Release 4B

This page is part of the FHIR Specification (v4.3.0: R4B - STU). 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

Immunizationrecommendation.profile.xml

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

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

Jump past Narrative

StructureDefinition for immunizationrecommendation

<?xml version="1.0" encoding="UTF-8"?>

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="ImmunizationRecommendation"/> 
  <meta> 
    <lastUpdated value="2022-05-28T12:47:40.239+10:00"/> 
  </meta> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">
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          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <a href="formats.html#table" title="The logical name of the element">Name</a> 
          </th> 
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="formats.html#table" title="Information about the use of the element">Flags</a> 
          </th> 
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a> 
          </th> 
          <th class="hierarchy" style="width: 100px">
            <a href="formats.html#table" title="Reference to the type of the element">Type</a> 
          </th> 
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="formats.html#table" title="Additional information about the element">Description &amp; Constraints</a> 
            <span style="float: right">
              <a href="formats.html#table" title="Legend for this format">
                <img alt="doco" src="help16.png" style="background-color: inherit"/> 
              </a> 
            </span> 
          </th> 
        </tr> 
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            ABJRU5ErkJggg==" style="background-color: white; background-color: inherit" title="Resource"/>  
            <span title="ImmunizationRecommendation : A patient's point-in-time set of recommendations (i.e. forecasting)
             according to a published schedule with optional supporting justification.">ImmunizationRecommendation</span> 
            <a name="ImmunizationRecommendation"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="versions.html#std-process" style="padding-left: 3px; padding-right: 3px; border: 1px grey solid; font-weight: bold; color:
             black; background-color: #fff5e6" title="Standards Status = Trial Use">TU</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="domainresource.html">DomainResource</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Guidance or advice relating to an immunization
            <br/>  Elements defined in Ancestors: 
            <a href="resource.html#Resource" title="The logical id of the resource, as used in the URL for the resource. Once assigned, this
             value never changes.">id</a> , 
            <a href="resource.html#Resource" title="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.">meta</a> , 
            <a href="resource.html#Resource" title="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.">implicitRules</a> , 
            <a href="resource.html#Resource" title="The base language in which the resource is written.">language</a> , 
            <a href="domainresource.html#DomainResource" title="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 &quot;clinically
             safe&quot; for a human to just read the narrative. Resource definitions may define what
             content should be represented in the narrative to ensure clinical safety.">text</a> , 
            <a href="domainresource.html#DomainResource" title="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.">contained</a> , 
            <a href="domainresource.html#DomainResource" title="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.">extension</a> , 
            <a href="domainresource.html#DomainResource" title="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).">modifierExtension</a> 
          </td> 
        </tr> 

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            <span title="ImmunizationRecommendation.identifier : A unique identifier assigned to this particular
             recommendation record.">identifier</span> 
            <a name="ImmunizationRecommendation.identifier"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#Identifier">Identifier</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Business identifier
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            lQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="ImmunizationRecommendation.patient : The patient the recommendation(s) are for.">patient</span> 
            <a name="ImmunizationRecommendation.patient"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">1..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="patient.html">Patient</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Who this profile is for</td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVB
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            RgwAAAABJRU5ErkJggg==" style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type"/>  
            <span title="ImmunizationRecommendation.date : The date the immunization recommendation(s) were created.">date</span> 
            <a name="ImmunizationRecommendation.date"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">1..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#dateTime">dateTime</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Date recommendation(s) created</td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <span title="ImmunizationRecommendation.authority : Indicates the authority who published the protocol
             (e.g. ACIP).">authority</span> 
            <a name="ImmunizationRecommendation.authority"> </a> 
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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           padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="organization.html">Organization</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Who is responsible for protocol</td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
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            <span title="ImmunizationRecommendation.recommendation : Vaccine administration recommendations.">recommendation</span> 
