HL7 FHIR Implementation Guide: Profiles for ICSR Transfusion and Vaccination Adverse Event Detection and Reporting
1.0.0 - STU 1

This page is part of the Profiles for ICSR Transfusion and Vaccination Adverse Event Detection and Reporting (v1.0.0: STU 1) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: VAERS Sample Event - JSON Representation

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{
  "resourceType" : "AdverseEvent",
  "id" : "VAERSExampleEvent",
  "meta" : {
    "profile" : [
      "http://hl7.org/fhir/us/icsr-ae-reporting/StructureDefinition/vaers-adverseevent"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource \"VAERSExampleEvent\" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-vaers-adverseevent.html\">VAERS Adverse Event</a></p></div><p><b>actuality</b>: actual</p><p><b>event</b>: Bell's Palsy <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (meddra.org#10004223)</span></p><p><b>subject</b>: <a href=\"Patient-VAERSPatient.html\">Patient/VAERSPatient</a> \" LNAME\"</p><p><b>date</b>: 2017-04-23</p><p><b>seriousness</b>: Serious <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.0.0/CodeSystem-adverse-event-seriousness.html\">AdverseEventSeriousness</a>#serious)</span></p><p><b>outcome</b>: Recovering <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-adverse-event-outcome.html\">AdverseEventOutcome</a>#recovering)</span></p><blockquote><p><b>suspectEntity</b></p><p><b>instance</b>: <a href=\"Immunization-VAERSExampleImmunization.html\">Immunization/VAERSExampleImmunization</a></p><h3>Causalities</h3><table class=\"grid\"><tr><td>-</td><td><b>ProductRelatedness</b></td></tr><tr><td>*</td><td>Suspect</td></tr></table></blockquote><blockquote><p><b>suspectEntity</b></p><p><b>instance</b>: <a href=\"MedicationAdministration-VAERSHydrocortisoneAdministration.html\">MedicationAdministration/VAERSHydrocortisoneAdministration</a></p><h3>Causalities</h3><table class=\"grid\"><tr><td>-</td><td><b>ProductRelatedness</b></td></tr><tr><td>*</td><td>Concomitant</td></tr></table></blockquote></div>"
  },
  "actuality" : "actual",
  "event" : {
    "coding" : [
      {
        "system" : "http://meddra.org",
        "code" : "10004223",
        "display" : "Bell's Palsy"
      }
    ]
  },
  "subject" : {
    "reference" : "Patient/VAERSPatient"
  },
  "date" : "2017-04-23",
  "seriousness" : {
    "extension" : [
      {
        "url" : "http://hl7.org/fhir/us/icsr-ae-reporting/StructureDefinition/icsr-ext-eventseriousness",
        "valueCodeableConcept" : {
          "coding" : [
            {
              "system" : "urn:oid:2.16.840.1.113883.3.989.2.1.1.19",
              "code" : "26"
            }
          ]
        }
      }
    ],
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/adverse-event-seriousness",
        "code" : "serious"
      }
    ]
  },
  "outcome" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/adverse-event-outcome",
        "code" : "recovering"
      }
    ]
  },
  "suspectEntity" : [
    {
      "instance" : {
        "reference" : "Immunization/VAERSExampleImmunization"
      },
      "causality" : [
        {
          "productRelatedness" : "Suspect"
        }
      ]
    },
    {
      "instance" : {
        "reference" : "MedicationAdministration/VAERSHydrocortisoneAdministration"
      },
      "causality" : [
        {
          "productRelatedness" : "Concomitant"
        }
      ]
    }
  ]
}