DSTU2

This page is part of the FHIR Specification (v1.0.2: DSTU 2). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

D.9.1.4 StructureDefinition: DAF-Immunization - Detailed Descriptions

Definitions for the daf-immunization Profile.

Immunization(DAF-Immunization)
Definition

Describes the event of a patient being administered a vaccination or a record of a vaccination as reported by a patient, a clinician or another party and may include vaccine reaction information and what vaccination protocol was followed.

Control0..*
TypeImmunization
InvariantsDefined on this element
imm-1: If immunization was not administred (wasNotGiven=true) then there SHALL be no reaction nor explanation.reason present (xpath: not(f:wasNotGiven/@value=true() and (count(f:reaction) > 0 or exists(f:explanation/f:reason))))
imm-2: If immunization was administered (wasNotGiven=false) then explanation.reasonNotGiven SHALL be absent. (xpath: not(f:wasNotGiven/@value=false() and exists(f:explanation/f:reasonNotGiven)))
Immunization.id
Definition

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

Control0..1
Typeid
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. Bundles always have an id, though it is usually a generated UUID.

Immunization.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

Control0..1
TypeMeta
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.

Control0..1
Typeuri
Is Modifiertrue
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 as much as possible.

Immunization.language
Definition

The base language in which the resource is written.

Control0..1
BindingA human language.
The codes SHALL be taken from http://tools.ietf.org/html/bcp47
Typecode
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).

Immunization.text
Definition

A human-readable narrative that contains a summary of the resource, and may 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.

Control0..1 This element is affected by the following invariants: dom-1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative.

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.

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained 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.

Immunization.extension
Definition

May be used to represent additional information that is not part of the basic definition of the resource. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

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. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content
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.

Immunization.identifier
Definition

A unique identifier assigned to this immunization record.

Control0..*
TypeIdentifier
Must Supporttrue
Immunization.status
Definition

Indicates the current status of the vaccination event.

Control1..1
BindingA set of codes indicating the current status of an Immunization
The codes SHALL be taken from MedicationAdministrationStatus
Typecode
Is Modifiertrue
Must Supporttrue
Comments

Will generally be set to show that the immunization has been completed.

Immunization.date
Definition

Date vaccine administered or was to be administered.

Control1..1
TypedateTime
Must Supporttrue
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.

Immunization.vaccineCode
Definition

Vaccine Product Type (bind to CVX).

Control1..1
BindingThis identifies the CVX code system
The codes SHOULD be taken from Vaccine Administered Value Set
TypeCodeableConcept
Must Supporttrue
Immunization.patient
Definition

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

Control1..1
TypeReference(U.S. Data Access Framework (DAF) Patient Profile)
Must Supporttrue
Alternate NamesPatient
Immunization.wasNotGiven
Definition

Indicates if the vaccination was or was not given.

Control1..1
Typeboolean
Is Modifiertrue
Immunization.reported
Definition

True if this administration was reported rather than directly administered.

Control1..1
Typeboolean
Must Supporttrue
Comments

May need source of reported info (e.g. parent), but leave out for now.

Immunization.performer
Definition

Clinician who administered the vaccine.

Control0..1
TypeChoice of: Reference(U.S. Data Access Framework (DAF) Practitioner Profile), Reference(U.S. DAF Organization Profile)
Must Supporttrue
Immunization.requester
Definition

Clinician who ordered the vaccination.

Control0..1
TypeChoice of: Reference(U.S. Data Access Framework (DAF) Practitioner Profile), Reference(U.S. DAF Organization Profile)
Must Supporttrue
Comments

Other participants - delegate to Provenance resource.

Immunization.encounter
Definition

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

Control0..1
TypeReference(U.S. Data Access Framework (DAF) Encounter profile)
Immunization.manufacturer
Definition

Vaccine Manufacturer.

Control0..1
TypeReference(U.S. DAF Organization Profile)
Must Supporttrue
Comments

Not in QUICK as resource.

Immunization.location
Definition

The service delivery location where the vaccine administration occurred.

Control0..1
TypeReference(Location)
Immunization.lotNumber
Definition

Lot number of the vaccine product.

Control0..1
Typestring
Must Supporttrue
Immunization.expirationDate
Definition

Date vaccine batch expires.

