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4.19 Resource ImmunizationRecommendation - Content

This resource maintained by the Public Health and Emergency Response Work Group

A patient's point-of-time immunization status and recommendation with optional supporting justification.

4.19.1 Scope and Usage

The ImmunizationRecommendation resource is intended to cover communication of a specified patient's immunization recommendation and status across all healthcare disciplines in all care settings and all regions.

Additionally, the ImmunizationRecommendation resource is expected to cover key concepts related to the querying of a patient's immunization recommendation and status. This resource - through consultation with the PHER work group - is believed to meet key use cases and information requirements as defined in the existing HL7 v3 POIZ domain and Immunization Domain Analysis Model.

4.19.2 Boundaries and Relationships

This resource references the following resources:

  • Allergy/Intolerance
  • Patient
  • Organization
  • Immunization
  • Observation

One of the considerations for this resource is if it is better for this resource to be a profile of the CarePlan resource or if it is more appropriate for this to be a separate resource due to the number of immunization profile-specific data elements. Please consider this when submitting your ballot comments.

This resource is referenced by [Procedure]

4.19.3 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. ImmunizationRecommendation DomainResourceGuidance or advice relating to an immunization
... identifier 0..*IdentifierBusiness identifier
... patient 1..1PatientWho this profile is for
... recommendation 1..*ElementVaccine administration recommendations
.... date 1..1dateTimeDate recommendation created
.... vaccineType 1..1CodeableConceptVaccine recommendation applies to
VaccineType (Example)
.... doseNumber 0..1positiveIntRecommended dose number
.... forecastStatus 1..1CodeableConceptVaccine administration status
ImmunizationRecommendationStatus (Example)
.... dateCriterion 0..*ElementDates governing proposed immunization
..... code 1..1CodeableConceptType of date
ImmunizationRecommendationDateCriterion (Example)
..... value 1..1dateTimeRecommended date
.... protocol 0..1ElementProtocol used by recommendation
..... doseSequence 0..1integerNumber of dose within sequence
..... description 0..1stringProtocol details
..... authority 0..1OrganizationWho is responsible for protocol
..... series 0..1stringName of vaccination series
.... supportingImmunization 0..*ImmunizationPast immunizations supporting recommendation
.... supportingPatientInformation 0..*Observation | AllergyIntolerancePatient observations supporting recommendation

UML Diagram

ImmunizationRecommendation (DomainResource)A unique identifier assigned to this particular recommendation recordidentifier : Identifier 0..*The patient for whom the recommendations are forpatient : Reference(Patient) 1..1RecommendationThe date the immunization recommendation was createddate : dateTime 1..1Vaccine that pertains to the recommendationvaccineType : CodeableConcept 1..1 « (The type of vaccine administeredVaccineType) »This indicates the next recommended dose number (e.g. dose 2 is the next recommended dose)doseNumber : positiveInt 0..1Vaccine administration statusforecastStatus : CodeableConcept 1..1 « (The patient's status with respect to a vaccination protocolImmunizationRecommendationStatus) »Immunization event history that supports the status and recommendationsupportingImmunization : Reference(Immunization) 0..*Patient Information that supports the status and recommendation. This includes patient observations, adverse reactions and allergy/intolerance informationsupportingPatientInformation : Reference(Observation|AllergyIntolerance) 0..*DateCriterionDate classification of recommendation - e.g. earliest date to give, latest date to give, etccode : CodeableConcept 1..1 « (Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.)ImmunizationRecommendationDateCriterion) »Date recommendationvalue : dateTime 1..1ProtocolIndicates the nominal position in a series of the next dose. This is the recommended dose number as per a specified protocoldoseSequence : integer 0..1Contains the description about the protocol under which the vaccine was administereddescription : string 0..1Indicates the authority who published the protocol? E.g. ACIPauthority : Reference(Organization) 0..1One possible path to achieve presumed immunity against a disease - within the context of an authorityseries : string 0..1Vaccine date recommendations - e.g. earliest date to administer, latest date to administer, etcdateCriterion0..*Contains information about the protocol under which the vaccine was administeredprotocol0..1Vaccine administration recommendationsrecommendation1..*