            <a name="ImmunizationRecommendation.recommendation"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
            <a href="conformance-rules.html#constraints" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element has or is affected by some invariants">I</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">1..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="backboneelement.html">BackboneElement</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Vaccine administration recommendations
            <br/>  
            <span style="font-style: italic" title="imr-1">+ Rule: One of vaccineCode or targetDisease SHALL be present</span> 
            <br/>  
          </td> 
        </tr> 

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            <span title="ImmunizationRecommendation.recommendation.vaccineCode : Vaccine(s) or vaccine group that
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            <a name="ImmunizationRecommendation.recommendation.vaccineCode"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Vaccine  or vaccine group recommendation applies to
            <br/>  
            <a href="valueset-vaccine-code.html">Vaccine Administered Value Set</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.">Example</a> )
            <br/>  
          </td> 
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            <span title="ImmunizationRecommendation.recommendation.targetDisease : The targeted disease for the
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            <a name="ImmunizationRecommendation.recommendation.targetDisease"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Disease to be immunized against
            <br/>  
            <a href="valueset-immunization-recommendation-target-disease.html">Immunization Recommendation Target Disease Codes</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.">Example</a> )
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
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            <span title="ImmunizationRecommendation.recommendation.contraindicatedVaccineCode : Vaccine(s) which
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            <a name="ImmunizationRecommendation.recommendation.contraindicatedVaccineCode"> </a> 
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Vaccine which is contraindicated to fulfill the recommendation
            <br/>  
            <a href="valueset-vaccine-code.html">Vaccine Administered Value Set</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.">Example</a> )
            <br/>  
          </td> 
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            <span title="ImmunizationRecommendation.recommendation.forecastStatus : Indicates the patient status
             with respect to the path to immunity for the target disease.">forecastStatus</span> 
            <a name="ImmunizationRecommendation.recommendation.forecastStatus"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
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            <a href="conformance-rules.html#isModifier" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is a modifier element">?!</a> 
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">1..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
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            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
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            <br/>  
            <a href="valueset-immunization-recommendation-status.html">Immunization Recommendation Status Codes</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.">Example</a> )
          </td> 
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            <span title="ImmunizationRecommendation.recommendation.forecastReason : The reason for the assigned
             forecast status.">forecastReason</span> 
            <a name="ImmunizationRecommendation.recommendation.forecastReason"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Vaccine administration status reason
            <br/>  
            <a href="valueset-immunization-recommendation-reason.html">Immunization Recommendation Reason Codes</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.">Example</a> )
            <br/>  
          </td> 
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            <span title="ImmunizationRecommendation.recommendation.dateCriterion : Vaccine date recommendations.
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            <a name="ImmunizationRecommendation.recommendation.dateCriterion"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="backboneelement.html">BackboneElement</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Dates governing proposed immunization
            <br/>  
          </td> 
        </tr> 

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            <a name="ImmunizationRecommendation.recommendation.dateCriterion.code"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Type of date
            <br/>  
            <a href="valueset-immunization-recommendation-date-criterion.html">Immunization Recommendation Date Criterion Codes</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.">Example</a> )
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            <span title="ImmunizationRecommendation.recommendation.dateCriterion.value : The date whose meaning
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            <a name="ImmunizationRecommendation.recommendation.dateCriterion.value"> </a> 
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
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            <span title="ImmunizationRecommendation.recommendation.description : Contains the description about
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            <a href="datatypes.html#string">string</a> 
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
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            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <span title="A sequence of Unicode characters">doseNumberString</span> 
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            <a href="datatypes.html#string">string</a> 
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            <a href="references.html#Reference">Reference</a> (
