Extensions for Using Data Elements from FHIR R5 in FHIR R4
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Extensions for Using Data Elements from FHIR R5 in FHIR R4 - Downloaded Version null See the Directory of published versions

Resource Profile: Profile_R5_Immunization_R4 - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 0

Definitions for the profile-Immunization resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. Immunization
Definition

Describes the event of a patient being administered a vaccine or a record of an immunization as reported by a patient, a clinician or another party.

ShortImmunization event information
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Immunization.implicitRules
Definition

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.

ShortA set of rules under which this content was created
Comments

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's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Immunization.extension
Definition

An Extension


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.

ShortExtensionAdditional content defined by implementations
Comments

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.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Immunization.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. Immunization.extension:basedOn
    Slice NamebasedOn
    Definition

    R5: Immunization.basedOn (new:Reference(CarePlan,MedicationRequest,ServiceRequest,ImmunizationRecommendation))

    ShortR5: Authority that the immunization event is based on (new)
    Comments

    Element Immunization.basedOn has a context of Immunization based on following the parent source element upwards and mapping to Immunization. Element Immunization.basedOn has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). Allows tracing of an authorization for the Immunization.

    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(R5: Authority that the immunization event is based on (new)) (Extension Type: Reference(Cross-version Profile for R5.CarePlan for use in FHIR R4, CarePlan, Cross-version Profile for R5.MedicationRequest for use in FHIR R4, MedicationRequest, Cross-version Profile for R5.ServiceRequest for use in FHIR R4, ServiceRequest, Cross-version Profile for R5.ImmunizationRecommendation for use in FHIR R4, ImmunizationRecommendation))
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. Immunization.extension:administeredProduct
    Slice NameadministeredProduct
    Definition

    R5: Immunization.administeredProduct (new:CodeableReference(Medication))

    ShortR5: Product that was administered (new)
    Comments

    Element Immunization.administeredProduct has a context of Immunization based on following the parent source element upwards and mapping to Immunization. Element Immunization.administeredProduct has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(R5: Product that was administered (new)) (Complex Extension)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    10. Immunization.extension:supportingInformation
    Slice NamesupportingInformation
    Definition

    R5: Immunization.supportingInformation (new:Reference(Resource))

    ShortR5: Additional information in support of the immunization (new)
    Comments

    Element Immunization.supportingInformation has a context of Immunization based on following the parent source element upwards and mapping to Immunization. Element Immunization.supportingInformation has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(R5: Additional information in support of the immunization (new)) (Extension Type: Reference(Cross-version Profile for R5.Resource for use in FHIR R4, Resource))
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    12. Immunization.extension:informationSource
    Slice NameinformationSource
    Definition

    R5: Immunization.informationSource (new:CodeableReference(Patient,Practitioner,PractitionerRole,RelatedPerson,Organization))

    ShortR5: Indicates the source of a reported record (new)
    Comments

    Element Immunization.informationSource has a context of Immunization based on following the parent source element upwards and mapping to Immunization. Element Immunization.informationSource has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). Typically will not be populated if primarySource = True, not required even if primarySource = False.

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(R5: Indicates the source of a reported record (new)) (Complex Extension)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    14. Immunization.extension:reason
    Slice Namereason
    Definition

    R5: Immunization.reason additional types (CodeableReference(http://hl7.org/fhir/StructureDefinition/Condition), CodeableReference(http://hl7.org/fhir/StructureDefinition/Observation), CodeableReference(http://hl7.org/fhir/StructureDefinition/DiagnosticReport))

    ShortR5: Why immunization occurred additional types
    Comments

    Element Immunization.reason is mapped to FHIR R4 element Immunization.reasonCode as SourceIsBroaderThanTarget. Element Immunization.reason is mapped to FHIR R4 element Immunization.reasonReference as SourceIsBroaderThanTarget. The mappings for Immunization.reason do not cover the following types: CodeableReference.

    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(R5: Why immunization occurred additional types) (Complex Extension)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    16. Immunization.modifierExtension
    Definition

    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'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).

    ShortExtensions that cannot be ignored
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Summaryfalse
    Requirements

    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.

    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    18. Immunization.status
    Definition

    Indicates the current status of the immunization event.

    Shortcompleted | entered-in-error | not-done
    Comments

    Will generally be set to show that the immunization has been completed or not done. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

    Control1..1
    BindingThe codes SHALL be taken from ImmunizationStatusCodeshttp://hl7.org/fhir/ValueSet/immunization-status|4.0.1
    (required to http://hl7.org/fhir/ValueSet/immunization-status|4.0.1)

    A set of codes indicating the current status of an Immunization.