Control0..1
Typedate
Must Supporttrue
Immunization.site
Definition

Body site where vaccine was administered.

Control0..1
BindingThis identifies the body site at which the substance was administered
The codes SHOULD be taken from Vaccine Administered Body Site
TypeCodeableConcept
Must Supporttrue
Immunization.route
Definition

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

Control0..1
BindingThis identifies the route of substance administration.
The codes SHOULD be taken from Medication Route FDA Value Set
TypeCodeableConcept
Must Supporttrue
Immunization.doseQuantity
Definition

The comparator is not used on a SimpleQuantity

Control0..1
TypeQuantity(SimpleQuantity)
Must Supporttrue
Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

InvariantsDefined on this element
qty-3: If a code for the unit is present, the system SHALL also be present (xpath: not(exists(f:code)) or exists(f:system))
sqty-1: The comparator is not used on a SimpleQuantity (xpath: not(exists(f:comparator)))
Immunization.note
Definition

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

Control0..*
TypeAnnotation
Immunization.explanation
Definition

Reasons why a vaccine was or was not administered.

Control0..1
TypeBackboneElement
Must Supporttrue
Immunization.explanation.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Immunization.explanation.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

Immunization.explanation.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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
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.

Immunization.explanation.reason
Definition

Reasons why a vaccine was administered.

Control0..*
BindingThe reason why a vaccine was administered
For example codes, see Immunization Reason Codes
TypeCodeableConcept
Must Supporttrue
Immunization.explanation.reasonNotGiven
Definition

Reason why a vaccine was not administered.

Control0..*
BindingThe reason why a vaccine was not administered
For example codes, see Immunization Reasons for Not Immunizing Codes
TypeCodeableConcept
Must Supporttrue
Immunization.reaction
Definition

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

Control0..*
TypeBackboneElement
Must Supporttrue
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.

Immunization.reaction.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Immunization.reaction.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
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.

Immunization.reaction.date
Definition

Date of reaction to the immunization.

Control0..1
TypedateTime
Must Supporttrue
Immunization.reaction.detail
Definition

Details of the reaction.

Control0..1
TypeReference(Observation)
Immunization.reaction.reported
Definition

Self-reported indicator.

Control0..1
Typeboolean
Must Supporttrue
Comments

Not in QUICK.

Immunization.vaccinationProtocol
Definition

Contains information about the protocol(s) under which the vaccine was administered.

Control0..*
TypeBackboneElement
Must Supporttrue
Immunization.vaccinationProtocol.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Immunization.vaccinationProtocol.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

Immunization.vaccinationProtocol.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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
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.

Immunization.vaccinationProtocol.doseSequence
Definition

Nominal position in a series.

Control1..1
TypepositiveInt
Must Supporttrue
Immunization.vaccinationProtocol.description
Definition

Contains the description about the protocol under which the vaccine was administered.

Control0..1
Typestring
Must Supporttrue
Immunization.vaccinationProtocol.authority
Definition

Indicates the authority who published the protocol. E.g. ACIP.

Control0..1
TypeReference(U.S. DAF Organization Profile)
Must Supporttrue
Immunization.vaccinationProtocol.series
Definition

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

Control0..1
Typestring
Must Supporttrue
Immunization.vaccinationProtocol.seriesDoses
Definition

The recommended number of doses to achieve immunity.

Control0..1
TypepositiveInt
Must Supporttrue
Immunization.vaccinationProtocol.targetDisease
Definition

The targeted disease.

Control1..1
BindingThe disease target of the vaccination protocol
For example codes, see Vaccination Protocol Dose Target Codes
TypeCodeableConcept
Must Supporttrue
Immunization.vaccinationProtocol.doseStatus
Definition

Indicates if the immunization event should "count" against the protocol.

Control1..1
BindingThe status of the vaccination protocol (i.e. should this count)
For example codes, see Vaccination Protocol Dose Status codes
TypeCodeableConcept
Must Supporttrue
Comments

May need to differentiate between status declarations by a provider vs. a CDS engine.

Immunization.vaccinationProtocol.doseStatusReason
Definition

Provides an explanation as to why an immunization event should or should not count against the protocol.

Control0..1
BindingThe reason for the determining if a vaccination should count or why vaccination should not count.
For example codes, see Vaccination Protocol Dose Status Reason codes
TypeCodeableConcept
Must Supporttrue