span title="ImmunizationRecommendation.recommendation.dateCriterion.value : The date whose
             meaning is specified by dateCriterion.code.">value</span> 
            <a name="ImmunizationRecommendation.recommendation.dateCriterion.value"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">1..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#dateTime">dateTime</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Recommended date
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALElEQVR4Xu3IsQ0AIAwEsez6+89AqKGGJj7JzVWS+m
          m3zgcAAMxwDQAAgFcaYAVAgNGLTjgAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Primitive Data Type"/>  
            <span title="ImmunizationRecommendation.recommendation.description : Contains the description
             about the protocol under which the vaccine was administered.">description</span> 
            <a name="ImmunizationRecommendation.recommendation.description"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#markdown">markdown</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Protocol details
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALElEQVR4Xu3IsQ0AIAw
          Esez6+89AqKGGJj7JzVWS+mm3zgcAAMxwDQAAgFcaYAVAgNGLTjgAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type"/>  
            <span title="ImmunizationRecommendation.recommendation.series : One possible path to achieve
             presumed immunity against a disease - within the context of an authority.">series</span> 
            <a name="ImmunizationRecommendation.recommendation.series"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#string">string</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Name of vaccination series
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALElEQVR4Xu3IsQ0AIAwEsez6+89AqKGGJj7JzVWS+m
          m3zgcAAMxwDQAAgFcaYAVAgNGLTjgAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Primitive Data Type"/>  
            <span title="ImmunizationRecommendation.recommendation.doseNumber : Nominal position of the
             recommended dose in a series as determined by the evaluation and forecasting process
             (e.g. dose 2 is the next recommended dose).">doseNumber</span> 
            <a name="ImmunizationRecommendation.recommendation.doseNumber"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#string">string</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Recommended dose number within series
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALElEQVR4Xu3IsQ0AIAw
          Esez6+89AqKGGJj7JzVWS+mm3zgcAAMxwDQAAgFcaYAVAgNGLTjgAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type"/>  
            <span title="ImmunizationRecommendation.recommendation.seriesDoses : The recommended number
             of doses to achieve immunity as determined by the evaluation and forecasting process.">seriesDoses</span> 
            <a name="ImmunizationRecommendation.recommendation.seriesDoses"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#string">string</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Recommended number of doses for immunity
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALElEQVR4Xu3IsQ0AIAwEsez6+89AqKGGJj7JzVWS+m
          m3zgcAAMxwDQAAgFcaYAVAgNGLTjgAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="ImmunizationRecommendation.recommendation.supportingImmunization : Immunization
             event history and/or evaluation that supports the status and recommendation.">supportingImmunization</span> 
            <a name="ImmunizationRecommendation.recommendation.supportingImmunization"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="immunization.html">Immunization</a>  | 
            <a href="immunizationevaluation.html">ImmunizationEvaluation</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Past immunizations supporting recommendation
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAJUlEQVR4Xu3IIQEAAAg
          DsHd9/w4EQIOamFnaBgAA4MMKAACAKwNp30CqZFfFmwAAAABJRU5ErkJggg==)">
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:(snipped in html view)" style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource"/>  
            <span title="ImmunizationRecommendation.recommendation.supportingPatientInformation : Patient
             Information that supports the status and recommendation.  This includes patient
             observations, adverse reactions and allergy/intolerance information.">supportingPatientInformation</span> 
            <a name="ImmunizationRecommendation.recommendation.supportingPatientInformation"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="resourcelist.html">Any</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Patient observations supporting recommendation
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr> 
          <td class="hierarchy" colspan="5">
            <br/>  
            <a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format">
              <img alt="doco" src="data:(snipped in html view)" style="background-color: inherit"/>  Documentation for this format
            </a> 
          </td> 
        </tr> 
      </table> 
    </div> 
  </text> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-category">
    <valueString value="Clinical.Medications"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="trial-use"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="pher"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="1"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category">
    <valueCode value="patient"/> 
  </extension> 
  <url value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"/> 
  <version value="6.0.0-ballot2"/> 
  <name value="ImmunizationRecommendation"/> 
  <status value="draft"/> 
  <experimental value="false"/> 
  <date value="2024-08-12T16:52:12+08:00"/> 
  <publisher value="HL7 International / Public Health"/> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://www.hl7.org/Special/committees/fiwg"/> 
    </telecom> 
  </contact> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://www.hl7.org/Special/committees/pher"/> 