    Typecode
    Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains statuses entered-in-error and not-done which means that the resource should not be treated as valid
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. Immunization.vaccineCode
    Definition

    Vaccine that was administered or was to be administered.

    ShortVaccine product administered
    Control1..1
    BindingFor example codes, see VaccineAdministeredValueSethttp://hl7.org/fhir/ValueSet/vaccine-code|4.0.1
    (example to http://hl7.org/fhir/ValueSet/vaccine-code|4.0.1)

    The code for vaccine product administered.

    TypeCodeableConcept
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. Immunization.patient
    Definition

    The patient who either received or did not receive the immunization.

    ShortWho was immunized
    Control1..1
    TypeReference(Patient)
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. Immunization.occurrence[x]
    Definition

    Date vaccine administered or was to be administered.

    ShortVaccine administration date
    Comments

    When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given. An exact date is always preferable, but the use of the String data type is acceptable when an exact date is not known. A small number of vaccines (e.g. live oral typhoid vaccine) are given as a series of patient self-administered dose over a span of time. In cases like this, often, only the first dose (typically a provider supervised dose) is recorded with the occurrence indicating the date/time of the first dose.

    Control1..1
    TypeChoice of: dateTime, string
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. Immunization.isSubpotent
    Definition

    Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent.

    ShortDose potency
    Comments

    Typically, the recognition of the dose being sub-potent is retrospective, after the administration (ex. notification of a manufacturer recall after administration). However, in the case of a partial administration (the patient moves unexpectedly and only some of the dose is actually administered), subpotency may be recognized immediately, but it is still important to record the event.

    Control0..1
    Typeboolean
    Is Modifiertrue because This element is labeled as a modifier because an immunization event with a subpotent vaccine doesn't protect the patient the same way as a potent dose.
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Meaning if MissingBy default, a dose should be considered to be potent.
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

    Guidance on how to interpret the contents of this table can be foundhere

    0. Immunization
    2. Immunization.extension
    Control0..*
    SlicingThis element introduces a set of slices on Immunization.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 4. Immunization.extension:basedOn
      Slice NamebasedOn
      Definition

      R5: Immunization.basedOn (new:Reference(CarePlan,MedicationRequest,ServiceRequest,ImmunizationRecommendation))

      ShortR5: Authority that the immunization event is based on (new)
      Comments

      Element Immunization.basedOn has a context of Immunization based on following the parent source element upwards and mapping to Immunization. Element Immunization.basedOn has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). Allows tracing of an authorization for the Immunization.

      Control0..*
      TypeExtension(R5: Authority that the immunization event is based on (new)) (Extension Type: Reference(Cross-version Profile for R5.CarePlan for use in FHIR R4, CarePlan, Cross-version Profile for R5.MedicationRequest for use in FHIR R4, MedicationRequest, Cross-version Profile for R5.ServiceRequest for use in FHIR R4, ServiceRequest, Cross-version Profile for R5.ImmunizationRecommendation for use in FHIR R4, ImmunizationRecommendation))
      6. Immunization.extension:administeredProduct
      Slice NameadministeredProduct
      Definition

      R5: Immunization.administeredProduct (new:CodeableReference(Medication))

      ShortR5: Product that was administered (new)
      Comments

      Element Immunization.administeredProduct has a context of Immunization based on following the parent source element upwards and mapping to Immunization. Element Immunization.administeredProduct has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

      Control0..1
      TypeExtension(R5: Product that was administered (new)) (Complex Extension)
      8. Immunization.extension:supportingInformation
      Slice NamesupportingInformation
      Definition

      R5: Immunization.supportingInformation (new:Reference(Resource))

      ShortR5: Additional information in support of the immunization (new)
      Comments

      Element Immunization.supportingInformation has a context of Immunization based on following the parent source element upwards and mapping to Immunization. Element Immunization.supportingInformation has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

      Control0..*
      TypeExtension(R5: Additional information in support of the immunization (new)) (Extension Type: Reference(Cross-version Profile for R5.Resource for use in FHIR R4, Resource))
      10. Immunization.extension:informationSource
      Slice NameinformationSource
      Definition

      R5: Immunization.informationSource (new:CodeableReference(Patient,Practitioner,PractitionerRole,RelatedPerson,Organization))

      ShortR5: Indicates the source of a reported record (new)
      Comments

      Element Immunization.informationSource has a context of Immunization based on following the parent source element upwards and mapping to Immunization. Element Immunization.informationSource has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). Typically will not be populated if primarySource = True, not required even if primarySource = False.