XML Template

<ImmunizationRecommendation xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business identifier --></identifier>
 <patient><!-- 1..1 Reference(Patient) Who this profile is for --></patient>
 <recommendation>  <!-- 1..* Vaccine administration recommendations -->
  <date value="[dateTime]"/><!-- 1..1 Date recommendation created -->
  <vaccineType><!-- 1..1 CodeableConcept Vaccine recommendation applies to --></vaccineType>
  <doseNumber value="[positiveInt]"/><!-- 0..1 Recommended dose number -->
  <forecastStatus><!-- 1..1 CodeableConcept Vaccine administration status --></forecastStatus>
  <dateCriterion>  <!-- 0..* Dates governing proposed immunization -->
   <code><!-- 1..1 CodeableConcept Type of date --></code>
   <value value="[dateTime]"/><!-- 1..1 Recommended date -->
  </dateCriterion>
  <protocol>  <!-- 0..1 Protocol used by recommendation -->
   <doseSequence value="[integer]"/><!-- 0..1 Number of dose within sequence -->
   <description value="[string]"/><!-- 0..1 Protocol details -->
   <authority><!-- 0..1 Reference(Organization) Who is responsible for protocol --></authority>
   <series value="[string]"/><!-- 0..1 Name of vaccination series -->
  </protocol>
  <supportingImmunization><!-- 0..* Reference(Immunization) 
      Past immunizations supporting recommendation --></supportingImmunization>
  <supportingPatientInformation><!-- 0..* Reference(Observation|
    AllergyIntolerance) Patient observations supporting recommendation --></supportingPatientInformation>
 </recommendation>
</ImmunizationRecommendation>

JSON Template

{doco
  "resourceType" : "ImmunizationRecommendation",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business identifier
  "patient" : { Reference(Patient) }, // R!  Who this profile is for
  "recommendation" : [{ // R!  Vaccine administration recommendations
    "date" : "<dateTime>", // R!  Date recommendation created
    "vaccineType" : { CodeableConcept }, // R!  Vaccine recommendation applies to
    "doseNumber" : "<positiveInt>", // Recommended dose number
    "forecastStatus" : { CodeableConcept }, // R!  Vaccine administration status
    "dateCriterion" : [{ // Dates governing proposed immunization
      "code" : { CodeableConcept }, // R!  Type of date
      "value" : "<dateTime>" // R!  Recommended date
    }],
    "protocol" : { // Protocol used by recommendation
      "doseSequence" : <integer>, // Number of dose within sequence
      "description" : "<string>", // Protocol details
      "authority" : { Reference(Organization) }, // Who is responsible for protocol
      "series" : "<string>" // Name of vaccination series
    },
    "supportingImmunization" : [{ Reference(Immunization) }], // 
      Past immunizations supporting recommendation
    "supportingPatientInformation" : [{ Reference(Observation|
    AllergyIntolerance) }] // Patient observations supporting recommendation
  }]
}

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. ImmunizationRecommendation DomainResourceGuidance or advice relating to an immunization
... identifier 0..*IdentifierBusiness identifier
... patient 1..1PatientWho this profile is for
... recommendation 1..*ElementVaccine administration recommendations
.... date 1..1dateTimeDate recommendation created
.... vaccineType 1..1CodeableConceptVaccine recommendation applies to
VaccineType (Example)
.... doseNumber 0..1positiveIntRecommended dose number
.... forecastStatus 1..1CodeableConceptVaccine administration status
ImmunizationRecommendationStatus (Example)
.... dateCriterion 0..*ElementDates governing proposed immunization
..... code 1..1CodeableConceptType of date
ImmunizationRecommendationDateCriterion (Example)
..... value 1..1dateTimeRecommended date
.... protocol 0..1ElementProtocol used by recommendation
..... doseSequence 0..1integerNumber of dose within sequence
..... description 0..1stringProtocol details
..... authority 0..1OrganizationWho is responsible for protocol
..... series 0..1stringName of vaccination series
.... supportingImmunization 0..*ImmunizationPast immunizations supporting recommendation
.... supportingPatientInformation 0..*Observation | AllergyIntolerancePatient observations supporting recommendation

UML Diagram

ImmunizationRecommendation (DomainResource)A unique identifier assigned to this particular recommendation recordidentifier : Identifier 0..*The patient for whom the recommendations are forpatient : Reference(Patient) 1..1RecommendationThe date the immunization recommendation was createddate : dateTime 1..1Vaccine that pertains to the recommendationvaccineType : CodeableConcept 1..1 « (The type of vaccine administeredVaccineType) »This indicates the next recommended dose number (e.g. dose 2 is the next recommended dose)doseNumber : positiveInt 0..1Vaccine administration statusforecastStatus : CodeableConcept 1..1 « (The patient's status with respect to a vaccination protocolImmunizationRecommendationStatus) »Immunization event history that supports the status and recommendationsupportingImmunization : Reference(Immunization) 0..*Patient Information that supports the status and recommendation. This includes patient observations, adverse reactions and allergy/intolerance informationsupportingPatientInformation : Reference(Observation|AllergyIntolerance) 0..*DateCriterionDate classification of recommendation - e.g. earliest date to give, latest date to give, etccode : CodeableConcept 1..1 « (Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.)ImmunizationRecommendationDateCriterion) »Date recommendationvalue : dateTime 1..1ProtocolIndicates the nominal position in a series of the next dose. This is the recommended dose number as per a specified protocoldoseSequence : integer 0..1Contains the description about the protocol under which the vaccine was administereddescription : string 0..1Indicates the authority who published the protocol? E.g. ACIPauthority : Reference(Organization) 0..1One possible path to achieve presumed immunity against a disease - within the context of an authorityseries : string 0..1Vaccine date recommendations - e.g. earliest date to administer, latest date to administer, etcdateCriterion0..*Contains information about the protocol under which the vaccine was administeredprotocol0..1Vaccine administration recommendationsrecommendation1..*

