QI-Core Implementation Guide

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D.4.1 StructureDefinition-qicore-immunizationnotdone

Introduction:

See the patterns page for implementation and usage patterns.

Examples:

D.4.1.1 Formal Views of Profile Content

The official URL for this profile is:

http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-immunizationnotdone

Negation profile of Immunization for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

This profile builds on Immunization.

This profile was published on Wed Aug 22 00:00:00 UTC 2018 as a draft by Health Level Seven, Inc. - CQI WG.

Description of Profiles, Differentials, and Snapshots.

Text Summary
Differential Table
Snapshot Table
All

Summary

Mandatory: 3 elements (1 nested mandatory element)
Must-Support: 7 elements
Fixed Value: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

http://hl7.org/fhir/StructureDefinition/valueset-reference

Name	Flags	Card.	Type	Description & Constraints
Immunization		0..*	Immunization
status	S	1..1	code	Fixed Value: not-done
statusReason	S	1..1	CodeableConcept	Binding: Negation Reason Codes (extensible)
vaccineCode	S	1..1	CodeableConcept	Binding: US Core Vaccine Administered Value Set (CVX) (extensible)
coding
valueset-reference	S	1..1	uri	What wasn't administered URL: http://hl7.org/fhir/StructureDefinition/valueset-reference
patient	S	1..1	Reference(QICorePatient)
encounter		0..1	Reference(QICoreEncounter)
recorded	S	1..1	dateTime
primarySource	S	1..1	boolean
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Immunization	I	0..*	Immunization	Immunization event information
id	Σ	0..1	string	Logical id of this artifact
meta	ΣI	0..1	Meta	Metadata about the resource
implicitRules	?!ΣI	0..1	uri	A set of rules under which this content was created
language	I	0..1	code	Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages
text	I	0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension	I	0..*	Extension	Additional content defined by implementations
modifierExtension	?!I	0..*	Extension	Extensions that cannot be ignored
identifier	I	0..*	Identifier	Business identifier
status	?!SΣI	1..1	code	completed \| entered-in-error \| not-done Binding: ImmunizationStatusCodes (required) Fixed Value: not-done
statusReason	SI	1..1	CodeableConcept	Reason not done Binding: Negation Reason Codes (extensible)
vaccineCode	SΣI	1..1	CodeableConcept	Vaccine product administered Binding: US Core Vaccine Administered Value Set (CVX) (extensible)
id		0..1	string	Unique id for inter-element referencing
extension	I	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	ΣI	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension	I	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
valueset-reference	SI	1..1	uri	What wasn't administered URL: http://hl7.org/fhir/StructureDefinition/valueset-reference
system	ΣI	0..1	uri	Identity of the terminology system
version	ΣI	0..1	string	Version of the system - if relevant
code	ΣI	0..1	code	Symbol in syntax defined by the system
display	ΣI	0..1	string	Representation defined by the system
userSelected	ΣI	0..1	boolean	If this coding was chosen directly by the user
text	ΣI	0..1	string	Plain text representation of the concept
patient	SΣI	1..1	Reference(QICorePatient)	Who was immunized
encounter	I	0..1	Reference(QICoreEncounter)	Encounter immunization was part of
occurrence[x]	ΣI	1..1		Vaccine administration date
occurrenceDateTime			dateTime
occurrenceString			string
recorded	SI	1..1	dateTime	When the immunization was first captured in the subject's record
primarySource	SΣI	1..1	boolean	Indicates context the data was recorded in
