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4.13 Resource Immunization - Content

Immunization event information.

4.13.1 Scope and Usage

The immunization resource is intended to cover the administration of vaccines to patients across all healthcare disciplines in all care settings and all regions. This includes immunization of both humans and animals but does not include the administration of non-vaccine agents, even those that may have or claim immunological effects.

Additionally, the immunization resource is expected to cover key concepts related to the creation, revision and querying of a patient's immunization history. 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 v2.x immunization implementation guide, HL7 v3 POIZ domain and Immunization Domain Analysis Model.

4.13.2 Boundaries and Relationships

This resource references the following resources:

Administration of vaccines is intended to be handled using the Immunization resource. MedicationAdministration is intended for tracking the administration of non-vaccine medications. Some systems treat immunizations in the same way as any other medication administration. Such systems SHOULD use an immunization resource to represent these. If systems need to use a MedicationAdministration resource to capture vaccinations for workflow or other reasons, they SHOULD also expose an equivalent Immunization instance.

4.13.3 Resource Content

Immunization (Resource)A unique identifier assigned to this adverse reaction recordidentifier : Identifier 0..*Date vaccine administered or was to be administereddate : dateTime 1..1Vaccine that was administered or was to be administeredvaccineType : CodeableConcept 1..1 <<The type of vaccine administeredVaccineType>>The patient to whom the vaccine was to be administeredsubject : Resource(Patient) 1..1Indicates if the vaccination was refusedrefusedIndicator : boolean 1..1True if this administration was reported rather than directly administeredreported : boolean 1..1Clinician who administered the vaccineperformer : Resource(Practitioner) 0..1Clinician who ordered the vaccinationrequester : Resource(Practitioner) 0..1Name of vaccine manufacturermanufacturer : Resource(Organization) 0..1The service delivery location where the vaccine administration occurredlocation : Resource(Location) 0..1Lot number of the vaccine productlotNumber : string 0..1Date vaccine batch expiresexpirationDate : date 0..1Body site where vaccine was administeredsite : CodeableConcept 0..1 <<The site at which the vaccine was administeredImmunizationSite>>The path by which the vaccine product is taken into the bodyroute : CodeableConcept 0..1 <<The route by which the vaccine was administeredImmunizationRoute>>The quantity of vaccine product that was administereddoseQuantity : Quantity 0..1ExplanationReasons why a vaccine was administeredreason : CodeableConcept 0..* <<The reason why a vaccine was administeredImmunizationReason>>Refusal or exemption reasonsrefusalReason : CodeableConcept 0..* <<The reason why a vaccine administration was refusedNoImmunizationReason>>ReactionDate of reaction to the immunizationdate : dateTime 0..1Details of the reactiondetail : Resource(AdverseReaction|Observation) 0..1Self-reported indicatorreported : boolean 0..1VaccinationProtocolNominal position in a seriesdoseSequence : integer 1..1Contains the description about the protocol under which the vaccine was administereddescription : string 0..1Indicates the authority who published the protocol? E.g. ACIPauthority : Resource(Organization) 0..1One possible path to achieve presumed immunity against a disease - within the context of an authorityseries : string 0..1The recommended number of doses to achieve immunityseriesDoses : integer 0..1The targeted diseasedoseTarget : CodeableConcept 1..1 <<The disease target of the vaccination protocolVaccinationProtocolDoseTarget>>Indicates if the immunization event should "count" against the protocoldoseStatus : CodeableConcept 1..1 <<The status of the vaccination protocol (i.e. should this count)VaccinationProtocolDoseStatus>>Provides an explanation as to why a immunization event should or should not count against the protocoldoseStatusReason : CodeableConcept 0..1 <<The reason for the determining if a vaccination should count or why vaccination should not count.VaccinationProtocolDoseStatusReason>>Reasons why a vaccine was administered or refusedexplanation0..1Categorical data indicating that an adverse event is associated in time to an immunizationreaction0..*Contains information about the protocol(s) under which the vaccine was administeredvaccinationProtocol0..*

This resource is referenced by Condition, ImmunizationRecommendation and Procedure

