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Public Health and Emergency Response Work Group | Maturity Level: 5 | Trial Use | Security Category: Patient | Compartments: Patient, Practitioner |
Detailed Descriptions for the elements in the Immunization resource.
| Immunization | |
| Element Id | Immunization |
| Definition | Describes the event of a patient being administered a vaccine or a record of an immunization as reported by a patient, a clinician or another party. |
| Short Display | Immunization event information |
| Cardinality | 0..* |
| Type | DomainResource |
| Summary | false |
| Immunization.identifier | |
| Element Id | Immunization.identifier |
| Definition | A unique identifier assigned to this immunization record. |
| Short Display | Business identifier |
| Note | This is a business identifier, not a resource identifier (see discussion) |
| Cardinality | 0..* |
| Type | Identifier |
| Summary | false |
| Immunization.basedOn | |
| Element Id | Immunization.basedOn |
| Definition | A plan, order or recommendation fulfilled in whole or in part by this immunization. |
| Short Display | Authority that the immunization event is based on |
| Cardinality | 0..* |
| Type | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) |
| Summary | true |
| Comments | Allows tracing of an authorization for the Immunization. |
| Immunization.status | |
| Element Id | Immunization.status |
| Definition | Indicates the current status of the immunization event. |
| Short Display | completed | entered-in-error | not-done |
| Cardinality | 1..1 |
| Terminology Binding | Immunization Status Codes (Required) |
| Type | code |
| Is Modifier | true (Reason: This element is labeled as a modifier because it is a status element that contains statuses entered-in-error and not-done which means that the resource should not be treated as valid) |
| Summary | true |
| Comments | Will generally be set to show that the immunization has been completed or not done. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. |
| Immunization.statusReason | |
| Element Id | Immunization.statusReason |
| Definition | Indicates the reason the immunization event was not performed. |
| Short Display | Reason for current status |
| Cardinality | 0..1 |
| Terminology Binding | Immunization Status Reason Codes (Example) |
| Type | CodeableConcept |
| Summary | false |
| Comments | This is generally only used for the status of "not-done". The reason for performing the immunization event is captured in reasonCode, not here. |
| Immunization.vaccineCode | |
| Element Id | Immunization.vaccineCode |
| Definition | Vaccine that was administered or was to be administered. |
| Short Display | Vaccine administered |
| Cardinality | 1..1 |
| Terminology Binding | Vaccine Administered Value Set (Example) |
| Type | CodeableConcept |
| Summary | true |
| Comments | The code for the administered vaccine may be reported at various levels of granularity from a very generic code for a general type of vaccine (e.g. the SNOMED or CVX code for the flu vaccine) to a very discrete code for a specific product including the form and packaging (e.g. an NDC code). Because vaccineCode uses the CodeableConcept data type, multiple codes at different levels of granularity may be reported for a single immunization event provided that all codes are appropriate for the same vaccine. For example, both NDC and CVX codes may be provided for a given immunization event by repeating the coding element within vaccineCode. |
| Immunization.administeredProduct | |
| Element Id | Immunization.administeredProduct |
| Definition | An indication of which product was administered to the patient. This is typically a more detailed representation of the concept conveyed by the vaccineCode data element. If a Medication resource is referenced, it may be to a stand-alone resource or a contained resource within the Immunization resource. |
| Short Display | Product that was administered |
| Cardinality | 0..1 |
| Type | CodeableReference(Medication) |
| Summary | false |
| Immunization.manufacturer | |
| Element Id | Immunization.manufacturer |
| Definition | Name of vaccine manufacturer. |
| Short Display | Vaccine manufacturer |
| Cardinality | 0..1 |
| Type | CodeableReference(Organization) |
| Summary | false |
| Immunization.lotNumber | |
| Element Id | Immunization.lotNumber |