            <a href="immunization.html">Immunization</a>  | 
            <a href="immunizationevaluation.html">ImmunizationEvaluation</a> )
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            <a href="formats.html#table" title="Legend for this format">
              <img alt="doco" src="help16.png" style="background-color: inherit"/>  Documentation for this format
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        <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/> 
        <expression value="contained.contained.empty()"/> 
        <xpath value="not(parent::f:contained and f:contained)"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-3"/> 
        <severity value="error"/> 
        <human value="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"/> 
        <expression value="contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descenda
        nts().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(uri) = '#').exists()).not()).trace('unmatched',
         id).empty()"/> 
        <xpath value="not(exists(for $contained in f:contained return $contained[not(exists(parent::*/descendant::f:refere
        nce/@value=concat('#', $contained/*/f:id/@value)) or exists(descendant::f:reference[@value='#']))]))"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-4"/> 
        <severity value="error"/> 
        <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or
         a meta.lastUpdated"/> 
        <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/> 
        <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-5"/> 
        <severity value="error"/> 
        <human value="If a resource is contained in another resource, it SHALL NOT have a security label"/> 
        <expression value="contained.meta.security.empty()"/> 
        <xpath value="not(exists(f:contained/*/f:meta/f:security))"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
          <valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display
           the resource to a human safely. Including a human readable representation in the resource
           makes for a much more robust eco-system and cheaper handling of resources by intermediary
           systems. Some ecosystems restrict distribution of resources to only those systems that
           do fully understand the resources, and as a consequence implementers may believe that
           the narrative is superfluous. However experience shows that such eco-systems often open
           up to new participants over time."/> 
        </extension> 
        <key value="dom-6"/> 
        <severity value="warning"/> 
        <human value="A resource should have narrative for robust management"/> 
        <expression value="text.`div`.exists()"/> 
        <xpath value="exists(f:text/h:div)"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Entity. Role, or Act"/> 
      </mapping> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="VXU_V04"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="SubstanceAdministration[moodCode=RMD]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="clinical.medication"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.id">
      <path value="ImmunizationRecommendation.id"/> 
      <short value="Logical id of this artifact"/> 
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this
       value never changes."/> 
      <comment value="The only time that a resource does not have an id is when it is being submitted to the
       server using a create operation."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="ImmunizationRecommendation.meta">
      <path value="ImmunizationRecommendation.meta"/> 
      <short value="Metadata about the resource"/> 
      <definition value="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."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.meta"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Meta"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="ImmunizationRecommendation.implicitRules">
      <path value="ImmunizationRecommendation.implicitRules"/> 
      <short value="A set of rules under which this content was created"/> 
      <definition value="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."/> 
      <comment value="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."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.implicitRules"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="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"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="ImmunizationRecommendation.language">
      <path value="ImmunizationRecommendation.language"/> 
      <short value="Language of the resource content"/> 
      <definition value="The base language in which the resource is written."/> 
      <comment value="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)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.language"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="IETF language tag"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> 
      </binding> 
    </element> 
    <element id="ImmunizationRecommendation.text">
      <path value="ImmunizationRecommendation.text"/> 
      <short value="Text summary of the resource, for human interpretation"/> 
      <definition value="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 &quot;clinically
       safe&quot; for a human to just read the narrative. Resource definitions may define what
       content should be represented in the narrative to ensure clinical safety."/> 
      <comment value="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 &quot;text blob&quot;
       or where text is additionally entered raw or narrated and encoded information is added
       later."/> 
      <alias value="narrative"/> 
      <alias value="html"/> 
      <alias value="xhtml"/> 
      <alias value="display"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DomainResource.text"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Narrative"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Act.text?"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.contained">
      <path value="ImmunizationRecommendation.contained"/> 
      <short value="Contained, inline Resources"/> 
      <definition value="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."/> 