      Control0..1
      TypeExtension(R5: Indicates the source of a reported record (new)) (Complex Extension)
      12. Immunization.extension:reason
      Slice Namereason
      Definition

      R5: Immunization.reason additional types (CodeableReference(http://hl7.org/fhir/StructureDefinition/Condition), CodeableReference(http://hl7.org/fhir/StructureDefinition/Observation), CodeableReference(http://hl7.org/fhir/StructureDefinition/DiagnosticReport))

      ShortR5: Why immunization occurred additional types
      Comments

      Element Immunization.reason is mapped to FHIR R4 element Immunization.reasonCode as SourceIsBroaderThanTarget. Element Immunization.reason is mapped to FHIR R4 element Immunization.reasonReference as SourceIsBroaderThanTarget. The mappings for Immunization.reason do not cover the following types: CodeableReference.

      Control0..*
      TypeExtension(R5: Why immunization occurred additional types) (Complex Extension)
      14. Immunization.manufacturer
      16. Immunization.manufacturer.extension
      Control0..*
      SlicingThis element introduces a set of slices on Immunization.manufacturer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 18. Immunization.manufacturer.extension:manufacturer
        Slice Namemanufacturer
        Definition

        R5: Immunization.manufacturer additional types (CodeableReference(http://hl7.org/fhir/StructureDefinition/Organization)) additional types from child elements (concept)

        ShortR5: manufacturer additional types
        Comments

        Element Immunization.manufacturer is mapped to FHIR R4 element Immunization.manufacturer as SourceIsBroaderThanTarget. The mappings for Immunization.manufacturer do not cover the following types: CodeableReference. The mappings for Immunization.manufacturer do not cover the following types based on type expansion: concept.

        Control0..1
        TypeExtension(R5: manufacturer additional types) (Extension Type: CodeableConcept)
        20. Immunization.performer
        22. Immunization.performer.actor
        24. Immunization.performer.actor.extension
        Control0..*
        SlicingThis element introduces a set of slices on Immunization.performer.actor.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 26. Immunization.performer.actor.extension:actor
          Slice Nameactor
          Definition

          R5: Immunization.performer.actor

          ShortR5: actor
          Comments

          Element Immunization.performer.actor is mapped to FHIR R4 element Immunization.performer.actor as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element Immunization.performer.actor with unmapped reference targets: Patient, RelatedPerson. When the individual practitioner who performed the action is known, it is best to send.

          Control0..1
          TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
          28. Immunization.programEligibility
          30. Immunization.programEligibility.extension
          Control2..*
          SlicingThis element introduces a set of slices on Immunization.programEligibility.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 32. Immunization.programEligibility.extension:program
            Slice Nameprogram
            Definition

            R5: Immunization.programEligibility.program (new:CodeableConcept)

            ShortR5: The program that eligibility is declared for (new)
            Comments

            Element Immunization.programEligibility.program has a context of Immunization.programEligibility based on following the parent source element upwards and mapping to Immunization. Element Immunization.programEligibility.program has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

            Control1..1
            TypeExtension(R5: The program that eligibility is declared for (new)) (Extension Type: CodeableConcept)
            34. Immunization.programEligibility.extension:programStatus
            Slice NameprogramStatus
            Definition

            R5: Immunization.programEligibility.programStatus (new:CodeableConcept)

            ShortR5: The patient's eligibility status for the program (new)
            Comments

            Element Immunization.programEligibility.programStatus has a context of Immunization.programEligibility based on following the parent source element upwards and mapping to Immunization. Element Immunization.programEligibility.programStatus has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

            Control1..1
            TypeExtension(R5: The patient's eligibility status for the program (new)) (Extension Type: CodeableConcept)

            Guidance on how to interpret the contents of this table can be foundhere

            0. Immunization
            Definition

            Describes the event of a patient being administered a vaccine or a record of an immunization as reported by a patient, a clinician or another party.

            ShortImmunization event information
            Control0..*
            Is Modifierfalse
            Summaryfalse
            Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
            dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
            dom-6: A resource should have narrative for robust management (text.`div`.exists())
            2. Immunization.id
            Definition

            The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

            ShortLogical id of this artifact
            Comments

            The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

            Control0..1
            Typeid
            Is Modifierfalse
            Summarytrue
            4. Immunization.meta
            Definition

            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.

            ShortMetadata about the resource
            Control0..1
            TypeMeta
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            6. Immunization.implicitRules
            Definition

            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.

            ShortA set of rules under which this content was created
            Comments

            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's narrative along with other profiles, value sets, etc.

            Control0..1
            Typeuri
            Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            8. Immunization.language
            Definition

            The base language in which the resource is written.

            ShortLanguage of the resource content
            Comments

            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).

            Control0..1
            BindingThe codes SHOULD be taken from CommonLanguages .
            (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

            A human language.