reportOrigin	I	0..1	CodeableConcept	Indicates the source of a secondarily reported record Binding: ImmunizationOriginCodes (example)
location	I	0..1	Reference(Location)	Where immunization occurred
manufacturer	I	0..1	Reference(Organization)	Vaccine manufacturer
lotNumber	I	0..1	string	Vaccine lot number
expirationDate	I	0..1	date	Vaccine expiration date
site	I	0..1	CodeableConcept	Body site vaccine was administered Binding: CodesForImmunizationSiteOfAdministration (example)
route	I	0..1	CodeableConcept	How vaccine entered body Binding: ImmunizationRouteCodes (example)
doseQuantity	I	0..1	SimpleQuantity	Amount of vaccine administered
performer	ΣI	0..*	BackboneElement	Who performed event
id		0..1	string	Unique id for inter-element referencing
extension	I	0..*	Extension	Additional content defined by implementations
modifierExtension	?!ΣI	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	ΣI	0..1	CodeableConcept	What type of performance was done Binding: ImmunizationFunctionCodes (extensible)
actor	ΣI	1..1	Reference(Practitioner \| PractitionerRole \| Organization)	Individual or organization who was performing
note	ΣI	0..*	Annotation	Additional immunization notes
reasonCode	I	0..*	CodeableConcept	Why immunization occurred Binding: ImmunizationReasonCodes (example)
reasonReference	I	0..*	Reference(Condition \| Observation \| DiagnosticReport)	Why immunization occurred
isSubpotent	?!ΣI	0..1	boolean	Dose potency
subpotentReason	I	0..*	CodeableConcept	Reason for being subpotent Binding: ImmunizationSubpotentReason (example)
education	I	0..*	BackboneElement	Educational material presented to patient imm-1: One of documentType or reference SHALL be present
id		0..1	string	Unique id for inter-element referencing
extension	I	0..*	Extension	Additional content defined by implementations
modifierExtension	?!ΣI	0..*	Extension	Extensions that cannot be ignored even if unrecognized
documentType	I	0..1	string	Educational material document identifier
reference	I	0..1	uri	Educational material reference pointer
publicationDate	I	0..1	dateTime	Educational material publication date
presentationDate	I	0..1	dateTime	Educational material presentation date
programEligibility	I	0..*	CodeableConcept	Patient eligibility for a vaccination program Binding: ImmunizationProgramEligibility (example)
fundingSource	I	0..1	CodeableConcept	Funding source for the vaccine Binding: ImmunizationFundingSource (example)
reaction	I	0..*	BackboneElement	Details of a reaction that follows immunization
id		0..1	string	Unique id for inter-element referencing
extension	I	0..*	Extension	Additional content defined by implementations
modifierExtension	?!ΣI	0..*	Extension	Extensions that cannot be ignored even if unrecognized
date	I	0..1	dateTime	When reaction started
detail	I	0..1	Reference(Observation)	Additional information on reaction
reported	I	0..1	boolean	Indicates self-reported reaction
protocolApplied	I	0..*	BackboneElement	Protocol followed by the provider
id		0..1	string	Unique id for inter-element referencing
extension	I	0..*	Extension	Additional content defined by implementations
modifierExtension	?!ΣI	0..*	Extension	Extensions that cannot be ignored even if unrecognized
series	I	0..1	string	Name of vaccine series
authority	I	0..1	Reference(Organization)	Who is responsible for publishing the recommendations
targetDisease	I	0..*	CodeableConcept	Vaccine preventatable disease being targetted Binding: ImmunizationTargetDiseaseCodes (example)
doseNumber[x]	I	1..1		Dose number within series
doseNumberPositiveInt			positiveInt
doseNumberString			string
seriesDoses[x]	I	0..1		Recommended number of doses for immunity
seriesDosesPositiveInt			positiveInt
seriesDosesString			string
Documentation for this format

