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This page is part of the US Core (v0.0.0: STU1 Ballot 1) based on FHIR v1.8.0. The current version which supercedes this version is 5.0.1. For a full list of available versions, see the Directory of published versions

D.4.1 StructureDefinition-us-core-immunization

his profile sets minimum expectations for the Immunization resource to record, fetch and search immunization history associated with a patient. It identifies which core elements, extensions, vocabularies and value sets SHALL be present in the resource when using this profile.

Example Usage Scenarios:

The following are example usage scenarios for the US Core-Core Immunization profile:

  • Query for immunizations belonging to a Patient
  • Record immunizations belonging to a Patient
Mandatory Data Elements and Terminology

The following data-elements are mandatory (i.e data MUST be present). These are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Profile Definition below provides the formal summary, definitions, and terminology requirements.

Each Immunization must have:

  1. a status
  2. a date the vaccine was administered
  3. a vaccine code that identifies the kind of vaccine administered
  4. a patient
  5. a flag to indicate whether vaccine was given
  6. a flag to indicate whether the vaccine was reported by patient rather than directly administered.

Profile specific implementation guidance:

Examples

  • [Immunization-imm-1]Immunization-imm-1.html)

D.4.1.1 Formal Views of Profile Content

The official URL for this profile is: 

http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization

This profile builds on Immunization.

This profile was published on Mon Aug 01 00:00:00 AEST 2016 as a draft by Health Level Seven International (FHIR-Infrastructure).

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

Complete Summary of the Mandatory Requirements

  1. One status in Immunization.status which has an required binding to:
  2. One dateTime in Immunization.date
  3. One vaccine code in Immunization.vaccineCode which has:
    • a required binding to the CVX value set
    • SHOULD have a translation to the to the NDC value set
  4. One patient in Immunization.patient
  5. One boolean value in Immunization.wasNotGiven
  6. One boolean value in Immunization.primarySource
NameFlagsCard.TypeDescription & Constraintsdoco
.. Immunization I0..*US Core Immunization Profile
... id ∑0..1idLogical id of this artifact
... meta ∑0..1MetaMetadata about the resource
... implicitRules ?!∑0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierBusiness identifier
... status ?!S1..1codecompleted | entered-in-error
Binding: Immunization Status (required)
... date S1..1dateTimeVaccination administration date
... vaccineCode S1..1CodeableConceptVaccine Product Type (bind to CVX)
Binding: Vaccine Administered Value Set (example)
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... coding ∑CodingCode defined by a terminology system
Slice: Unordered, Open, by code
.... coding S1..1CodingCode defined by a terminology system
Binding: Vaccine Administered Value Set (CVX) (required)
.... coding S0..1CodingCode defined by a terminology system
Binding: Vaccine National Drug Code (NDC) (required)
.... text ∑0..1stringPlain text representation of the concept
... patient S1..1Reference(US Core Patient Profile)Who was immunized
... wasNotGiven ?!S1..1booleanFlag for whether immunization was given
... primarySource S1..1booleanIndicates context the data was recorded in
... reportOrigin 0..1CodeableConceptIndicates the source of a secondarily reported record
Binding: ImmunizationOrigin (example)
... performer 0..1Reference(Practitioner)Who administered vaccine
... requester 0..1Reference(Practitioner)Who ordered vaccination
... encounter 0..1Reference(Encounter)Encounter administered as part of
... manufacturer 0..1Reference(Organization)Vaccine manufacturer
... location 0..1Reference(Location)Where vaccination occurred
... lotNumber 0..1stringVaccine lot number
... expirationDate 0..1dateVaccine expiration date
... site 0..1CodeableConceptBody site vaccine was administered
Binding: Codes for Immunization Site of Administration (example)
... route 0..1CodeableConceptHow vaccine entered body
Binding: Immunization Route Codes (example)
... doseQuantity 0..1SimpleQuantityAmount of vaccine administered
... note ∑0..*AnnotationVaccination notes
... explanation I0..1BackboneElementAdministration/non-administration reasons
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!∑0..*ExtensionExtensions that cannot be ignored
.... reason 0..*CodeableConceptWhy immunization occurred
Binding: Immunization Reason Codes (example)
.... reasonNotGiven 0..*CodeableConceptWhy immunization did not occur
Binding: Immunization Reasons for Not Immunizing Codes (example)
... reaction I0..*BackboneElementDetails of a reaction that follows immunization
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!∑0..*ExtensionExtensions that cannot be ignored
.... date 0..1dateTimeWhen reaction started
.... detail 0..1Reference(Observation)Additional information on reaction
.... reported 0..1booleanIndicates self-reported reaction
... vaccinationProtocol I0..*BackboneElementWhat protocol was followed
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!∑0..*ExtensionExtensions that cannot be ignored
.... doseSequence 0..1positiveIntDose number within series
.... description 0..1stringDetails of vaccine protocol
.... authority 0..1Reference(Organization)Who is responsible for protocol
.... series 0..1stringName of vaccine series
.... seriesDoses 0..1positiveIntRecommended number of doses for immunity
.... targetDisease 1..*CodeableConceptDisease immunized against
Binding: Vaccination Protocol Dose Target Codes (example)
.... doseStatus 1..1CodeableConceptIndicates if dose counts towards immunity
Binding: Vaccination Protocol Dose Status codes (example)
.... doseStatusReason 0..1CodeableConceptWhy dose does (not) count
Binding: Vaccination Protocol Dose Status Reason codes (example)

doco Documentation for this format

Complete Summary of the Mandatory Requirements

  1. One status in Immunization.status which has an required binding to:
  2. One dateTime in Immunization.date
  3. One vaccine code in Immunization.vaccineCode which has:
    • a required binding to the CVX value set
    • SHOULD have a translation to the to the NDC value set
  4. One patient in Immunization.patient
  5. One boolean value in Immunization.wasNotGiven
  6. One boolean value in Immunization.primarySource