            Additional BindingsPurpose
            AllLanguagesMax Binding
            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            10. Immunization.text
            Definition

            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 "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

            ShortText summary of the resource, for human interpretation
            Comments

            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 "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

            Control0..1
            TypeNarrative
            Is Modifierfalse
            Summaryfalse
            Alternate Namesnarrative, html, xhtml, display
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            12. Immunization.contained
            Definition

            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.

            ShortContained, inline Resources
            Comments

            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.

            Control0..*
            TypeResource
            Is Modifierfalse
            Summaryfalse
            Alternate Namesinline resources, anonymous resources, contained resources
            14. Immunization.extension
            Definition

            An Extension

            ShortExtension
            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on Immunization.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 16. Immunization.extension:basedOn
              Slice NamebasedOn
              Definition

              R5: Immunization.basedOn (new:Reference(CarePlan,MedicationRequest,ServiceRequest,ImmunizationRecommendation))

              ShortR5: Authority that the immunization event is based on (new)
              Comments

              Element Immunization.basedOn has a context of Immunization based on following the parent source element upwards and mapping to Immunization. Element Immunization.basedOn has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). Allows tracing of an authorization for the Immunization.

              Control0..*
              This element is affected by the following invariants: ele-1
              TypeExtension(R5: Authority that the immunization event is based on (new)) (Extension Type: Reference(Cross-version Profile for R5.CarePlan for use in FHIR R4, CarePlan, Cross-version Profile for R5.MedicationRequest for use in FHIR R4, MedicationRequest, Cross-version Profile for R5.ServiceRequest for use in FHIR R4, ServiceRequest, Cross-version Profile for R5.ImmunizationRecommendation for use in FHIR R4, ImmunizationRecommendation))
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              18. Immunization.extension:administeredProduct
              Slice NameadministeredProduct
              Definition

              R5: Immunization.administeredProduct (new:CodeableReference(Medication))

              ShortR5: Product that was administered (new)
              Comments

              Element Immunization.administeredProduct has a context of Immunization based on following the parent source element upwards and mapping to Immunization. Element Immunization.administeredProduct has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(R5: Product that was administered (new)) (Complex Extension)
              Is Modifierfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              20. Immunization.extension:supportingInformation
              Slice NamesupportingInformation
              Definition

              R5: Immunization.supportingInformation (new:Reference(Resource))

              ShortR5: Additional information in support of the immunization (new)
              Comments

              Element Immunization.supportingInformation has a context of Immunization based on following the parent source element upwards and mapping to Immunization. Element Immunization.supportingInformation has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

              Control0..*
              This element is affected by the following invariants: ele-1
              TypeExtension(R5: Additional information in support of the immunization (new)) (Extension Type: Reference(Cross-version Profile for R5.Resource for use in FHIR R4, Resource))
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              22. Immunization.extension:informationSource
              Slice NameinformationSource
              Definition

              R5: Immunization.informationSource (new:CodeableReference(Patient,Practitioner,PractitionerRole,RelatedPerson,Organization))

              ShortR5: Indicates the source of a reported record (new)
              Comments

              Element Immunization.informationSource has a context of Immunization based on following the parent source element upwards and mapping to Immunization. Element Immunization.informationSource has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). Typically will not be populated if primarySource = True, not required even if primarySource = False.

              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(R5: Indicates the source of a reported record (new)) (Complex Extension)
              Is Modifierfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              24. Immunization.extension:reason
              Slice Namereason
              Definition

              R5: Immunization.reason additional types (CodeableReference(http://hl7.org/fhir/StructureDefinition/Condition), CodeableReference(http://hl7.org/fhir/StructureDefinition/Observation), CodeableReference(http://hl7.org/fhir/StructureDefinition/DiagnosticReport))

              ShortR5: Why immunization occurred additional types
              Comments

              Element Immunization.reason is mapped to FHIR R4 element Immunization.reasonCode as SourceIsBroaderThanTarget. Element Immunization.reason is mapped to FHIR R4 element Immunization.reasonReference as SourceIsBroaderThanTarget. The mappings for Immunization.reason do not cover the following types: CodeableReference.

              Control0..*
              This element is affected by the following invariants: ele-1
              TypeExtension(R5: Why immunization occurred additional types) (Complex Extension)
              Is Modifierfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              26. Immunization.modifierExtension
              Definition

              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'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).

              ShortExtensions that cannot be ignored
              Comments

              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.

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
              Summaryfalse
              Requirements

              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.

              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              28. Immunization.identifier
              Definition

              A unique identifier assigned to this immunization record.

