Immunization Decision Support Forecast Implementation Guide STU1 (Release 0.2.0 Ballot 2)

This page is part of the Immunization Decision Support Forecast FHIR IG (v0.2.0: STU 1 Ballot 2) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

XML Format: StructureDefinition-immds-immunizationrecommendation

Raw xml


<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="immds-immunizationrecommendation"/>
  <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 style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a></th><th style="width: 100px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/R4/help16.png" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td 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(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-immds-immunizationrecommendation-definitions.html#ImmunizationRecommendation" title="Defines constraints and extensions on the immunizationrecommendation resource for the minimal set of data to perform the Immunization Decision Support Forecast operation.">ImmunizationRecommendation</a><a name="ImmunizationRecommendation"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Guidance or advice relating to an immunization<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7;"><td 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(tbl_bck01.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-immds-immunizationrecommendation-definitions.html#ImmunizationRecommendation.recommendation" title="Vaccine administration recommendations.">recommendation</a><a name="ImmunizationRecommendation.recommendation"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..*</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Vaccine administration recommendations<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td 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(tbl_bck010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-immds-immunizationrecommendation-definitions.html#ImmunizationRecommendation.recommendation.vaccineCode" title="Vaccine(s) or vaccine group that pertain to the recommendation.">vaccineCode</a><a name="ImmunizationRecommendation.recommendation.vaccineCode"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Vaccine  or vaccine group recommendation applies to<br/><span style="font-weight:bold">Binding: </span><a href="https://build.fhir.org/ig/HL7/US-Core-R4//ValueSet-us-core-vaccines-cvx.html">US Core Vaccine Administered Value Set (CVX)</a> (<a href="http://hl7.org/fhir/R4/terminologies.html#extensible" title="To be conformant, the concept in this element SHALL be from the specified value set if any of the codes within the value set can apply to the concept being communicated.  If the value set does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.">extensible</a>)<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7;"><td 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(tbl_bck010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-immds-immunizationrecommendation-definitions.html#ImmunizationRecommendation.recommendation.targetDisease" title="The targeted disease for the recommendation.">targetDisease</a><a name="ImmunizationRecommendation.recommendation.targetDisease"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Disease to be immunized against<br/><span style="font-weight:bold">Binding: </span><a href="https://build.fhir.org/ig/HL7/US-Core-R4//ValueSet-us-core-vaccines-cvx.html">US Core Vaccine Administered Value Set (CVX)</a> (<a href="http://hl7.org/fhir/R4/terminologies.html#extensible" title="To be conformant, the concept in this element SHALL be from the specified value set if any of the codes within the value set can apply to the concept being communicated.  If the value set does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.">extensible</a>)</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td 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(tbl_bck010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-immds-immunizationrecommendation-definitions.html#ImmunizationRecommendation.recommendation.contraindicatedVaccineCode" title="Vaccine(s) which should not be used to fulfill the recommendation.">contraindicatedVaccineCode</a><a name="ImmunizationRecommendation.recommendation.contraindicatedVaccineCode"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Vaccine which is contraindicated to fulfill the recommendation<br/><span style="font-weight:bold">Binding: </span><a href="https://build.fhir.org/ig/HL7/US-Core-R4//ValueSet-us-core-vaccines-cvx.html">US Core Vaccine Administered Value Set (CVX)</a> (<a href="http://hl7.org/fhir/R4/terminologies.html#extensible" title="To be conformant, the concept in this element SHALL be from the specified value set if any of the codes within the value set can apply to the concept being communicated.  If the value set does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.">extensible</a>)<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7;"><td 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(tbl_bck010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-immds-immunizationrecommendation-definitions.html#ImmunizationRecommendation.recommendation.forecastStatus" title="Indicates the patient status with respect to the path to immunity for the target disease.">forecastStatus</a><a name="ImmunizationRecommendation.recommendation.forecastStatus"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Vaccine recommendation status<br/><span style="font-weight:bold">Binding: </span><a href="http://hl7.org/fhir/R4/valueset-immunization-recommendation-status.html">ImmunizationRecommendationStatusCodes</a> (<a href="http://hl7.org/fhir/R4/terminologies.html#extensible" title="To be conformant, the concept in this element SHALL be from the specified value set if any of the codes within the value set can apply to the concept being communicated.  If the value set does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.">extensible</a>)</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td 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(tbl_bck010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-immds-immunizationrecommendation-definitions.html#ImmunizationRecommendation.recommendation.forecastReason" title="While an extensible value set is provided for this element, there is not a broadly agreed upon value set to use. Implementations will likely make extensive use of the text element within the CodeableConcept data type to convey information.">forecastReason</a><a name="ImmunizationRecommendation.recommendation.forecastReason"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Vaccine administration status reason<br/><span style="font-weight:bold">Binding: </span><a href="http://hl7.org/fhir/R4/valueset-immunization-recommendation-reason.html">ImmunizationRecommendationReasonCodes</a> (<a href="http://hl7.org/fhir/R4/terminologies.html#extensible" title="To be conformant, the concept in this element SHALL be from the specified value set if any of the codes within the value set can apply to the concept being communicated.  If the value set does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.">extensible</a>)<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7;"><td 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(tbl_bck001.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-immds-immunizationrecommendation-definitions.html#ImmunizationRecommendation.recommendation.dateCriterion" title="Vaccine date recommendations.  For example, earliest date to administer, latest date to administer, etc.">dateCriterion</a><a name="ImmunizationRecommendation.recommendation.dateCriterion"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Dates governing proposed immunization<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td 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(tbl_bck0000.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-immds-immunizationrecommendation-definitions.html#ImmunizationRecommendation.recommendation.dateCriterion.code" title="Date classification of recommendation.  For example, earliest date to give, latest date to give, etc.">code</a><a name="ImmunizationRecommendation.recommendation.dateCriterion.code"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Type of date<br/><span style="font-weight:bold">Binding: </span><a href="http://hl7.org/fhir/R4/valueset-immunization-recommendation-date-criterion.html">ImmunizationRecommendationDateCriterionCodes</a> (<a href="http://hl7.org/fhir/R4/terminologies.html#extensible" title="To be conformant, the concept in this element SHALL be from the specified value set if any of the codes within the value set can apply to the concept being communicated.  If the value set does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.">extensible</a>)</td></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/R4/help16.png" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