    </telecom> 
  </contact> 
  <description value="A patient's point-in-time set of recommendations (i.e. forecasting) according to
   a published schedule with optional supporting justification."/> 
  <jurisdiction> 
    <coding> 
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/> 
      <code value="001"/> 
      <display value="World"/> 
    </coding> 
  </jurisdiction> 
  <fhirVersion value="6.0.0-ballot2"/> 
  <mapping> 
    <identity value="workflow"/> 
    <uri value="http://hl7.org/fhir/workflow"/> 
    <name value="Workflow Pattern"/> 
  </mapping> 
  <mapping> 
    <identity value="w5"/> 
    <uri value="http://hl7.org/fhir/fivews"/> 
    <name value="FiveWs Pattern Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="v2"/> 
    <uri value="http://hl7.org/v2"/> 
    <name value="HL7 V2 Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="rim"/> 
    <uri value="http://hl7.org/v3"/> 
    <name value="RIM Mapping"/> 
  </mapping> 
  <kind value="resource"/> 
  <abstract value="false"/> 
  <type value="ImmunizationRecommendation"/> 
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
  <derivation value="specialization"/> 
  <snapshot> 
    <element id="ImmunizationRecommendation">
      <path value="ImmunizationRecommendation"/> 
      <short value="Guidance or advice relating to an immunization"/> 
      <definition value="A patient's point-in-time set of recommendations (i.e. forecasting) according to
       a published schedule with optional supporting justification."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ImmunizationRecommendation"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <constraint> 
        <key value="dom-2"/> 
        <severity value="error"/> 
        <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/> 
        <expression value="contained.contained.empty()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-3"/> 
        <severity value="error"/> 
        <human value="If the resource is contained in another resource, it SHALL be referred to from
         elsewhere in the resource or SHALL refer to the containing resource"/> 
        <expression value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofTy
        pe(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url)))
         or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical)
         = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmat
        ched', id).empty()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-4"/> 
        <severity value="error"/> 
        <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId
         or a meta.lastUpdated"/> 
        <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-5"/> 
        <severity value="error"/> 
        <human value="If a resource is contained in another resource, it SHALL NOT have a security label"/> 
        <expression value="contained.meta.security.empty()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
          <valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can
           display the resource to a human safely. Including a human readable representation
           in the resource makes for a much more robust eco-system and cheaper handling of
           resources by intermediary systems. Some ecosystems restrict distribution of resources
           to only those systems that do fully understand the resources, and as a consequence
           implementers may believe that the narrative is superfluous. However experience
           shows that such eco-systems often open up to new participants over time."/> 
        </extension> 
        <key value="dom-6"/> 
        <severity value="warning"/> 
        <human value="A resource should have narrative for robust management"/> 
        <expression value="text.`div`.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Entity, Role, or Act,SubstanceAdministration[moodCode=RMD]"/> 
      </mapping> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="clinical.medication"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="VXU_V04"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.id">
      <path value="ImmunizationRecommendation.id"/> 
      <short value="Logical id of this artifact"/> 
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned,
       this value never changes."/> 
      <comment value="Within the context of the FHIR RESTful interactions, the resource has an id except
       for cases like the create and conditional update. Otherwise, the use of the resouce
       id depends on the given use case."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler
       magic (j)  -->
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="ImmunizationRecommendation.meta">
      <path value="ImmunizationRecommendation.meta"/> 
      <short value="Metadata about the resource"/> 
      <definition value="The metadata about the resource. This is content that is maintained by the infrastructure.
       Changes to the content might not always be associated with version changes to the
       resource."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.meta"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Meta"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="ImmunizationRecommendation.implicitRules">
      <path value="ImmunizationRecommendation.implicitRules"/> 
      <short value="A set of rules under which this content was created"/> 
      <definition value="A reference to a set of rules that were followed when the resource was constructed,
       and which must be understood when processing the content. Often, this is a reference
       to an implementation guide that defines the special rules along with other profiles
       etc."/> 
      <comment value="Asserting this rule set restricts the content to be only understood by a limited
       set of trading partners. This inherently limits the usefulness of the data in the
       long term. However, the existing health eco-system is highly fractured, and not
       yet ready to define, collect, and exchange data in a generally computable sense.