| Definition | Lot number of the vaccine product. |
| Short Display | Vaccine lot number |
| Cardinality | 0..1 |
| Type | string |
| Summary | false |
| Immunization.expirationDate | |
| Element Id | Immunization.expirationDate |
| Definition | Date vaccine batch expires. |
| Short Display | Vaccine expiration date |
| Cardinality | 0..1 |
| Type | date |
| Summary | false |
| Immunization.patient | |
| Element Id | Immunization.patient |
| Definition | The patient who either received or did not receive the immunization. |
| Short Display | Who was immunized |
| Cardinality | 1..1 |
| Type | Reference(Patient) |
| Summary | true |
| Immunization.encounter | |
| Element Id | Immunization.encounter |
| Definition | The visit or admission or other contact between patient and health care provider the immunization was performed as part of. |
| Short Display | Encounter immunization was part of |
| Cardinality | 0..1 |
| Type | Reference(Encounter) |
| Summary | false |
| Immunization.supportingInformation | |
| Element Id | Immunization.supportingInformation |
| Definition | Additional information that is relevant to the immunization (e.g. for a vaccine recipient who is pregnant, the gestational age of the fetus). The reason why a vaccine was given (e.g. occupation, underlying medical condition) should be conveyed in Immunization.reason, not as supporting information. The reason why a vaccine was not given (e.g. contraindication) should be conveyed in Immunization.statusReason, not as supporting information. |
| Short Display | Additional information in support of the immunization |
| Cardinality | 0..* |
| Type | Reference(Any) |
| Summary | false |
| Immunization.occurrence[x] | |
| Element Id | Immunization.occurrence[x] |
| Definition | Date vaccine administered or was to be administered. |
| Short Display | Vaccine administration date |
| Cardinality | 1..1 |
| Type | dateTime|string |
| [x] Note | See Choice of Datatypes for further information about how to use [x] |
| Summary | true |
| Comments | When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given. An exact date is always preferable, but the use of the String data type is acceptable when an exact date is not known. A small number of vaccines (e.g. live oral typhoid vaccine) are given as a series of patient self-administered dose over a span of time. In cases like this, often, only the first dose (typically a provider supervised dose) is recorded with the occurrence indicating the date/time of the first dose. |
| Immunization.primarySource | |
| Element Id | Immunization.primarySource |
| Definition | Indicates whether the data contained in the resource was captured by the individual/organization which was responsible for the administration of the vaccine rather than as 'secondary reported' data documented by a third party. A value of 'true' means this data originated with the individual/organization which was responsible for the administration of the vaccine. |
| Short Display | Indicates context the data was captured in |
| Cardinality | 0..1 |
| Type | boolean |
| Summary | true |
| Comments | Reflects the “reliability” of the content. |
| Immunization.informationSource | |
| Element Id | Immunization.informationSource |
| Definition | Typically the source of the data when the report of the immunization event is not based on information from the person who administered the vaccine. |
| Short Display | Indicates the source of a reported record |
| Cardinality | 0..1 |
| Terminology Binding | Immunization Origin Codes (Example) |
| Type | CodeableReference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) |
| Summary | false |
| Comments | Typically will not be populated if primarySource = True, not required even if primarySource = False. |
| Immunization.location | |
| Element Id | Immunization.location |
| Definition | The service delivery location where the vaccine administration occurred. |
| Short Display | Where immunization occurred |
| Cardinality | 0..1 |
| Type | Reference(Location) |
| Summary | false |
| Immunization.site | |
| Element Id | Immunization.site |
| Definition | Body site where vaccine was administered. |
| Short Display | Body site vaccine was administered |
| Cardinality | 0..1 |
| Terminology Binding | Codes for Immunization Site of Administration (Example) |
| Type | CodeableConcept |
| Summary | false |
| Immunization.route | |