Summary

Mandatory: 3 elements (1 nested mandatory element)
Must-Support: 7 elements
Fixed Value: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

http://hl7.org/fhir/StructureDefinition/valueset-reference

Differential View

Name	Flags	Card.	Type	Description & Constraints
Immunization		0..*	Immunization
status	S	1..1	code	Fixed Value: not-done
statusReason	S	1..1	CodeableConcept	Binding: Negation Reason Codes (extensible)
vaccineCode	S	1..1	CodeableConcept	Binding: US Core Vaccine Administered Value Set (CVX) (extensible)
coding
valueset-reference	S	1..1	uri	What wasn't administered URL: http://hl7.org/fhir/StructureDefinition/valueset-reference
patient	S	1..1	Reference(QICorePatient)
encounter		0..1	Reference(QICoreEncounter)
recorded	S	1..1	dateTime
primarySource	S	1..1	boolean
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Immunization	I	0..*	Immunization	Immunization event information
id	Σ	0..1	string	Logical id of this artifact
meta	ΣI	0..1	Meta	Metadata about the resource
implicitRules	?!ΣI	0..1	uri	A set of rules under which this content was created
language	I	0..1	code	Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages
text	I	0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension	I	0..*	Extension	Additional content defined by implementations
modifierExtension	?!I	0..*	Extension	Extensions that cannot be ignored
identifier	I	0..*	Identifier	Business identifier
status	?!SΣI	1..1	code	completed \| entered-in-error \| not-done Binding: ImmunizationStatusCodes (required) Fixed Value: not-done
statusReason	SI	1..1	CodeableConcept	Reason not done Binding: Negation Reason Codes (extensible)
vaccineCode	SΣI	1..1	CodeableConcept	Vaccine product administered Binding: US Core Vaccine Administered Value Set (CVX) (extensible)
id		0..1	string	Unique id for inter-element referencing
extension	I	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	ΣI	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension	I	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
valueset-reference	SI	1..1	uri	What wasn't administered URL: http://hl7.org/fhir/StructureDefinition/valueset-reference
system	ΣI	0..1	uri	Identity of the terminology system
version	ΣI	0..1	string	Version of the system - if relevant
code	ΣI	0..1	code	Symbol in syntax defined by the system
display	ΣI	0..1	string	Representation defined by the system
userSelected	ΣI	0..1	boolean	If this coding was chosen directly by the user
text	ΣI	0..1	string	Plain text representation of the concept
patient	SΣI	1..1	Reference(QICorePatient)	Who was immunized
encounter	I	0..1	Reference(QICoreEncounter)	Encounter immunization was part of
occurrence[x]	ΣI	1..1		Vaccine administration date
occurrenceDateTime			dateTime
occurrenceString			string
recorded	SI	1..1	dateTime	When the immunization was first captured in the subject's record
primarySource	SΣI	1..1	boolean	Indicates context the data was recorded in
reportOrigin	I	0..1	CodeableConcept	Indicates the source of a secondarily reported record Binding: ImmunizationOriginCodes (example)
location	I	0..1	Reference(Location)	Where immunization occurred
manufacturer	I	0..1	Reference(Organization)	Vaccine manufacturer
lotNumber	I	0..1	string	Vaccine lot number
expirationDate	I	0..1	date	Vaccine expiration date
site	I	0..1	CodeableConcept	Body site vaccine was administered Binding: CodesForImmunizationSiteOfAdministration (example)
route	I	0..1	CodeableConcept	How vaccine entered body Binding: ImmunizationRouteCodes (example)
doseQuantity	I	0..1	SimpleQuantity	Amount of vaccine administered
performer	ΣI	0..*	BackboneElement	Who performed event
id		0..1	string	Unique id for inter-element referencing
extension	I	0..*	Extension	Additional content defined by implementations
modifierExtension	?!ΣI	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	ΣI	0..1	CodeableConcept	What type of performance was done Binding: ImmunizationFunctionCodes (extensible)
actor	ΣI	1..1	Reference(Practitioner \| PractitionerRole \| Organization)	Individual or organization who was performing
note	ΣI	0..*	Annotation	Additional immunization notes
reasonCode	I	0..*	CodeableConcept	Why immunization occurred Binding: ImmunizationReasonCodes (example)
reasonReference	I	0..*	Reference(Condition \| Observation \| DiagnosticReport)	Why immunization occurred
isSubpotent	?!ΣI	0..1	boolean	Dose potency
subpotentReason	I	0..*	CodeableConcept	Reason for being subpotent Binding: ImmunizationSubpotentReason (example)
education	I	0..*	BackboneElement	Educational material presented to patient imm-1: One of documentType or reference SHALL be present
id		0..1	string	Unique id for inter-element referencing
extension	I	0..*	Extension	Additional content defined by implementations
modifierExtension	?!ΣI	0..*	Extension	Extensions that cannot be ignored even if unrecognized
documentType	I	0..1	string	Educational material document identifier
reference	I	0..1	uri	Educational material reference pointer
publicationDate	I	0..1	dateTime	Educational material publication date
presentationDate	I	0..1	dateTime	Educational material presentation date
programEligibility	I	0..*	CodeableConcept	Patient eligibility for a vaccination program Binding: ImmunizationProgramEligibility (example)
fundingSource	I	0..1	CodeableConcept	Funding source for the vaccine Binding: ImmunizationFundingSource (example)
reaction	I	0..*	BackboneElement	Details of a reaction that follows immunization
id		0..1	string	Unique id for inter-element referencing
extension	I	0..*	Extension	Additional content defined by implementations
modifierExtension	?!ΣI	0..*	Extension	Extensions that cannot be ignored even if unrecognized
date	I	0..1	dateTime	When reaction started
detail	I	0..1	Reference(Observation)	Additional information on reaction
reported	I	0..1	boolean	Indicates self-reported reaction
protocolApplied	I	0..*	BackboneElement	Protocol followed by the provider
id		0..1	string	Unique id for inter-element referencing
extension	I	0..*	Extension	Additional content defined by implementations
modifierExtension	?!ΣI	0..*	Extension	Extensions that cannot be ignored even if unrecognized
series	I	0..1	string	Name of vaccine series
authority	I	0..1	Reference(Organization)	Who is responsible for publishing the recommendations
targetDisease	I	0..*	CodeableConcept	Vaccine preventatable disease being targetted Binding: ImmunizationTargetDiseaseCodes (example)
doseNumber[x]	I	1..1		Dose number within series
doseNumberPositiveInt			positiveInt
doseNumberString			string
seriesDoses[x]	I	0..1		Recommended number of doses for immunity
seriesDosesPositiveInt			positiveInt
seriesDosesString			string
Documentation for this format