       Wherever possible, implementers and/or specification writers should avoid using
       this element. Often, when used, the URL is a reference to an implementation guide
       that defines these special rules as part of its narrative along with other profiles,
       value sets, etc."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.implicitRules"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional
       knowledge about the resource that modifies its meaning or interpretation"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="ImmunizationRecommendation.language">
      <path value="ImmunizationRecommendation.language"/> 
      <short value="Language of the resource content"/> 
      <definition value="The base language in which the resource is written."/> 
      <comment value="Language is provided to support indexing and accessibility (typically, services
       such as text to speech use the language tag). The html language tag in the narrative
       applies  to the narrative. The language tag on the resource may be used to specify
       the language of other presentations generated from the data in the resource. Not
       all the content has to be in the base language. The Resource.language should not
       be assumed to apply to the narrative automatically. If a language is specified,
       it should it also be specified on the div element in the html (see rules in HTML5
       for information about the relationship between xml:lang and the html lang attribute)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.language"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="required"/> 
        <description value="IETF language tag for a human language"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot2"/> 
        <additional> 
          <purpose value="starter"/> 
          <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> 
        </additional> 
      </binding> 
    </element> 
    <element id="ImmunizationRecommendation.text">
      <path value="ImmunizationRecommendation.text"/> 
      <short value="Text summary of the resource, for human interpretation"/> 
      <definition value="A human-readable narrative that contains a summary of the resource and can be used
       to represent the content of the resource to a human. The narrative need not encode
       all the structured data, but is required to contain sufficient detail to make it
       &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions
       may define what content should be represented in the narrative to ensure clinical
       safety."/> 
      <comment value="Contained resources do not have a narrative. Resources that are not contained SHOULD
       have a narrative. In some cases, a resource may only have text with little or no
       additional discrete data (as long as all minOccurs=1 elements are satisfied). 
       This may be necessary for data from legacy systems where information is captured
       as a &quot;text blob&quot; or where text is additionally entered raw or narrated
       and encoded information is added later."/> 
      <alias value="narrative"/> 
      <alias value="html"/> 
      <alias value="xhtml"/> 
      <alias value="display"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DomainResource.text"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Narrative"/> 
      </type> 
      <condition value="dom-6"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Act.text?"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.contained">
      <path value="ImmunizationRecommendation.contained"/> 
      <short value="Contained, inline Resources"/> 
      <definition value="These resources do not have an independent existence apart from the resource that
       contains them - they cannot be identified independently, nor can they have their
       own independent transaction scope. This is allowed to be a Parameters resource
       if and only if it is referenced by a resource that provides context/meaning."/> 
      <comment value="This should never be done when the content can be identified properly, as once
       identification is lost, it is extremely difficult (and context dependent) to restore
       it again. Contained resources may have profiles and tags in their meta elements,
       but SHALL NOT have security labels."/> 
      <alias value="inline resources"/> 
      <alias value="anonymous resources"/> 
      <alias value="contained resources"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.contained"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Resource"/> 
      </type> 
      <condition value="dom-2"/> 
      <condition value="dom-4"/> 
      <condition value="dom-3"/> 
      <condition value="dom-5"/> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.extension">
      <path value="ImmunizationRecommendation.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part
       of the definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.modifierExtension">
      <path value="ImmunizationRecommendation.modifierExtension"/> 
      <short value="Extensions that cannot be ignored"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource and that modifies the understanding of the element that contains
       it and/or the understanding of the containing element's descendants. Usually modifier
       elements provide negation or qualification. To make the use of extensions safe
       and managable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there
       is a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       resource that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.identifier">
      <path value="ImmunizationRecommendation.identifier"/> 
      <short value="Business identifier"/> 
      <definition value="A unique identifier assigned to this particular recommendation record."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ImmunizationRecommendation.identifier"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Identifier"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".id"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.patient">
      <path value="ImmunizationRecommendation.patient"/> 
      <short value="Who this profile is for"/> 
      <definition value="The patient the recommendation(s) are for."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ImmunizationRecommendation.patient"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request.subject"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="PID-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".partipication[typeCode=SUBJ].role"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.date">
      <path value="ImmunizationRecommendation.date"/> 
      <short value="Date recommendation(s) created"/> 