              ShortBusiness identifier
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..*
              TypeIdentifier
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              30. Immunization.status
              Definition

              Indicates the current status of the immunization event.

              Shortcompleted | entered-in-error | not-done
              Comments

              Will generally be set to show that the immunization has been completed or not done. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

              Control1..1
              BindingThe codes SHALL be taken from ImmunizationStatusCodes
              (required to http://hl7.org/fhir/ValueSet/immunization-status|4.0.1)

              A set of codes indicating the current status of an Immunization.

              Typecode
              Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains statuses entered-in-error and not-done which means that the resource should not be treated as valid
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              32. Immunization.statusReason
              Definition

              Indicates the reason the immunization event was not performed.

              ShortReason not done
              Comments

              This is generally only used for the status of "not-done". The reason for performing the immunization event is captured in reasonCode, not here.

              Control0..1
              BindingFor example codes, see ImmunizationStatusReasonCodes
              (example to http://hl7.org/fhir/ValueSet/immunization-status-reason|4.0.1)

              The reason why a vaccine was not administered.

              TypeCodeableConcept
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              34. Immunization.vaccineCode
              Definition

              Vaccine that was administered or was to be administered.

              ShortVaccine product administered
              Control1..1
              BindingFor example codes, see VaccineAdministeredValueSet
              (example to http://hl7.org/fhir/ValueSet/vaccine-code|4.0.1)

              The code for vaccine product administered.

              TypeCodeableConcept
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              36. Immunization.patient
              Definition

              The patient who either received or did not receive the immunization.

              ShortWho was immunized
              Control1..1
              TypeReference(Patient)
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              38. Immunization.encounter
              Definition

              The visit or admission or other contact between patient and health care provider the immunization was performed as part of.

              ShortEncounter immunization was part of
              Control0..1
              TypeReference(Encounter)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              40. Immunization.occurrence[x]
              Definition

              Date vaccine administered or was to be administered.

              ShortVaccine administration date
              Comments

              When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given. An exact date is always preferable, but the use of the String data type is acceptable when an exact date is not known. A small number of vaccines (e.g. live oral typhoid vaccine) are given as a series of patient self-administered dose over a span of time. In cases like this, often, only the first dose (typically a provider supervised dose) is recorded with the occurrence indicating the date/time of the first dose.

              Control1..1
              TypeChoice of: dateTime, string
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              42. Immunization.recorded
              Definition

              The date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event.

              ShortWhen the immunization was first captured in the subject's record
              Control0..1
              TypedateTime
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              44. Immunization.primarySource
              Definition

              An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded.

              ShortIndicates context the data was recorded in
              Comments

              Reflects the “reliability” of the content.

              Control0..1
              Typeboolean
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              46. Immunization.reportOrigin
              Definition

              The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.

              ShortIndicates the source of a secondarily reported record
              Comments

              Should not be populated if primarySource = True, not required even if primarySource = False.

              Control0..1
              BindingFor example codes, see ImmunizationOriginCodes
              (example to http://hl7.org/fhir/ValueSet/immunization-origin|4.0.1)

              The source of the data for a record which is not from a primary source.

              TypeCodeableConcept
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              48. Immunization.location
              Definition

              The service delivery location where the vaccine administration occurred.

              ShortWhere immunization occurred
              Control0..1
              TypeReference(Location)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              50. Immunization.manufacturer
              Definition

              Name of vaccine manufacturer.

              ShortVaccine manufacturer
              Control0..1
              TypeReference(Organization)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              52. Immunization.manufacturer.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              54. Immunization.manufacturer.extension
              Definition

              An Extension

              ShortExtension
              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on Immunization.manufacturer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 56. Immunization.manufacturer.extension:manufacturer
                Slice Namemanufacturer
                Definition

                R5: Immunization.manufacturer additional types (CodeableReference(http://hl7.org/fhir/StructureDefinition/Organization)) additional types from child elements (concept)

                ShortR5: manufacturer additional types
                Comments

                Element Immunization.manufacturer is mapped to FHIR R4 element Immunization.manufacturer as SourceIsBroaderThanTarget. The mappings for Immunization.manufacturer do not cover the following types: CodeableReference. The mappings for Immunization.manufacturer do not cover the following types based on type expansion: concept.

                Control0..1
                TypeExtension(R5: manufacturer additional types) (Extension Type: CodeableConcept)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                58. Immunization.manufacturer.reference
                Definition

                A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                ShortLiteral reference, Relative, internal or absolute URL
                Comments

                Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                Control0..1
                This element is affected by the following invariants: ref-1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                60. Immunization.manufacturer.type
                Definition

                The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                ShortType the reference refers to (e.g. "Patient")
                Comments

                This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                Control0..1
                BindingUnless not suitable, these codes SHALL be taken from ResourceType .
                (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                Aa resource (or, for logical models, the URI of the logical model).