  </text>
  <url
       value="http://hl7.org/fhir/uv/immds/StructureDefinition/immds-immunizationrecommendation"/>
  <version value="0.2.0"/>
  <name value="ImmDSImmunizationRecommendationProfile"/>
  <title
         value="Immunization Decision Support ImmunizationRecommendation Profile"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2019-06-27T20:00:00-04:00"/>
  <publisher value="HL7 International - Public Health Work Group"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value
             value="https://confluence.hl7.org/display/PHWG/Public+Health+Work+Group"/>
    </telecom>
  </contact>
  <description
               value="Defines constraints and extensions on the immunizationrecommendation resource for the minimal set of data to perform the Immunization Decision Support Forecast operation."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
      <display value="United States of America"/>
    </coding>
  </jurisdiction>
  <fhirVersion value="4.0.0"/>
  <mapping>
    <identity value="workflow"/>
    <uri value="http://hl7.org/fhir/workflow"/>
    <name value="Workflow Pattern"/>
  </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>
  <mapping>
    <identity value="w5"/>
    <uri value="http://hl7.org/fhir/fivews"/>
    <name value="FiveWs Pattern Mapping"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="false"/>
  <type value="ImmunizationRecommendation"/>
  <baseDefinition
                  value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"/>
  <derivation value="constraint"/>
  <snapshot>
    <element id="ImmunizationRecommendation">
      <path value="ImmunizationRecommendation"/>
      <short value="Guidance or advice relating to an immunization"/>
      <definition
                  value="Defines constraints and extensions on the immunizationrecommendation resource for the minimal set of data to perform the Immunization Decision Support Forecast operation."/>
      <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()"/>
        <xpath value="not(parent::f:contained and f:contained)"/>
        <source value="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()"/>
        <xpath
               value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
        <source value="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(((&#39;#&#39;+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = &#39;#&#39;).exists() or descendants().where(as(canonical) = &#39;#&#39;).exists() or descendants().where(as(canonical) = &#39;#&#39;).exists()).not()).trace(&#39;unmatched&#39;, id).empty()"/>
        <xpath
               value="not(exists(for $contained in f:contained return $contained[not(parent::*/descendant::f:reference/@value=concat(&#39;#&#39;, $contained/*/id/@value) or descendant::f:reference[@value=&#39;#&#39;])]))"/>
        <source value="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()"/>
        <xpath value="exists(f:text/h:div)"/>
        <source value="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()"/>
        <xpath value="not(exists(f:contained/*/f:meta/f:security))"/>
        <source value="DomainResource"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Request"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="VXU_V04"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="SubstanceAdministration[moodCode=RMD]"/>
      </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="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <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>
      <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 it&#39;s 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>
      <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 it&#39;s 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>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/>
        </extension>
        <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="preferred"/>
        <description value="A human language."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/languages"/>
      </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 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>
      <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, and nor can they have their own independent transaction scope."/>
      <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>
      <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 manageable, 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>
      <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&#39;s descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, 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](http://hl7.org/fhir/R4/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>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/>
      <isSummary value="false"/>
      <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>
      <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>
      <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>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.subject"/>
      </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>
      <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>
      <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."/>
      <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())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="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()"/>
        <xpath value="exists(f:vaccineCode) or exists(f:targetDisease)"/>
        <source value="ImmunizationRecommendation.recommendation"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=&#39;COMP&#39;].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>
      <type>
        <code value="string"/>
      </type>
      <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 manageable, 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>
      <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&#39;s descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, 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](http://hl7.org/fhir/R4/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>
      <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>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <strength value="extensible"/>
        <description value="The type of vaccine administered."/>
        <valueSet
                  value="http://hl7.org/fhir/us/core/ValueSet/us-core-vaccines-cvx"/>
      </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."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImmunizationRecommendation.recommendation.targetDisease"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <strength value="extensible"/>
        <description
                     value="The disease that the recommended vaccination targets."/>
        <valueSet