      <definition value="The date the immunization recommendation(s) were created."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ImmunizationRecommendation.date"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request.authoredOn"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-15"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".partipication[typeCode=AUTH].time"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.authority">
      <path value="ImmunizationRecommendation.authority"/> 
      <short value="Who is responsible for protocol"/> 
      <definition value="Indicates the authority who published the protocol (e.g. ACIP)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ImmunizationRecommendation.authority"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = 59779-9"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT]"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation">
      <path value="ImmunizationRecommendation.recommendation"/> 
      <short value="Vaccine administration recommendations"/> 
      <definition value="Vaccine administration recommendations."/> 
      <comment value="A given instance of the .recommendation backbone element should correspond to a
       single recommended administration or the entire immunization series when there
       is no recommended administration"/> 
      <min value="1"/> 
      <max value="*"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation"/> 
        <min value="1"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="imr-1"/> 
        <severity value="error"/> 
        <human value="One of vaccineCode or targetDisease SHALL be present"/> 
        <expression value="vaccineCode.exists() or targetDisease.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode='COMP'].target[classCode=SBADM, moodCode=RMD]"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.id">
      <path value="ImmunizationRecommendation.recommendation.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler
       magic (j)  -->
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.extension">
      <path value="ImmunizationRecommendation.recommendation.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part
       of the definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.modifierExtension">
      <path value="ImmunizationRecommendation.recommendation.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element and that modifies the understanding of the element in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and managable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.vaccineCode">
      <path value="ImmunizationRecommendation.recommendation.vaccineCode"/> 
      <short value="Vaccine  or vaccine group recommendation applies to"/> 
      <definition value="Vaccine(s) or vaccine group that pertain to the recommendation."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.vaccineCode"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <condition value="imr-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="VaccineCode"/> 
        </extension> 
        <strength value="example"/> 
        <description value="The type of vaccine administered."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/vaccine-code"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request.code"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = ( 30956-7 | 38890-0 )"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".partipication[typeCode=CSM].role[classCode=ADMM].code"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.targetDisease">
      <path value="ImmunizationRecommendation.recommendation.targetDisease"/> 
      <short value="Disease to be immunized against"/> 
      <definition value="The targeted disease for the recommendation."/> 
      <comment value="A given instance of the .recommendation backbone element should correspond to a
       single recommended administration but sometimes that administration (e.g. MMR)
       will encompass multiple diseases, thus the targetDisease element is allowed to
       repeat."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.targetDisease"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <condition value="imr-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="TargetDisease"/> 
        </extension> 
        <strength value="example"/> 
        <description value="The disease that the recommended vaccination targets."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/immunization-target-disease"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = ( 30956-7 | 38890-0 )"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".partipication[typeCode=CSM].role[classCode=ADMM].code"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.contraindicatedVaccineCode">
      <path value="ImmunizationRecommendation.recommendation.contraindicatedVaccineCode"/> 
      <short value="Vaccine which is contraindicated to fulfill the recommendation"/> 
      <definition value="Vaccine(s) which should not be used to fulfill the recommendation."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.contraindicatedVaccineCode"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="VaccineCode"/> 
        </extension> 
        <strength value="example"/> 
        <description value="The type of vaccine administered."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/vaccine-code"/> 
      </binding> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.forecastStatus">
      <path value="ImmunizationRecommendation.recommendation.forecastStatus"/> 
      <short value="Vaccine recommendation status"/> 
      <definition value="Indicates the patient status with respect to the path to immunity for the target
       disease."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.forecastStatus"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="This element is labeled as a modifier because the forecastStatus indicates whether
       a patient needs additional doses (due, overdue, etc.) or not  (contraindicated,
       complete, etc.)."/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImmunizationRecommendationStatus"/> 
        </extension> 
        <strength value="example"/> 
        <description value="The patient's status with respect to a vaccination protocol."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/immunization-recommendation-status"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = 59783-1"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=SUBJ] .source[classCode=OBS, moodCode=EVN, code=&quot;Immunizat
        ion Forecast Status&quot;].value"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.forecastReason">
      <path value="ImmunizationRecommendation.recommendation.forecastReason"/> 
      <short value="Vaccine administration status reason"/> 
      <definition value="The reason for the assigned forecast status."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.forecastReason"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImmunizationRecommendationReason"/> 
        </extension> 
        <strength value="example"/> 