      <comment value="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."/> 
      <alias value="inline resources"/> 
      <alias value="anonymous resources"/> 
      <alias value="contained resources"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.contained"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Resource"/> 
      </type> 
      <constraint> 
        <key value="dom-r4b"/> 
        <severity value="warning"/> 
        <human value="Containing new R4B resources within R4 resources may cause interoperability issues if
         instances are shared with R4 systems"/> 
        <expression value="($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable
         or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this
         is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition
         or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus
         or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence
         or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefi
        nition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition
         or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorizat
        ion or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource
         is SubscriptionTopic)"/> 
        <xpath value="not(f:Citation|f:Evidence|f:EvidenceReport|f:EvidenceVariable|f:MedicinalProductDefinition|f:Package
        dProductDefinition|f:AdministrableProductDefinition|f:Ingredient|f:ClinicalUseDefinition|f:RegulatedA
        uthorization|f:SubstanceDefinition|f:SubscriptionStatus|f:SubscriptionTopic) or not(parent::f:Citatio
        n|parent::f:Evidence|parent::f:EvidenceReport|parent::f:EvidenceVariable|parent::f:MedicinalProductDe
        finition|parent::f:PackagedProductDefinition|parent::f:AdministrableProductDefinition|parent::f:Ingre
        dient|parent::f:ClinicalUseDefinition|parent::f:RegulatedAuthorization|parent::f:SubstanceDefinition|
        f:SubscriptionStatus|f:SubscriptionTopic)"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.extension">
      <path value="ImmunizationRecommendation.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="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."/> 
      <comment value="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."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.modifierExtension">
      <path value="ImmunizationRecommendation.modifierExtension"/> 
      <short value="Extensions that cannot be ignored"/> 
      <definition value="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)."/> 
      <comment value="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."/> 
      <requirements value="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](extensibility.ht
      ml#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource
       that contains them"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.identifier">
      <path value="ImmunizationRecommendation.identifier"/> 
      <short value="Business identifier"/> 
      <definition value="A unique identifier assigned to this particular recommendation record."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ImmunizationRecommendation.identifier"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Identifier"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".id"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.patient">
      <path value="ImmunizationRecommendation.patient"/> 
      <short value="Who this profile is for"/> 
      <definition value="The patient the recommendation(s) are for."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ImmunizationRecommendation.patient"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request.subject"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="PID-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".partipication[typeCode=SUBJ].role"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.date">
      <path value="ImmunizationRecommendation.date"/> 
      <short value="Date recommendation(s) created"/> 
      <definition value="The date the immunization recommendation(s) were created."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ImmunizationRecommendation.date"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request.authoredOn"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-15"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".partipication[typeCode=AUTH].time"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.authority">
      <path value="ImmunizationRecommendation.authority"/> 
      <short value="Who is responsible for protocol"/> 
      <definition value="Indicates the authority who published the protocol (e.g. ACIP)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ImmunizationRecommendation.authority"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = 59779-9"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT]"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation">
      <path value="ImmunizationRecommendation.recommendation"/> 
      <short value="Vaccine administration recommendations"/> 
      <definition value="Vaccine administration recommendations."/> 
      <min value="1"/> 
      <max value="*"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation"/> 
        <min value="1"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children unless an empty Parameters resource"/> 
        <expression value="hasValue() or (children().count() &gt; id.count()) or $this is Parameters"/> 
        <xpath value="@value|f:*|h:div|self::f:Parameters"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="imr-1"/> 
        <severity value="error"/> 
        <human value="One of vaccineCode or targetDisease SHALL be present"/> 
        <expression value="vaccineCode.exists() or targetDisease.exists()"/> 
        <xpath value="exists(f:vaccineCode) or exists(f:targetDisease)"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode='COMP'].target[classCode=SBADM, moodCode=RMD]"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.id">
      <path value="ImmunizationRecommendation.recommendation.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.extension">
      <path value="ImmunizationRecommendation.recommendation.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="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."/> 