| Element Id | Immunization.route |
| Definition | The path by which the vaccine product is taken into the body. |
| Short Display | How vaccine entered body |
| Cardinality | 0..1 |
| Terminology Binding | Immunization Route Codes (Example) |
| Type | CodeableConcept |
| Summary | false |
| Immunization.doseQuantity | |
| Element Id | Immunization.doseQuantity |
| Definition | The quantity of vaccine product that was administered. |
| Short Display | Amount of vaccine administered |
| Cardinality | 0..1 |
| Type | SimpleQuantity |
| Summary | false |
| Immunization.performer | |
| Element Id | Immunization.performer |
| Definition | Indicates who performed the immunization event. |
| Short Display | Who performed event |
| Cardinality | 0..* |
| Summary | true |
| Immunization.performer.function | |
| Element Id | Immunization.performer.function |
| Definition | Describes the type of performance (e.g. ordering provider, administering provider, etc.). |
| Short Display | What type of performance was done |
| Cardinality | 0..1 |
| Terminology Binding | Immunization Function Codes (Extensible) |
| Type | CodeableConcept |
| Summary | true |
| Immunization.performer.actor | |
| Element Id | Immunization.performer.actor |
| Definition | The practitioner or organization who performed the action. |
| Short Display | Individual or organization who was performing |
| Cardinality | 1..1 |
| Type | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson) |
| Summary | true |
| Comments | When the individual practitioner who performed the action is known, it is best to send. |
| Immunization.note | |
| Element Id | Immunization.note |
| Definition | Extra information about the immunization that is not conveyed by the other attributes. |
| Short Display | Additional immunization notes |
| Cardinality | 0..* |
| Type | Annotation |
| Summary | true |
| Immunization.reason | |
| Element Id | Immunization.reason |
| Definition | Describes why the immunization occurred in coded or textual form, or Indicates another resource (Condition, Observation or DiagnosticReport) whose existence justifies this immunization. |
| Short Display | Why immunization occurred |
| Cardinality | 0..* |
| Terminology Binding | Immunization Reason Codes (Example) |
| Type | CodeableReference(Condition | Observation | DiagnosticReport) |
| Summary | false |
| Immunization.isSubpotent | |
| Element Id | Immunization.isSubpotent |
| Definition | Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent. |
| Short Display | Dose potency |
| Cardinality | 0..1 |
| Type | boolean |
| Is Modifier | true (Reason: This element is labeled as a modifier because an immunization event with a subpotent vaccine doesn't protect the patient the same way as a potent dose.) |
| Meaning if Missing | By default, a dose should be considered to be potent. |
| Summary | true |
| Comments | Typically, the recognition of the dose being sub-potent is retrospective, after the administration (ex. notification of a manufacturer recall after administration). However, in the case of a partial administration (the patient moves unexpectedly and only some of the dose is actually administered), subpotency may be recognized immediately, but it is still important to record the event. |
| Immunization.subpotentReason | |
| Element Id | Immunization.subpotentReason |
| Definition | Reason why a dose is considered to be subpotent. |
| Short Display | Reason for being subpotent |
| Cardinality | 0..* |
| Terminology Binding | Immunization Subpotent Reason (Example) |
| Type | CodeableConcept |
| Summary | false |
| Immunization.programEligibility | |
| Element Id | Immunization.programEligibility |
| Definition | Indicates a patient's eligibility for a funding program. |
| Short Display | Patient eligibility for a specific vaccination program |
| Cardinality | 0..* |
| Summary | false |
| Immunization.programEligibility.program | |
| Element Id | Immunization.programEligibility.program |
| Definition | Indicates which program the patient had their eligility evaluated for. |
| Short Display | The program that eligibility is declared for |
| Cardinality | 1..1 |
| Terminology Binding | Vaccine Funding Programs (Example) |
| Type | CodeableConcept |
| Summary | false |
| Immunization.programEligibility.programStatus | |
| Element Id | Immunization.programEligibility.programStatus |