                Typeuri
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                62. Immunization.manufacturer.identifier
                Definition

                An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                ShortLogical reference, when literal reference is not known
                Comments

                When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..1
                TypeIdentifier
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                64. Immunization.manufacturer.display
                Definition

                Plain text narrative that identifies the resource in addition to the resource reference.

                ShortText alternative for the resource
                Comments

                This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                66. Immunization.lotNumber
                Definition

                Lot number of the vaccine product.

                ShortVaccine lot number
                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                68. Immunization.expirationDate
                Definition

                Date vaccine batch expires.

                ShortVaccine expiration date
                Control0..1
                Typedate
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                70. Immunization.site
                Definition

                Body site where vaccine was administered.

                ShortBody site vaccine was administered
                Control0..1
                BindingFor example codes, see CodesForImmunizationSiteOfAdministration
                (example to http://hl7.org/fhir/ValueSet/immunization-site|4.0.1)

                The site at which the vaccine was administered.

                TypeCodeableConcept
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                72. Immunization.route
                Definition

                The path by which the vaccine product is taken into the body.

                ShortHow vaccine entered body
                Control0..1
                BindingFor example codes, see ImmunizationRouteCodes
                (example to http://hl7.org/fhir/ValueSet/immunization-route|4.0.1)

                The route by which the vaccine was administered.

                TypeCodeableConcept
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                74. Immunization.doseQuantity
                Definition

                The quantity of vaccine product that was administered.

                ShortAmount of vaccine administered
                Control0..1
                TypeQuantity(SimpleQuantity)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                76. Immunization.performer
                Definition

                Indicates who performed the immunization event.

                ShortWho performed event
                Control0..*
                TypeBackboneElement
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                78. Immunization.performer.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                80. Immunization.performer.extension
                Definition

                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.

                ShortAdditional content defined by implementations
                Comments

                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.

                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                82. Immunization.performer.modifierExtension
                Definition

                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'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).

                ShortExtensions that cannot be ignored even if unrecognized
                Comments

                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.

                Control0..*
                TypeExtension
                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                Summarytrue
                Requirements

                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.

                Alternate Namesextensions, user content, modifiers
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                84. Immunization.performer.function
                Definition

                Describes the type of performance (e.g. ordering provider, administering provider, etc.).

                ShortWhat type of performance was done
                Control0..1
                BindingUnless not suitable, these codes SHALL be taken from ImmunizationFunctionCodes
                (extensible to http://hl7.org/fhir/ValueSet/immunization-function|4.0.1)

                The role a practitioner or organization plays in the immunization event.

                TypeCodeableConcept
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                86. Immunization.performer.actor
                Definition

                The practitioner or organization who performed the action.

                ShortIndividual or organization who was performing
                Comments

                When the individual practitioner who performed the action is known, it is best to send.

                Control1..1
                TypeReference(Practitioner, PractitionerRole, Organization)
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                88. Immunization.performer.actor.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                90. Immunization.performer.actor.extension
                Definition

                An Extension

                ShortExtension
                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on Immunization.performer.actor.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 92. Immunization.performer.actor.extension:actor
                  Slice Nameactor
                  Definition

                  R5: Immunization.performer.actor

                  ShortR5: actor
                  Comments

                  Element Immunization.performer.actor is mapped to FHIR R4 element Immunization.performer.actor as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element Immunization.performer.actor with unmapped reference targets: Patient, RelatedPerson. When the individual practitioner who performed the action is known, it is best to send.

                  Control0..1
                  TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  94. Immunization.performer.actor.reference
                  Definition

                  A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                  ShortLiteral reference, Relative, internal or absolute URL
                  Comments

                  Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                  Control0..1
                  This element is affected by the following invariants: ref-1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  96. Immunization.performer.actor.type
                  Definition

                  The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                  The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                  ShortType the reference refers to (e.g. "Patient")
                  Comments

                  This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                  Control0..1
                  BindingUnless not suitable, these codes SHALL be taken from ResourceType .
                  (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                  Aa resource (or, for logical models, the URI of the logical model).

                  Typeuri
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  98. Immunization.performer.actor.identifier
                  Definition

                  An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                  ShortLogical reference, when literal reference is not known
                  Comments

                  When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                  When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                  Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control0..1
                  TypeIdentifier
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  100. Immunization.performer.actor.display
                  Definition

                  Plain text narrative that identifies the resource in addition to the resource reference.

                  ShortText alternative for the resource
                  Comments

                  This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  102. Immunization.note
                  Definition

                  Extra information about the immunization that is not conveyed by the other attributes.