        <description value="The reason for the patient's status with respect to a vaccination protocol."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/immunization-recommendation-reason"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = 30982-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.dateCriterion">
      <path value="ImmunizationRecommendation.recommendation.dateCriterion"/> 
      <short value="Dates governing proposed immunization"/> 
      <definition value="Vaccine date recommendations.  For example, earliest date to administer, latest
       date to administer, etc."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.dateCriterion"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request.occurrence[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-3: 30980-7 = Next dose recommended, 59777-3 = Latest next dose should be given,
         59778-1 = Dose is overdue"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode='LIMIT'].target[classCode=OBS, moodCode=EVN, isCriterionInd=tr
        ue]"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.dateCriterion.id">
      <path value="ImmunizationRecommendation.recommendation.dateCriterion.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler
       magic (j)  -->
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.dateCriterion.extension">
      <path value="ImmunizationRecommendation.recommendation.dateCriterion.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part
       of the definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.dateCriterion.modifierExtension">
      <path value="ImmunizationRecommendation.recommendation.dateCriterion.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element and that modifies the understanding of the element in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and managable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.dateCriterion.code">
      <path value="ImmunizationRecommendation.recommendation.dateCriterion.code"/> 
      <short value="Type of date"/> 
      <definition value="Date classification of recommendation.  For example, earliest date to give, latest
       date to give, etc."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.dateCriterion.code"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImmunizationRecommendationDateCriterion"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Classifies date criterion with respect to conveying information about a patient's
         vaccination status (e.g. due date, latest to give date, etc.)."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/immunization-recommendation-date-criterion"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.dateCriterion.value">
      <path value="ImmunizationRecommendation.recommendation.dateCriterion.value"/> 
      <short value="Recommended date"/> 
      <definition value="The date whose meaning is specified by dateCriterion.code."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.dateCriterion.value"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".value"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.description">
      <path value="ImmunizationRecommendation.recommendation.description"/> 
      <short value="Protocol details"/> 
      <definition value="Contains the description about the protocol under which the vaccine was administered."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.description"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = 30956-7"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".text"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.series">
      <path value="ImmunizationRecommendation.recommendation.series"/> 
      <short value="Name of vaccination series"/> 
      <definition value="One possible path to achieve presumed immunity against a disease - within the context
       of an authority."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.series"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXA-5-administered code"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".title"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.doseNumber">
      <path value="ImmunizationRecommendation.recommendation.doseNumber"/> 
      <short value="Recommended dose number within series"/> 
      <definition value="Nominal position of the recommended dose in a series as determined by the evaluation
       and forecasting process (e.g. dose 2 is the next recommended dose)."/> 
      <comment value="The use of an integer is preferred if known. A string should only be used in cases
       where an integer is not available (such as when documenting a recurring booster
       dose)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.doseNumber"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = 30973-2"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP, .source[classCode=SBADM, moodCode=INT]].sequenceNumber"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.seriesDoses">
      <path value="ImmunizationRecommendation.recommendation.seriesDoses"/> 
      <short value="Recommended number of doses for immunity"/> 
      <definition value="The recommended number of doses to achieve immunity as determined by the evaluation
       and forecasting process."/> 
      <comment value="The use of an integer is preferred if known."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.seriesDoses"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = 59782-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP, .source[classCode=SBADM, moodCode=DEF]].sequenceNumber"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.supportingImmunization">
      <path value="ImmunizationRecommendation.recommendation.supportingImmunization"/> 
      <short value="Past immunizations supporting recommendation"/> 
      <definition value="Immunization event history and/or evaluation that supports the status and recommendation."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.supportingImmunization"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Immunization"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImmunizationEvaluation"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="? No clear way to associate in HL7 V2 or IG"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=RSON].target[classCode=SBADM, moodCode=EVN, code=&quot;immuniz
        ation&quot;]"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.supportingPatientInformation">
      <path value="ImmunizationRecommendation.recommendation.supportingPatientInformation"/> 
      <short value="Patient observations supporting recommendation"/> 
      <definition value="Patient Information that supports the status and recommendation.  This includes
       patient observations, adverse reactions and allergy/intolerance information."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.supportingPatientInformation"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request.supportingInfo"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX If OBX is associated with ( RXA : RXA-5-administered code = '998^No vaccine