      <comment value="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."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.modifierExtension">
      <path value="ImmunizationRecommendation.recommendation.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="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)."/> 
      <comment value="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."/> 
      <requirements value="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](extensibility.ht
      ml#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element
       that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.vaccineCode">
      <path value="ImmunizationRecommendation.recommendation.vaccineCode"/> 
      <short value="Vaccine  or vaccine group recommendation applies to"/> 
      <definition value="Vaccine(s) or vaccine group that pertain to the recommendation."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.vaccineCode"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="VaccineCode"/> 
        </extension> 
        <strength value="example"/> 
        <description value="The type of vaccine administered."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/vaccine-code"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request.code"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = ( 30956-7 | 38890-0 )"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".partipication[typeCode=CSM].role[classCode=ADMM].code"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.targetDisease">
      <path value="ImmunizationRecommendation.recommendation.targetDisease"/> 
      <short value="Disease to be immunized against"/> 
      <definition value="The targeted disease for the recommendation."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.targetDisease"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="TargetDisease"/> 
        </extension> 
        <strength value="example"/> 
        <description value="The disease that the recommended vaccination targets."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/immunization-recommendation-target-disease"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = ( 30956-7 | 38890-0 )"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".partipication[typeCode=CSM].role[classCode=ADMM].code"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.contraindicatedVaccineCode">
      <path value="ImmunizationRecommendation.recommendation.contraindicatedVaccineCode"/> 
      <short value="Vaccine which is contraindicated to fulfill the recommendation"/> 
      <definition value="Vaccine(s) which should not be used to fulfill the recommendation."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.contraindicatedVaccineCode"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="VaccineCode"/> 
        </extension> 
        <strength value="example"/> 
        <description value="The type of vaccine administered."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/vaccine-code"/> 
      </binding> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.forecastStatus">
      <path value="ImmunizationRecommendation.recommendation.forecastStatus"/> 
      <short value="Vaccine recommendation status"/> 
      <definition value="Indicates the patient status with respect to the path to immunity for the target disease."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.forecastStatus"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="This element is labeled as a modifier because the forecastStatus indicates whether a patient
       needs additional doses (due, overdue, etc) or not  (contraindicated, complete, etc)."/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImmunizationRecommendationStatus"/> 
        </extension> 
        <strength value="example"/> 
        <description value="The patient's status with respect to a vaccination protocol."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/immunization-recommendation-status"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = 59783-1"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=SUBJ] .source[classCode=OBS, moodCode=EVN, code=&quot;Immunization
         Forecast Status&quot;].value"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.forecastReason">
      <path value="ImmunizationRecommendation.recommendation.forecastReason"/> 
      <short value="Vaccine administration status reason"/> 
      <definition value="The reason for the assigned forecast status."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.forecastReason"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImmunizationRecommendationReason"/> 
        </extension> 
        <strength value="example"/> 
        <description value="The reason for the patient's status with respect to a vaccination protocol."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/immunization-recommendation-reason"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = 30982-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.dateCriterion">
      <path value="ImmunizationRecommendation.recommendation.dateCriterion"/> 
      <short value="Dates governing proposed immunization"/> 
      <definition value="Vaccine date recommendations.  For example, earliest date to administer, latest date to
       administer, etc."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.dateCriterion"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children unless an empty Parameters resource"/> 
        <expression value="hasValue() or (children().count() &gt; id.count()) or $this is Parameters"/> 
        <xpath value="@value|f:*|h:div|self::f:Parameters"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request.occurrence[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-3: 30980-7 = Next dose recommended, 59777-3 = Latest next dose should be given, 59778-1
         = Dose is overdue"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode='LIMIT'].target[classCode=OBS, moodCode=EVN, isCriterionInd=true]"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.dateCriterion.id">
      <path value="ImmunizationRecommendation.recommendation.dateCriterion.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.dateCriterion.extension">