                  ShortAdditional immunization notes
                  Control0..*
                  TypeAnnotation
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  104. Immunization.reasonCode
                  Definition

                  Reasons why the vaccine was administered.

                  ShortWhy immunization occurred
                  Control0..*
                  BindingFor example codes, see ImmunizationReasonCodes
                  (example to http://hl7.org/fhir/ValueSet/immunization-reason|4.0.1)

                  The reason why a vaccine was administered.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  106. Immunization.reasonReference
                  Definition

                  Condition, Observation or DiagnosticReport that supports why the immunization was administered.

                  ShortWhy immunization occurred
                  Control0..*
                  TypeReference(Condition, Observation, DiagnosticReport)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  108. Immunization.isSubpotent
                  Definition

                  Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent.

                  ShortDose potency
                  Comments

                  Typically, the recognition of the dose being sub-potent is retrospective, after the administration (ex. notification of a manufacturer recall after administration). However, in the case of a partial administration (the patient moves unexpectedly and only some of the dose is actually administered), subpotency may be recognized immediately, but it is still important to record the event.

                  Control0..1
                  Typeboolean
                  Is Modifiertrue because This element is labeled as a modifier because an immunization event with a subpotent vaccine doesn't protect the patient the same way as a potent dose.
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Meaning if MissingBy default, a dose should be considered to be potent.
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  110. Immunization.subpotentReason
                  Definition

                  Reason why a dose is considered to be subpotent.

                  ShortReason for being subpotent
                  Control0..*
                  BindingFor example codes, see ImmunizationSubpotentReason
                  (example to http://hl7.org/fhir/ValueSet/immunization-subpotent-reason|4.0.1)

                  The reason why a dose is considered to be subpotent.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  112. Immunization.education
                  Definition

                  Educational material presented to the patient (or guardian) at the time of vaccine administration.

                  ShortEducational material presented to patient
                  Control0..*
                  TypeBackboneElement
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  imm-1: One of documentType or reference SHALL be present (documentType.exists() or reference.exists())
                  114. Immunization.education.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  116. Immunization.education.extension
                  Definition

                  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.

                  ShortAdditional content defined by implementations
                  Comments

                  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.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  118. Immunization.education.modifierExtension
                  Definition

                  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'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).

                  ShortExtensions that cannot be ignored even if unrecognized
                  Comments

                  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.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                  Summarytrue
                  Requirements

                  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.

                  Alternate Namesextensions, user content, modifiers
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  120. Immunization.education.documentType
                  Definition

                  Identifier of the material presented to the patient.

                  ShortEducational material document identifier
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  122. Immunization.education.reference
                  Definition

                  Reference pointer to the educational material given to the patient if the information was on line.

                  ShortEducational material reference pointer
                  Control0..1
                  Typeuri
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  124. Immunization.education.publicationDate
                  Definition

                  Date the educational material was published.

                  ShortEducational material publication date
                  Control0..1
                  TypedateTime
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  126. Immunization.education.presentationDate
                  Definition

                  Date the educational material was given to the patient.

                  ShortEducational material presentation date
                  Control0..1
                  TypedateTime
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  128. Immunization.programEligibility
                  Definition

                  Indicates a patient's eligibility for a funding program.

                  ShortPatient eligibility for a vaccination program
                  Control0..*
                  BindingFor example codes, see ImmunizationProgramEligibility
                  (example to http://hl7.org/fhir/ValueSet/immunization-program-eligibility|4.0.1)

                  The patient's eligibility for a vaccation program.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  130. Immunization.programEligibility.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  132. Immunization.programEligibility.extension
                  Definition

                  An Extension

                  ShortExtension
                  Control2..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on Immunization.programEligibility.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 134. Immunization.programEligibility.extension:program
                    Slice Nameprogram
                    Definition

                    R5: Immunization.programEligibility.program (new:CodeableConcept)

                    ShortR5: The program that eligibility is declared for (new)
                    Comments

                    Element Immunization.programEligibility.program has a context of Immunization.programEligibility based on following the parent source element upwards and mapping to Immunization. Element Immunization.programEligibility.program has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

                    Control1..1
                    TypeExtension(R5: The program that eligibility is declared for (new)) (Extension Type: CodeableConcept)
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    136. Immunization.programEligibility.extension:programStatus
                    Slice NameprogramStatus
                    Definition

                    R5: Immunization.programEligibility.programStatus (new:CodeableConcept)

                    ShortR5: The patient's eligibility status for the program (new)
                    Comments

                    Element Immunization.programEligibility.programStatus has a context of Immunization.programEligibility based on following the parent source element upwards and mapping to Immunization. Element Immunization.programEligibility.programStatus has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

                    Control1..1
                    TypeExtension(R5: The patient's eligibility status for the program (new)) (Extension Type: CodeableConcept)
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    138. Immunization.programEligibility.coding
                    Definition

                    A reference to a code defined by a terminology system.