         administered^CVX'), could contain the reason the vaccine was not administered"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=RSON].target[classCode=OBS, moodCode=EVN]"/> 
      </mapping> 
    </element> 
  </snapshot> 
  <differential> 
    <element id="ImmunizationRecommendation">
      <path value="ImmunizationRecommendation"/> 
      <short value="Guidance or advice relating to an immunization"/> 
      <definition value="A patient's point-in-time set of recommendations (i.e. forecasting) according to
       a published schedule with optional supporting justification."/> 
      <min value="0"/> 
      <max value="*"/> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="clinical.medication"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="VXU_V04"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="SubstanceAdministration[moodCode=RMD]"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.identifier">
      <path value="ImmunizationRecommendation.identifier"/> 
      <short value="Business identifier"/> 
      <definition value="A unique identifier assigned to this particular recommendation record."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Identifier"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".id"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.patient">
      <path value="ImmunizationRecommendation.patient"/> 
      <short value="Who this profile is for"/> 
      <definition value="The patient the recommendation(s) are for."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request.subject"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="PID-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".partipication[typeCode=SUBJ].role"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.date">
      <path value="ImmunizationRecommendation.date"/> 
      <short value="Date recommendation(s) created"/> 
      <definition value="The date the immunization recommendation(s) were created."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request.authoredOn"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-15"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".partipication[typeCode=AUTH].time"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.authority">
      <path value="ImmunizationRecommendation.authority"/> 
      <short value="Who is responsible for protocol"/> 
      <definition value="Indicates the authority who published the protocol (e.g. ACIP)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = 59779-9"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT]"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation">
      <path value="ImmunizationRecommendation.recommendation"/> 
      <short value="Vaccine administration recommendations"/> 
      <definition value="Vaccine administration recommendations."/> 
      <comment value="A given instance of the .recommendation backbone element should correspond to a
       single recommended administration or the entire immunization series when there
       is no recommended administration"/> 
      <min value="1"/> 
      <max value="*"/> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="imr-1"/> 
        <severity value="error"/> 
        <human value="One of vaccineCode or targetDisease SHALL be present"/> 
        <expression value="vaccineCode.exists() or targetDisease.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode='COMP'].target[classCode=SBADM, moodCode=RMD]"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.vaccineCode">
      <path value="ImmunizationRecommendation.recommendation.vaccineCode"/> 
      <short value="Vaccine  or vaccine group recommendation applies to"/> 
      <definition value="Vaccine(s) or vaccine group that pertain to the recommendation."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <condition value="imr-1"/> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="VaccineCode"/> 
        </extension> 
        <strength value="example"/> 
        <description value="The type of vaccine administered."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/vaccine-code"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request.code"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = ( 30956-7 | 38890-0 )"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".partipication[typeCode=CSM].role[classCode=ADMM].code"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.targetDisease">
      <path value="ImmunizationRecommendation.recommendation.targetDisease"/> 
      <short value="Disease to be immunized against"/> 
      <definition value="The targeted disease for the recommendation."/> 
      <comment value="A given instance of the .recommendation backbone element should correspond to a
       single recommended administration but sometimes that administration (e.g. MMR)
       will encompass multiple diseases, thus the targetDisease element is allowed to
       repeat."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <condition value="imr-1"/> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="TargetDisease"/> 
        </extension> 
        <strength value="example"/> 
        <description value="The disease that the recommended vaccination targets."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/immunization-target-disease"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = ( 30956-7 | 38890-0 )"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".partipication[typeCode=CSM].role[classCode=ADMM].code"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.contraindicatedVaccineCode">
      <path value="ImmunizationRecommendation.recommendation.contraindicatedVaccineCode"/> 
      <short value="Vaccine which is contraindicated to fulfill the recommendation"/> 
      <definition value="Vaccine(s) which should not be used to fulfill the recommendation."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="VaccineCode"/> 
        </extension> 
        <strength value="example"/> 
        <description value="The type of vaccine administered."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/vaccine-code"/> 
      </binding> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.forecastStatus">
      <path value="ImmunizationRecommendation.recommendation.forecastStatus"/> 
      <short value="Vaccine recommendation status"/> 
      <definition value="Indicates the patient status with respect to the path to immunity for the target
       disease."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="This element is labeled as a modifier because the forecastStatus indicates whether
       a patient needs additional doses (due, overdue, etc.) or not  (contraindicated,
       complete, etc.)."/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImmunizationRecommendationStatus"/> 
        </extension> 
        <strength value="example"/> 