      <path value="ImmunizationRecommendation.recommendation.dateCriterion.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="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."/> 
      <comment value="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."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.dateCriterion.modifierExtension">
      <path value="ImmunizationRecommendation.recommendation.dateCriterion.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="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)."/> 
      <comment value="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."/> 
      <requirements value="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](extensibility.ht
      ml#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element
       that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.dateCriterion.code">
      <path value="ImmunizationRecommendation.recommendation.dateCriterion.code"/> 
      <short value="Type of date"/> 
      <definition value="Date classification of recommendation.  For example, earliest date to give, latest date
       to give, etc."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.dateCriterion.code"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImmunizationRecommendationDateCriterion"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Classifies date criterion with respect to conveying information about a patient's vaccination
         status (e.g. due date, latest to give date, etc.)."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/immunization-recommendation-date-criterion"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.dateCriterion.value">
      <path value="ImmunizationRecommendation.recommendation.dateCriterion.value"/> 
      <short value="Recommended date"/> 
      <definition value="The date whose meaning is specified by dateCriterion.code."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.dateCriterion.value"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".value"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.description">
      <path value="ImmunizationRecommendation.recommendation.description"/> 
      <short value="Protocol details"/> 
      <definition value="Contains the description about the protocol under which the vaccine was administered."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.description"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = 30956-7"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".text"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.series">
      <path value="ImmunizationRecommendation.recommendation.series"/> 
      <short value="Name of vaccination series"/> 
      <definition value="One possible path to achieve presumed immunity against a disease - within the context
       of an authority."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.series"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXA-5-administered code"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".title"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.doseNumber[x]">
      <path value="ImmunizationRecommendation.recommendation.doseNumber[x]"/> 
      <short value="Recommended dose number within series"/> 
      <definition value="Nominal position of the recommended dose in a series (e.g. dose 2 is the next recommended
       dose)."/> 
      <comment value="The use of an integer is prefered if known. A string should only be used in cases where
       an interger is not available (such as when documenting a recurring booster dose)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.doseNumber[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="positiveInt"/> 
      </type> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = 30973-2"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP, .source[classCode=SBADM, moodCode=INT]].sequenceNumber"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.seriesDoses[x]">
      <path value="ImmunizationRecommendation.recommendation.seriesDoses[x]"/> 
      <short value="Recommended number of doses for immunity"/> 
      <definition value="The recommended number of doses to achieve immunity."/> 
      <comment value="The use of an integer is prefered if known. A string should only be used in cases where
       an interger is not available (such as when documenting a recurring booster dose)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.seriesDoses[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="positiveInt"/> 
      </type> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = 59782-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP, .source[classCode=SBADM, moodCode=DEF]].sequenceNumber"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.supportingImmunization">
      <path value="ImmunizationRecommendation.recommendation.supportingImmunization"/> 
      <short value="Past immunizations supporting recommendation"/> 
      <definition value="Immunization event history and/or evaluation that supports the status and recommendation."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.supportingImmunization"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Immunization"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImmunizationEvaluation"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="? No clear way to associate in HL7 v2 or IG"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=RSON].target[classCode=SBADM, moodCode=EVN, code=&quot;immunization&q
        uot;]"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.supportingPatientInformation">
      <path value="ImmunizationRecommendation.recommendation.supportingPatientInformation"/> 
      <short value="Patient observations supporting recommendation"/> 
      <definition value="Patient Information that supports the status and recommendation.  This includes patient
       observations, adverse reactions and allergy/intolerance information."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ImmunizationRecommendation.recommendation.supportingPatientInformation"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request.supportingInfo"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX If OBX is associated with ( RXA : RXA-5-administered code = '998^No vaccine administered^CVX'),
         could contain the reason the vaccine was not administered"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=RSON].target[classCode=OBS, moodCode=EVN]"/> 