D.4.1.2 Terminology Bindings

Terminology Bindings

Path	Conformance	ValueSet / Code
Immunization.language	preferred	CommonLanguages Max Binding: AllLanguages
Immunization.status	required	Fixed Value: not-done
Immunization.statusReason	extensible	NegationReasonCodes
Immunization.vaccineCode	extensible	USCoreVaccineAdministeredValueSetCvx
Immunization.reportOrigin	example	ImmunizationOriginCodes
Immunization.site	example	CodesForImmunizationSiteOfAdministration
Immunization.route	example	ImmunizationRouteCodes
Immunization.performer.function	extensible	ImmunizationFunctionCodes
Immunization.reasonCode	example	ImmunizationReasonCodes
Immunization.subpotentReason	example	ImmunizationSubpotentReason
Immunization.programEligibility	example	ImmunizationProgramEligibility
Immunization.fundingSource	example	ImmunizationFundingSource
Immunization.protocolApplied.targetDisease	example	ImmunizationTargetDiseaseCodes

D.4.1.3 Constraints

Constraints

Id	Path	Details	Requirements
dom-2	Immunization	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	Immunization	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 : contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	Immunization	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	Immunization	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	Immunization	A resource should have narrative for robust management : text.`div`.exists()
ele-1	Immunization.meta	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.implicitRules	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.language	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.text	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.extension	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	Immunization.extension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Immunization.modifierExtension	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	Immunization.modifierExtension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Immunization.identifier	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.status	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.statusReason	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.vaccineCode	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.vaccineCode.extension	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	Immunization.vaccineCode.extension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Immunization.vaccineCode.coding	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.vaccineCode.coding.extension	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	Immunization.vaccineCode.coding.extension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Immunization.vaccineCode.coding.extension:notDoneValueSet	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	Immunization.vaccineCode.coding.extension:notDoneValueSet	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Immunization.vaccineCode.coding.system	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.vaccineCode.coding.version	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.vaccineCode.coding.code	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.vaccineCode.coding.display	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.vaccineCode.coding.userSelected	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.vaccineCode.text	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.patient	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.encounter	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.occurrence[x]	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.recorded	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.primarySource	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.reportOrigin	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.location	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.manufacturer	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.lotNumber	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.expirationDate	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.site	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.route	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.doseQuantity	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.performer	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.performer.extension	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	Immunization.performer.extension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Immunization.performer.modifierExtension	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	Immunization.performer.modifierExtension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Immunization.performer.function	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.performer.actor	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.note	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.reasonCode	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.reasonReference	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.isSubpotent	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.subpotentReason	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.education	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
imm-1	Immunization.education	One of documentType or reference SHALL be present : documentType.exists() or reference.exists()
ele-1	Immunization.education.extension	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	Immunization.education.extension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Immunization.education.modifierExtension	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	Immunization.education.modifierExtension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Immunization.education.documentType	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.education.reference	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.education.publicationDate	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.education.presentationDate	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.programEligibility	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.fundingSource	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.reaction	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.reaction.extension	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	Immunization.reaction.extension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Immunization.reaction.modifierExtension	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	Immunization.reaction.modifierExtension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Immunization.reaction.date	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.reaction.detail	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.reaction.reported	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.protocolApplied	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.protocolApplied.extension	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	Immunization.protocolApplied.extension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Immunization.protocolApplied.modifierExtension	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	Immunization.protocolApplied.modifierExtension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Immunization.protocolApplied.series	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.protocolApplied.authority	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.protocolApplied.targetDisease	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.protocolApplied.doseNumber[x]	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Immunization.protocolApplied.seriesDoses[x]	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())