Release 4B Ballot #1

This page is part of the FHIR Specification (v4.1.0: Release 4B Ballot #1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Immunization-example.json

Public Health and Emergency Response Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Patient, Practitioner

Raw JSON (canonical form + also see JSON Format Specification)

Example of Immunization

{
  "resourceType": "Immunization",
  "id": "example",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234</p><p><b>status</b>: completed</p><p><b>vaccineCode</b>: <span>Fluvax (Influenza)</span></p><p><b>patient</b>: <a>Generated Summary: Medical record number: 12345 (USUAL); active; Peter James Chalmers (OFFICIAL), Jim , Peter James Windsor (MAIDEN); , Phone: (03) 5555 6473, Phone: (03) 3410 5613, Phone: (03) 5555 8834; gender: male; birthDate: 1974-12-25; </a></p><p><b>encounter</b>: <a>Generated Summary: status: in-progress; <span>inpatient encounter</span></a></p><p><b>occurrence</b>: 2013-01-10</p><p><b>primarySource</b>: true</p><p><b>location</b>: <a>Generated Summary: id: B1-S.F2; status: active; name: South Wing, second floor; alias: BU MC, SW, F2, alias: Burgers University Medical Center, South Wing, second floor; description: Second floor of the Old South Wing, formerly in use by Psychiatry; mode: instance; Phone: 2328, Fax: 2329, second wing admissions, http://sampleorg.com/southwing; <span>Wing</span></a></p><p><b>manufacturer</b>: <a>Generated Summary: name: Health Level Seven International; alias: HL7 International; Phone: (+1) 734-677-7777, Fax: (+1) 734-677-6622, hq@HL7.org</a></p><p><b>lotNumber</b>: AAJN11K</p><p><b>expirationDate</b>: 2015-02-15</p><p><b>site</b>: <span>left arm</span></p><p><b>route</b>: <span>Injection, intramuscular</span></p><p><b>doseQuantity</b>: 5 mg</p><blockquote><p><b>performer</b></p><p><b>function</b>: <span>Ordering Provider</span></p><p><b>actor</b>: <a>Generated Summary: id: 23; active; Adam Careful </a></p></blockquote><blockquote><p><b>performer</b></p><p><b>function</b>: <span>Administering Provider</span></p><p><b>actor</b>: <a>Generated Summary: id: 23; active; Adam Careful </a></p></blockquote><p><b>note</b>: Notes on adminstration of vaccine</p><p><b>reasonCode</b>: <span>Procedure to meet occupational requirement</span></p><p><b>isSubpotent</b>: true</p><h3>Educations</h3><table><tr><td>-</td><td><b>DocumentType</b></td><td><b>PublicationDate</b></td><td><b>PresentationDate</b></td></tr><tr><td>*</td><td>253088698300010311120702</td><td>2012-07-02</td><td>2013-01-10</td></tr></table><p><b>programEligibility</b>: <span>Not Eligible</span></p><p><b>fundingSource</b>: <span>Private</span></p></div>"
  },
  "identifier": [
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234"
    }
  ],
  "status": "completed",
  "vaccineCode": {
    "coding": [
      {
        "system": "urn:oid:1.2.36.1.2001.1005.17",
        "code": "FLUVAX"
      }
    ],
    "text": "Fluvax (Influenza)"
  },
  "patient": {
    "reference": "Patient/example"
  },
  "encounter": {
    "reference": "Encounter/example"
  },
  "occurrenceDateTime": "2013-01-10",
  "primarySource": true,
  "location": {
    "reference": "Location/1"
  },
  "manufacturer": {
    "reference": "Organization/hl7"
  },
  "lotNumber": "AAJN11K",
  "expirationDate": "2015-02-15",
  "site": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActSite",
        "code": "LA",
        "display": "left arm"
      }
    ]
  },
  "route": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-RouteOfAdministration",
        "code": "IM",
        "display": "Injection, intramuscular"
      }
    ]
  },
  "doseQuantity": {
    "value": 5,
    "system": "http://unitsofmeasure.org",
    "code": "mg"
  },
  "performer": [
    {
      "function": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0443",
            "code": "OP"
          }
        ]
      },
      "actor": {
        "reference": "Practitioner/example"
      }
    },
    {
      "function": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0443",
            "code": "AP"
          }
        ]
      },
      "actor": {
        "reference": "Practitioner/example"
      }
    }
  ],
  "note": [
    {
      "text": "Notes on adminstration of vaccine"
    }
  ],
  "reasonCode": [
    {
      "coding": [
        {
          "system": "http://snomed.info/sct",
          "code": "429060002"
        }
      ]
    }
  ],
  "isSubpotent": true,
  "education": [
    {
      "documentType": "253088698300010311120702",
      "publicationDate": "2012-07-02",
      "presentationDate": "2013-01-10"
    }
  ],
  "programEligibility": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/immunization-program-eligibility",
          "code": "ineligible"
        }
      ]
    }
  ],
  "fundingSource": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/immunization-funding-source",
        "code": "private"
      }
    ]
  }
}

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.