      </mapping> 
    </element> 
  </snapshot> 
  <differential> 
    <element id="ImmunizationRecommendation">
      <path value="ImmunizationRecommendation"/> 
      <short value="Guidance or advice relating to an immunization"/> 
      <definition value="A patient's point-in-time set of recommendations (i.e. forecasting) according to a published
       schedule with optional supporting justification."/> 
      <min value="0"/> 
      <max value="*"/> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="VXU_V04"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="SubstanceAdministration[moodCode=RMD]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="clinical.medication"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.identifier">
      <path value="ImmunizationRecommendation.identifier"/> 
      <short value="Business identifier"/> 
      <definition value="A unique identifier assigned to this particular recommendation record."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Identifier"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".id"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.patient">
      <path value="ImmunizationRecommendation.patient"/> 
      <short value="Who this profile is for"/> 
      <definition value="The patient the recommendation(s) are for."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request.subject"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="PID-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".partipication[typeCode=SUBJ].role"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.date">
      <path value="ImmunizationRecommendation.date"/> 
      <short value="Date recommendation(s) created"/> 
      <definition value="The date the immunization recommendation(s) were created."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request.authoredOn"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-15"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".partipication[typeCode=AUTH].time"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.authority">
      <path value="ImmunizationRecommendation.authority"/> 
      <short value="Who is responsible for protocol"/> 
      <definition value="Indicates the authority who published the protocol (e.g. ACIP)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = 59779-9"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT]"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation">
      <path value="ImmunizationRecommendation.recommendation"/> 
      <short value="Vaccine administration recommendations"/> 
      <definition value="Vaccine administration recommendations."/> 
      <min value="1"/> 
      <max value="*"/> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="imr-1"/> 
        <severity value="error"/> 
        <human value="One of vaccineCode or targetDisease SHALL be present"/> 
        <expression value="vaccineCode.exists() or targetDisease.exists()"/> 
        <xpath value="exists(f:vaccineCode) or exists(f:targetDisease)"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode='COMP'].target[classCode=SBADM, moodCode=RMD]"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.vaccineCode">
      <path value="ImmunizationRecommendation.recommendation.vaccineCode"/> 
      <short value="Vaccine  or vaccine group recommendation applies to"/> 
      <definition value="Vaccine(s) or vaccine group that pertain to the recommendation."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="VaccineCode"/> 
        </extension> 
        <strength value="example"/> 
        <description value="The type of vaccine administered."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/vaccine-code"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request.code"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = ( 30956-7 | 38890-0 )"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".partipication[typeCode=CSM].role[classCode=ADMM].code"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.targetDisease">
      <path value="ImmunizationRecommendation.recommendation.targetDisease"/> 
      <short value="Disease to be immunized against"/> 
      <definition value="The targeted disease for the recommendation."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="TargetDisease"/> 
        </extension> 
        <strength value="example"/> 
        <description value="The disease that the recommended vaccination targets."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/immunization-recommendation-target-disease"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = ( 30956-7 | 38890-0 )"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".partipication[typeCode=CSM].role[classCode=ADMM].code"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.contraindicatedVaccineCode">
      <path value="ImmunizationRecommendation.recommendation.contraindicatedVaccineCode"/> 
      <short value="Vaccine which is contraindicated to fulfill the recommendation"/> 
      <definition value="Vaccine(s) which should not be used to fulfill the recommendation."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="VaccineCode"/> 
        </extension> 
        <strength value="example"/> 
        <description value="The type of vaccine administered."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/vaccine-code"/> 
      </binding> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.forecastStatus">
      <path value="ImmunizationRecommendation.recommendation.forecastStatus"/> 
      <short value="Vaccine recommendation status"/> 
      <definition value="Indicates the patient status with respect to the path to immunity for the target disease."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="This element is labeled as a modifier because the forecastStatus indicates whether a patient
       needs additional doses (due, overdue, etc) or not  (contraindicated, complete, etc)."/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImmunizationRecommendationStatus"/> 
        </extension> 
        <strength value="example"/> 
        <description value="The patient's status with respect to a vaccination protocol."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/immunization-recommendation-status"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = 59783-1"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=SUBJ] .source[classCode=OBS, moodCode=EVN, code=&quot;Immunization