| Definition | Indicates the patient's eligility status for for a specific payment program. |
| Short Display | The patient's eligibility status for the program |
| Cardinality | 1..1 |
| Terminology Binding | Immunization Program Eligibility (Example) |
| Type | CodeableConcept |
| Summary | false |
| Immunization.fundingSource | |
| Element Id | Immunization.fundingSource |
| Definition | Indicates the source of the vaccine actually administered. This may be different than the patient eligibility (e.g. the patient may be eligible for a publically purchased vaccine but due to inventory issues, vaccine purchased with private funds was actually administered). |
| Short Display | Funding source for the vaccine |
| Cardinality | 0..1 |
| Terminology Binding | Immunization Funding Source (Example) |
| Type | CodeableConcept |
| Summary | false |
| Immunization.reaction | |
| Element Id | Immunization.reaction |
| Definition | Categorical data indicating that an adverse event is associated in time to an immunization. |
| Short Display | Details of a reaction that follows immunization |
| Cardinality | 0..* |
| Summary | false |
| Comments | A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case, it should be recorded as a new AllergyIntolerance resource instance as most systems will not query against past Immunization.reaction elements. |
| Immunization.reaction.date | |
| Element Id | Immunization.reaction.date |
| Definition | Date of reaction to the immunization. |
| Short Display | When reaction started |
| Cardinality | 0..1 |
| Type | dateTime |
| Summary | false |
| Immunization.reaction.manifestation | |
| Element Id | Immunization.reaction.manifestation |
| Definition | Details of the reaction. |
| Short Display | Additional information on reaction |
| Cardinality | 0..1 |
| Type | CodeableReference(Observation) |
| Summary | false |
| Immunization.reaction.reported | |
| Element Id | Immunization.reaction.reported |
| Definition | Self-reported indicator. |
| Short Display | Indicates self-reported reaction |
| Cardinality | 0..1 |
| Type | boolean |
| Summary | false |
| Immunization.protocolApplied | |
| Element Id | Immunization.protocolApplied |
| Definition | The protocol (set of recommendations) being followed by the provider who administered the dose. |
| Short Display | Protocol followed by the provider |
| Cardinality | 0..* |
| Summary | false |
| Immunization.protocolApplied.series | |
| Element Id | Immunization.protocolApplied.series |
| Definition | One possible path to achieve presumed immunity against a disease - within the context of an authority. |
| Short Display | Name of vaccine series |
| Cardinality | 0..1 |
| Type | string |
| Summary | false |
| Immunization.protocolApplied.authority | |
| Element Id | Immunization.protocolApplied.authority |
| Definition | Indicates the authority who published the protocol (e.g. ACIP) that is being followed. |
| Short Display | Who is responsible for publishing the recommendations |
| Cardinality | 0..1 |
| Type | Reference(Organization) |
| Summary | false |
| Immunization.protocolApplied.targetDisease | |
| Element Id | Immunization.protocolApplied.targetDisease |
| Definition | The vaccine preventable disease the dose is being administered against. |
| Short Display | Vaccine preventatable disease being targeted |
| Cardinality | 0..* |
| Terminology Binding | Immunization Target Disease Codes (Example) |
| Type | CodeableConcept |
| Summary | false |
| Immunization.protocolApplied.doseNumber | |
| Element Id | Immunization.protocolApplied.doseNumber |
| Definition | Nominal position in a series as intended by the practitioner administering the dose. |
| Short Display | Dose number within series |
| Cardinality | 1..1 |
| Type | string |
| Summary | false |
| Comments | The use of an integer is preferred if known. Text should only be used in cases where an integer is not available (such as when documenting a recurring booster dose). |
| Immunization.protocolApplied.seriesDoses | |
| Element Id | Immunization.protocolApplied.seriesDoses |
| Definition | The recommended number of doses to achieve immunity as intended by the practitioner administering the dose. |
| Short Display | Recommended number of doses for immunity |
| Cardinality | 0..1 |
| Type | string |
| Summary | false |
| Comments | The use of an integer is preferred if known. |