<Immunization xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: extension, modifierExtension, language, text, and contained -->
 <identifier><!-- 0..* Identifier Business identifier --></identifier>
 <date value="[dateTime]"/><!-- 1..1 Vaccination administration date -->
 <vaccineType><!-- 1..1 CodeableConcept Vaccine product administered --></vaccineType>
 <subject><!-- 1..1 Resource(Patient) Who was immunized? --></subject>
 <refusedIndicator value="[boolean]"/><!-- 1..1 Was immunization refused? -->
 <reported value="[boolean]"/><!-- 1..1 Is this a self-reported record? -->
 <performer><!-- 0..1 Resource(Practitioner) Who administered vaccine? --></performer>
 <requester><!-- 0..1 Resource(Practitioner) Who ordered vaccination? --></requester>
 <manufacturer><!-- 0..1 Resource(Organization) Vaccine manufacturer --></manufacturer>
 <location><!-- 0..1 Resource(Location) Where did vaccination occur? --></location>
 <lotNumber value="[string]"/><!-- 0..1 Vaccine lot number -->
 <expirationDate value="[date]"/><!-- 0..1 Vaccine expiration date -->
 <site><!-- 0..1 CodeableConcept Body site vaccine  was administered --></site>
 <route><!-- 0..1 CodeableConcept How vaccine entered body --></route>
 <doseQuantity><!-- 0..1 Quantity Amount of vaccine administered --></doseQuantity>
 <explanation>  <!-- 0..1 Administration / refusal reasons -->
  <reason><!-- 0..* CodeableConcept Why immunization occurred --></reason>
  <refusalReason><!-- 0..* CodeableConcept Why immunization did not occur --></refusalReason>
 </explanation>
 <reaction>  <!-- 0..* Details of a reaction that follows immunization -->
  <date value="[dateTime]"/><!-- 0..1 When did reaction start? -->
  <detail><!-- 0..1 Resource(AdverseReaction|Observation) Additional information on reaction --></detail>
  <reported value="[boolean]"/><!-- 0..1 Was reaction self-reported? -->
 </reaction>
 <vaccinationProtocol>  <!-- 0..* What protocol was followed -->
  <doseSequence value="[integer]"/><!-- 1..1 What dose number within series? -->
  <description value="[string]"/><!-- 0..1 Details of vaccine protocol -->
  <authority><!-- 0..1 Resource(Organization) Who is responsible for protocol --></authority>
  <series value="[string]"/><!-- 0..1 Name of vaccine series -->
  <seriesDoses value="[integer]"/><!-- 0..1 Recommended number of doses for immunity -->
  <doseTarget><!-- 1..1 CodeableConcept Disease immunized against --></doseTarget>
  <doseStatus><!-- 1..1 CodeableConcept Does dose count towards immunity? --></doseStatus>
  <doseStatusReason><!-- 0..1 CodeableConcept Why does does count/not count? --></doseStatusReason>
 </vaccinationProtocol>
</Immunization>

Alternate definitions: Schema/Schematron, Resource Profile

4.13.3.1 Terminology Bindings

PathDefinitionTypeReference
Immunization.vaccineType The type of vaccine administeredExamplehttp://hl7.org/fhir/v3/vs/VaccineType
Immunization.site The site at which the vaccine was administeredExamplehttp://hl7.org/fhir/vs/immunization-site
Immunization.route The route by which the vaccine was administeredExamplehttp://hl7.org/fhir/vs/immunization-route
Immunization.explanation.reason The reason why a vaccine was administeredExamplehttp://hl7.org/fhir/vs/immunization-reason
Immunization.explanation.refusalReason The reason why a vaccine administration was refusedExamplehttp://hl7.org/fhir/vs/no-immunization-reason
Immunization.vaccinationProtocol.doseTarget The disease target of the vaccination protocolExamplehttp://hl7.org/fhir/vs/vaccination-protocol-dose-target
Immunization.vaccinationProtocol.doseStatus The status of the vaccination protocol (i.e. should this count)Examplehttp://hl7.org/fhir/vs/vaccination-protocol-dose-status
Immunization.vaccinationProtocol.doseStatusReason The reason for the determining if a vaccination should count or why vaccination should not count.Examplehttp://hl7.org/fhir/vs/vaccination-protocol-dose-status-reason

4.13.4 Search Parameters

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

NameTypeDescriptionPaths
_idtokenThe logical resource id associated with the resource (must be supported by all servers)
_languagetokenThe language of the resource
datedateVaccination Administration / Refusal DateImmunization.date
dose-sequencenumberWhat dose number within series?Immunization.vaccinationProtocol.doseSequence
identifiertokenBusiness identifierImmunization.identifier
locationreferenceThe service delivery location or facility in which the vaccine was / was to be administeredImmunization.location
(Location)
lot-numberstringVaccine Lot NumberImmunization.lotNumber
manufacturerreferenceVaccine ManufacturerImmunization.manufacturer
(Organization)
performerreferenceThe practitioner who administered the vaccinationImmunization.performer
(Practitioner)
reactionreferenceAdditional information on reactionImmunization.reaction.detail
(Observation, AdverseReaction)
reaction-datedateWhen did reaction start?Immunization.reaction.date
reasontokenWhy immunization occurredImmunization.explanation.reason
refusal-reasontokenExplanation of refusal / exemptionImmunization.explanation.refusalReason
refusedtokenWas immunization refused?Immunization.refusedIndicator
requesterreferenceThe practitioner who ordered the vaccinationImmunization.requester
(Practitioner)
subjectreferenceThe subject of the vaccination event / refusalImmunization.subject
(Patient)
vaccine-typetokenVaccine Product Type AdministeredImmunization.vaccineType
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