XML Template

<ImmunizationRecommendation xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business identifier --></identifier>
 <patient><!-- 1..1 Reference(Patient) Who this profile is for --></patient>
 <recommendation>  <!-- 1..* Vaccine administration recommendations -->
  <date value="[dateTime]"/><!-- 1..1 Date recommendation created -->
  <vaccineType><!-- 1..1 CodeableConcept Vaccine recommendation applies to --></vaccineType>
  <doseNumber value="[positiveInt]"/><!-- 0..1 Recommended dose number -->
  <forecastStatus><!-- 1..1 CodeableConcept Vaccine administration status --></forecastStatus>
  <dateCriterion>  <!-- 0..* Dates governing proposed immunization -->
   <code><!-- 1..1 CodeableConcept Type of date --></code>
   <value value="[dateTime]"/><!-- 1..1 Recommended date -->
  </dateCriterion>
  <protocol>  <!-- 0..1 Protocol used by recommendation -->
   <doseSequence value="[integer]"/><!-- 0..1 Number of dose within sequence -->
   <description value="[string]"/><!-- 0..1 Protocol details -->
   <authority><!-- 0..1 Reference(Organization) Who is responsible for protocol --></authority>
   <series value="[string]"/><!-- 0..1 Name of vaccination series -->
  </protocol>
  <supportingImmunization><!-- 0..* Reference(Immunization) 
      Past immunizations supporting recommendation --></supportingImmunization>
  <supportingPatientInformation><!-- 0..* Reference(Observation|
    AllergyIntolerance) Patient observations supporting recommendation --></supportingPatientInformation>
 </recommendation>
</ImmunizationRecommendation>

JSON Template

{doco
  "resourceType" : "ImmunizationRecommendation",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business identifier
  "patient" : { Reference(Patient) }, // R!  Who this profile is for
  "recommendation" : [{ // R!  Vaccine administration recommendations
    "date" : "<dateTime>", // R!  Date recommendation created
    "vaccineType" : { CodeableConcept }, // R!  Vaccine recommendation applies to
    "doseNumber" : "<positiveInt>", // Recommended dose number
    "forecastStatus" : { CodeableConcept }, // R!  Vaccine administration status
    "dateCriterion" : [{ // Dates governing proposed immunization
      "code" : { CodeableConcept }, // R!  Type of date
      "value" : "<dateTime>" // R!  Recommended date
    }],
    "protocol" : { // Protocol used by recommendation
      "doseSequence" : <integer>, // Number of dose within sequence
      "description" : "<string>", // Protocol details
      "authority" : { Reference(Organization) }, // Who is responsible for protocol
      "series" : "<string>" // Name of vaccination series
    },
    "supportingImmunization" : [{ Reference(Immunization) }], // 
      Past immunizations supporting recommendation
    "supportingPatientInformation" : [{ Reference(Observation|
    AllergyIntolerance) }] // Patient observations supporting recommendation
  }]
}

 

Alternate definitions: Schema/Schematron, Resource Profile (XML, JSON)

4.19.3.1 Terminology Bindings

PathDefinitionTypeReference
ImmunizationRecommendation.recommendation.vaccineType The type of vaccine administeredExamplehttp://hl7.org/fhir/vs/vaccinetype
ImmunizationRecommendation.recommendation.forecastStatus The patient's status with respect to a vaccination protocolExamplehttp://hl7.org/fhir/vs/immunization-recommendation-status
ImmunizationRecommendation.recommendation.dateCriterion.code Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.)Examplehttp://hl7.org/fhir/vs/immunization-recommendation-date-criterion

4.19.4 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

NameTypeDescriptionPaths
datedateDate recommendation createdImmunizationRecommendation.recommendation.date
dose-numbernumberRecommended dose numberImmunizationRecommendation.recommendation.doseNumber
dose-sequencetokenNumber of dose within sequenceImmunizationRecommendation.recommendation.protocol.doseSequence
identifiertokenBusiness identifierImmunizationRecommendation.identifier
informationreferencePatient observations supporting recommendationImmunizationRecommendation.recommendation.supportingPatientInformation
(AllergyIntolerance, Observation)
patientreferenceWho this profile is forImmunizationRecommendation.patient
(Patient)
statustokenVaccine administration statusImmunizationRecommendation.recommendation.forecastStatus
subjectreferenceWho this profile is forImmunizationRecommendation.patient
(Patient)
supportreferencePast immunizations supporting recommendationImmunizationRecommendation.recommendation.supportingImmunization
(Immunization)
vaccine-typetokenVaccine recommendation applies toImmunizationRecommendation.recommendation.vaccineType