                  value="http://hl7.org/fhir/us/core/ValueSet/us-core-vaccines-cvx"/>
      </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>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <strength value="extensible"/>
        <description value="The type of vaccine administered."/>
        <valueSet
                  value="http://hl7.org/fhir/us/core/ValueSet/us-core-vaccines-cvx"/>
      </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>
      <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>
        <strength value="extensible"/>
        <description
                     value="The patient&#39;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;Immunization Forecast Status&quot;].value"/>
      </mapping>
    </element>
    <element id="ImmunizationRecommendation.recommendation.forecastReason">
      <path value="ImmunizationRecommendation.recommendation.forecastReason"/>
      <short value="Vaccine administration status reason"/>
      <definition
                  value="While an extensible value set is provided for this element, there is not a broadly agreed upon value set to use. Implementations will likely make extensive use of the text element within the CodeableConcept data type to convey information."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ImmunizationRecommendation.recommendation.forecastReason"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <strength value="extensible"/>
        <description
                     value="The reason for the patient&#39;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())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <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=&#39;LIMIT&#39;].target[classCode=OBS, moodCode=EVN, isCriterionInd=true]"/>
      </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>
      <type>
        <code value="string"/>
      </type>
      <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 manageable, 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>
      <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&#39;s descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, 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](http://hl7.org/fhir/R4/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>
      <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>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="extensible"/>
        <description
                     value="Classifies date criterion with respect to conveying information about a patient&#39;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>
      <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="string"/>
      </type>
      <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>
      <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[x]">
      <path value="ImmunizationRecommendation.recommendation.doseNumber[x]"/>
      <short value="Recommended dose number within series"/>
      <definition
                  value="Nominal position of the recommended dose in a series (e.g. dose 2 is the next recommended dose)."/>
      <comment
               value="The use of an integer is prefered if known. A string should only be used in cases where an interger is not available (such as when documenting a recurring booster dose)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImmunizationRecommendation.recommendation.doseNumber[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="positiveInt"/>
      </type>
      <type>
        <code value="string"/>
      </type>
      <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[x]">
      <path value="ImmunizationRecommendation.recommendation.seriesDoses[x]"/>
      <short value="Recommended number of doses for immunity"/>
      <definition value="The recommended number of doses to achieve immunity."/>
      <comment
               value="The use of an integer is prefered if known. A string should only be used in cases where an interger is not available (such as when documenting a recurring booster dose)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ImmunizationRecommendation.recommendation.seriesDoses[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="positiveInt"/>
      </type>
      <type>
        <code value="string"/>
      </type>
      <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>
      <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;immunization&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>
      <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 = &#39;998^No vaccine administered^CVX&#39;), 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="Defines constraints and extensions on the immunizationrecommendation resource for the minimal set of data to perform the Immunization Decision Support Forecast operation."/>
      <min value="0"/>
      <max value="*"/>
    </element>
    <element id="ImmunizationRecommendation.recommendation">
      <path value="ImmunizationRecommendation.recommendation"/>
      <short value="Vaccine administration recommendations"/>
      <definition value="Vaccine administration recommendations."/>
      <min value="1"/>
      <max value="*"/>
      <type>
        <code value="BackboneElement"/>
      </type>
    </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>
      <binding>
        <strength value="extensible"/>
        <description value="The type of vaccine administered."/>
        <valueSet
                  value="http://hl7.org/fhir/us/core/ValueSet/us-core-vaccines-cvx"/>
      </binding>
    </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."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <strength value="extensible"/>
        <description
                     value="The disease that the recommended vaccination targets."/>
        <valueSet
                  value="http://hl7.org/fhir/us/core/ValueSet/us-core-vaccines-cvx"/>
      </binding>
    </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>
      <binding>
        <strength value="extensible"/>
        <description value="The type of vaccine administered."/>
        <valueSet
                  value="http://hl7.org/fhir/us/core/ValueSet/us-core-vaccines-cvx"/>
      </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>
      <isSummary value="true"/>
      <binding>
        <strength value="extensible"/>
        <description
                     value="The patient&#39;s status with respect to a vaccination protocol."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/immunization-recommendation-status"/>
      </binding>
    </element>
    <element id="ImmunizationRecommendation.recommendation.forecastReason">
      <path value="ImmunizationRecommendation.recommendation.forecastReason"/>
      <short value="Vaccine administration status reason"/>
      <definition
                  value="While an extensible value set is provided for this element, there is not a broadly agreed upon value set to use. Implementations will likely make extensive use of the text element within the CodeableConcept data type to convey information."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <strength value="extensible"/>
        <description
                     value="The reason for the patient&#39;s status with respect to a vaccination protocol."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/immunization-recommendation-reason"/>
      </binding>
    </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>
    </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>
      <binding>
        <strength value="extensible"/>
        <description
                     value="Classifies date criterion with respect to conveying information about a patient&#39;s vaccination status (e.g. due date, latest to give date, etc.)."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/immunization-recommendation-date-criterion"/>
      </binding>
    </element>
  </differential>
</StructureDefinition>