                    ShortCode defined by a terminology system
                    Comments

                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                    Control0..*
                    TypeCoding
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    Allows for alternative encodings within a code system, and translations to other code systems.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    140. Immunization.programEligibility.text
                    Definition

                    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                    ShortPlain text representation of the concept
                    Comments

                    Very often the text is the same as a displayName of one of the codings.

                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    142. Immunization.fundingSource
                    Definition

                    Indicates the source of the vaccine actually administered. This may be different than the patient eligibility (e.g. the patient may be eligible for a publically purchased vaccine but due to inventory issues, vaccine purchased with private funds was actually administered).

                    ShortFunding source for the vaccine
                    Control0..1
                    BindingFor example codes, see ImmunizationFundingSource
                    (example to http://hl7.org/fhir/ValueSet/immunization-funding-source|4.0.1)

                    The source of funding used to purchase the vaccine administered.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    144. Immunization.reaction
                    Definition

                    Categorical data indicating that an adverse event is associated in time to an immunization.

                    ShortDetails of a reaction that follows immunization
                    Comments

                    A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case, it should be recorded as a new AllergyIntolerance resource instance as most systems will not query against past Immunization.reaction elements.

                    Control0..*
                    TypeBackboneElement
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    146. Immunization.reaction.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    148. Immunization.reaction.extension
                    Definition

                    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.

                    ShortAdditional content defined by implementations
                    Comments

                    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.

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    150. Immunization.reaction.modifierExtension
                    Definition

                    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'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).

                    ShortExtensions that cannot be ignored even if unrecognized
                    Comments

                    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.

                    Control0..*
                    TypeExtension
                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                    Summarytrue
                    Requirements

                    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.

                    Alternate Namesextensions, user content, modifiers
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    152. Immunization.reaction.date
                    Definition

                    Date of reaction to the immunization.

                    ShortWhen reaction started
                    Control0..1
                    TypedateTime
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    154. Immunization.reaction.detail
                    Definition

                    Details of the reaction.

                    ShortAdditional information on reaction
                    Control0..1
                    TypeReference(Observation)
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    156. Immunization.reaction.reported
                    Definition

                    Self-reported indicator.

                    ShortIndicates self-reported reaction
                    Control0..1
                    Typeboolean
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    158. Immunization.protocolApplied
                    Definition

                    The protocol (set of recommendations) being followed by the provider who administered the dose.

                    ShortProtocol followed by the provider
                    Control0..*
                    TypeBackboneElement
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    160. Immunization.protocolApplied.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    162. Immunization.protocolApplied.extension
                    Definition

                    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.

                    ShortAdditional content defined by implementations
                    Comments

                    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.

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    164. Immunization.protocolApplied.modifierExtension
                    Definition

                    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'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).

                    ShortExtensions that cannot be ignored even if unrecognized
                    Comments

                    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.

                    Control0..*
                    TypeExtension
                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                    Summarytrue
                    Requirements

                    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.

                    Alternate Namesextensions, user content, modifiers
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    166. Immunization.protocolApplied.series
                    Definition

                    One possible path to achieve presumed immunity against a disease - within the context of an authority.

                    ShortName of vaccine series
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    168. Immunization.protocolApplied.authority
                    Definition

                    Indicates the authority who published the protocol (e.g. ACIP) that is being followed.

                    ShortWho is responsible for publishing the recommendations
                    Control0..1
                    TypeReference(Organization)
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    170. Immunization.protocolApplied.targetDisease
                    Definition

                    The vaccine preventable disease the dose is being administered against.

                    ShortVaccine preventatable disease being targetted
                    Control0..*
                    BindingFor example codes, see ImmunizationTargetDiseaseCodes
                    (example to http://hl7.org/fhir/ValueSet/immunization-target-disease|4.0.1)

                    The vaccine preventable disease the dose is being administered for.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    172. Immunization.protocolApplied.doseNumber[x]
                    Definition

                    Nominal position in a series.

                    ShortDose number within series
                    Comments

                    The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).

                    Control1..1
                    TypeChoice of: positiveInt, string
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    174. Immunization.protocolApplied.seriesDoses[x]
                    Definition

                    The recommended number of doses to achieve immunity.

                    ShortRecommended number of doses for immunity
                    Comments

                    The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).

                    Control0..1
                    TypeChoice of: positiveInt, string
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))