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Immunization I0..*US Core Immunization Profile
... id ∑0..1idLogical id of this artifact
... meta ∑0..1MetaMetadata about the resource
... implicitRules ?!∑0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierBusiness identifier
... status ?!S1..1codecompleted | entered-in-error
Binding: Immunization Status (required)
... date S1..1dateTimeVaccination administration date
... vaccineCode S1..1CodeableConceptVaccine Product Type (bind to CVX)
Binding: Vaccine Administered Value Set (example)
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... coding ∑CodingCode defined by a terminology system
Slice: Unordered, Open, by code
.... coding S1..1CodingCode defined by a terminology system
Binding: Vaccine Administered Value Set (CVX) (required)
.... coding S0..1CodingCode defined by a terminology system
Binding: Vaccine National Drug Code (NDC) (required)
.... text ∑0..1stringPlain text representation of the concept
... patient S1..1Reference(US Core Patient Profile)Who was immunized
... wasNotGiven ?!S1..1booleanFlag for whether immunization was given
... primarySource S1..1booleanIndicates context the data was recorded in
... reportOrigin 0..1CodeableConceptIndicates the source of a secondarily reported record
Binding: ImmunizationOrigin (example)
... performer 0..1Reference(Practitioner)Who administered vaccine
... requester 0..1Reference(Practitioner)Who ordered vaccination
... encounter 0..1Reference(Encounter)Encounter administered as part of
... manufacturer 0..1Reference(Organization)Vaccine manufacturer
... location 0..1Reference(Location)Where vaccination occurred
... lotNumber 0..1stringVaccine lot number
... expirationDate 0..1dateVaccine expiration date
... site 0..1CodeableConceptBody site vaccine was administered
Binding: Codes for Immunization Site of Administration (example)
... route 0..1CodeableConceptHow vaccine entered body
Binding: Immunization Route Codes (example)
... doseQuantity 0..1SimpleQuantityAmount of vaccine administered
... note ∑0..*AnnotationVaccination notes
... explanation I0..1BackboneElementAdministration/non-administration reasons
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!∑0..*ExtensionExtensions that cannot be ignored
.... reason 0..*CodeableConceptWhy immunization occurred
Binding: Immunization Reason Codes (example)
.... reasonNotGiven 0..*CodeableConceptWhy immunization did not occur
Binding: Immunization Reasons for Not Immunizing Codes (example)
... reaction I0..*BackboneElementDetails of a reaction that follows immunization
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!∑0..*ExtensionExtensions that cannot be ignored
.... date 0..1dateTimeWhen reaction started
.... detail 0..1Reference(Observation)Additional information on reaction
.... reported 0..1booleanIndicates self-reported reaction
... vaccinationProtocol I0..*BackboneElementWhat protocol was followed
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!∑0..*ExtensionExtensions that cannot be ignored
.... doseSequence 0..1positiveIntDose number within series
.... description 0..1stringDetails of vaccine protocol
.... authority 0..1Reference(Organization)Who is responsible for protocol
.... series 0..1stringName of vaccine series
.... seriesDoses 0..1positiveIntRecommended number of doses for immunity
.... targetDisease 1..*CodeableConceptDisease immunized against
Binding: Vaccination Protocol Dose Target Codes (example)
.... doseStatus 1..1CodeableConceptIndicates if dose counts towards immunity
Binding: Vaccination Protocol Dose Status codes (example)
.... doseStatusReason 0..1CodeableConceptWhy dose does (not) count
Binding: Vaccination Protocol Dose Status Reason codes (example)

doco Documentation for this format

Downloads: StructureDefinition: (XML, JSON, CSV), Schema: XML Schematron

 

D.4.1.2 Quick Start

Below is an overview of the required search and read operations.

Summary of Argonaut Search Criteria for StructureDefinition-us-core-immunization

Clients

  • A client has connected to a server and fetched all immunizations for a patient using GET /Immunization?patient=[id].

Servers

  • A server is capable of returning a all immunizations for a patient using GET /Immunization?patient=[id].

  • A server has ensured that every API request includes a valid Authorization token, supplied via:Authorization: Bearer {server-specific-token-here}
  • A server has rejected any unauthorized requests by returning an HTTP 401 Unauthorized response code.

GET /Immunization?patient=[id]

Support: Mandatory to support search by patient.

Implementation Notes: Search for all Immunization resources for a patient. Fetches a bundle of all Immunization resources for the specified patient (how to search by reference).

Response Class:

  • (Status 200): successful operation
  • (Status 400): invalid parameter
  • (Status 401/4xx): unauthorized request
  • (Status 403): insufficient scope

Example:

GET https://fhir-open-api-dstu2.smarthealthit.org/Immunization?patient=1032702