        <description value="The patient's status with respect to a vaccination protocol."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/immunization-recommendation-status"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = 59783-1"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=SUBJ] .source[classCode=OBS, moodCode=EVN, code=&quot;Immunizat
        ion Forecast Status&quot;].value"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.forecastReason">
      <path value="ImmunizationRecommendation.recommendation.forecastReason"/> 
      <short value="Vaccine administration status reason"/> 
      <definition value="The reason for the assigned forecast status."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImmunizationRecommendationReason"/> 
        </extension> 
        <strength value="example"/> 
        <description value="The reason for the patient's status with respect to a vaccination protocol."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/immunization-recommendation-reason"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = 30982-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.dateCriterion">
      <path value="ImmunizationRecommendation.recommendation.dateCriterion"/> 
      <short value="Dates governing proposed immunization"/> 
      <definition value="Vaccine date recommendations.  For example, earliest date to administer, latest
       date to administer, etc."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request.occurrence[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-3: 30980-7 = Next dose recommended, 59777-3 = Latest next dose should be given,
         59778-1 = Dose is overdue"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode='LIMIT'].target[classCode=OBS, moodCode=EVN, isCriterionInd=tr
        ue]"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.dateCriterion.code">
      <path value="ImmunizationRecommendation.recommendation.dateCriterion.code"/> 
      <short value="Type of date"/> 
      <definition value="Date classification of recommendation.  For example, earliest date to give, latest
       date to give, etc."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImmunizationRecommendationDateCriterion"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Classifies date criterion with respect to conveying information about a patient's
         vaccination status (e.g. due date, latest to give date, etc.)."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/immunization-recommendation-date-criterion"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.dateCriterion.value">
      <path value="ImmunizationRecommendation.recommendation.dateCriterion.value"/> 
      <short value="Recommended date"/> 
      <definition value="The date whose meaning is specified by dateCriterion.code."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".value"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.description">
      <path value="ImmunizationRecommendation.recommendation.description"/> 
      <short value="Protocol details"/> 
      <definition value="Contains the description about the protocol under which the vaccine was administered."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = 30956-7"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".text"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.series">
      <path value="ImmunizationRecommendation.recommendation.series"/> 
      <short value="Name of vaccination series"/> 
      <definition value="One possible path to achieve presumed immunity against a disease - within the context
       of an authority."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="string"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXA-5-administered code"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".title"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.doseNumber">
      <path value="ImmunizationRecommendation.recommendation.doseNumber"/> 
      <short value="Recommended dose number within series"/> 
      <definition value="Nominal position of the recommended dose in a series as determined by the evaluation
       and forecasting process (e.g. dose 2 is the next recommended dose)."/> 
      <comment value="The use of an integer is preferred if known. A string should only be used in cases
       where an integer is not available (such as when documenting a recurring booster
       dose)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="string"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = 30973-2"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP, .source[classCode=SBADM, moodCode=INT]].sequenceNumber"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.seriesDoses">
      <path value="ImmunizationRecommendation.recommendation.seriesDoses"/> 
      <short value="Recommended number of doses for immunity"/> 
      <definition value="The recommended number of doses to achieve immunity as determined by the evaluation
       and forecasting process."/> 
      <comment value="The use of an integer is preferred if known."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="string"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = 59782-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP, .source[classCode=SBADM, moodCode=DEF]].sequenceNumber"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.supportingImmunization">
      <path value="ImmunizationRecommendation.recommendation.supportingImmunization"/> 
      <short value="Past immunizations supporting recommendation"/> 
      <definition value="Immunization event history and/or evaluation that supports the status and recommendation."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Immunization"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImmunizationEvaluation"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="? No clear way to associate in HL7 V2 or IG"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=RSON].target[classCode=SBADM, moodCode=EVN, code=&quot;immuniz
        ation&quot;]"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.supportingPatientInformation">
      <path value="ImmunizationRecommendation.recommendation.supportingPatientInformation"/> 
      <short value="Patient observations supporting recommendation"/> 
      <definition value="Patient Information that supports the status and recommendation.  This includes
       patient observations, adverse reactions and allergy/intolerance information."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request.supportingInfo"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX If OBX is associated with ( RXA : RXA-5-administered code = '998^No vaccine
         administered^CVX'), could contain the reason the vaccine was not administered"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=RSON].target[classCode=OBS, moodCode=EVN]"/> 
      </mapping> 
    </element> 
  </differential> 
</StructureDefinition> 

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