         Forecast Status&quot;].value"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.forecastReason">
      <path value="ImmunizationRecommendation.recommendation.forecastReason"/> 
      <short value="Vaccine administration status reason"/> 
      <definition value="The reason for the assigned forecast status."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImmunizationRecommendationReason"/> 
        </extension> 
        <strength value="example"/> 
        <description value="The reason for the patient's status with respect to a vaccination protocol."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/immunization-recommendation-reason"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = 30982-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.dateCriterion">
      <path value="ImmunizationRecommendation.recommendation.dateCriterion"/> 
      <short value="Dates governing proposed immunization"/> 
      <definition value="Vaccine date recommendations.  For example, earliest date to administer, latest date to
       administer, etc."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request.occurrence[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-3: 30980-7 = Next dose recommended, 59777-3 = Latest next dose should be given, 59778-1
         = Dose is overdue"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode='LIMIT'].target[classCode=OBS, moodCode=EVN, isCriterionInd=true]"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.dateCriterion.code">
      <path value="ImmunizationRecommendation.recommendation.dateCriterion.code"/> 
      <short value="Type of date"/> 
      <definition value="Date classification of recommendation.  For example, earliest date to give, latest date
       to give, etc."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImmunizationRecommendationDateCriterion"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Classifies date criterion with respect to conveying information about a patient's vaccination
         status (e.g. due date, latest to give date, etc.)."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/immunization-recommendation-date-criterion"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.dateCriterion.value">
      <path value="ImmunizationRecommendation.recommendation.dateCriterion.value"/> 
      <short value="Recommended date"/> 
      <definition value="The date whose meaning is specified by dateCriterion.code."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".value"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.description">
      <path value="ImmunizationRecommendation.recommendation.description"/> 
      <short value="Protocol details"/> 
      <definition value="Contains the description about the protocol under which the vaccine was administered."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="string"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = 30956-7"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".text"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.series">
      <path value="ImmunizationRecommendation.recommendation.series"/> 
      <short value="Name of vaccination series"/> 
      <definition value="One possible path to achieve presumed immunity against a disease - within the context
       of an authority."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="string"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXA-5-administered code"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".title"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.doseNumber[x]">
      <path value="ImmunizationRecommendation.recommendation.doseNumber[x]"/> 
      <short value="Recommended dose number within series"/> 
      <definition value="Nominal position of the recommended dose in a series (e.g. dose 2 is the next recommended
       dose)."/> 
      <comment value="The use of an integer is prefered if known. A string should only be used in cases where
       an interger is not available (such as when documenting a recurring booster dose)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="positiveInt"/> 
      </type> 
      <type> 
        <code value="string"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = 30973-2"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP, .source[classCode=SBADM, moodCode=INT]].sequenceNumber"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.seriesDoses[x]">
      <path value="ImmunizationRecommendation.recommendation.seriesDoses[x]"/> 
      <short value="Recommended number of doses for immunity"/> 
      <definition value="The recommended number of doses to achieve immunity."/> 
      <comment value="The use of an integer is prefered if known. A string should only be used in cases where
       an interger is not available (such as when documenting a recurring booster dose)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="positiveInt"/> 
      </type> 
      <type> 
        <code value="string"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-5 : OBX-3 = 59782-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP, .source[classCode=SBADM, moodCode=DEF]].sequenceNumber"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.supportingImmunization">
      <path value="ImmunizationRecommendation.recommendation.supportingImmunization"/> 
      <short value="Past immunizations supporting recommendation"/> 
      <definition value="Immunization event history and/or evaluation that supports the status and recommendation."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Immunization"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImmunizationEvaluation"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="? No clear way to associate in HL7 v2 or IG"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=RSON].target[classCode=SBADM, moodCode=EVN, code=&quot;immunization&q
        uot;]"/> 
      </mapping> 
    </element> 
    <element id="ImmunizationRecommendation.recommendation.supportingPatientInformation">
      <path value="ImmunizationRecommendation.recommendation.supportingPatientInformation"/> 
      <short value="Patient observations supporting recommendation"/> 
      <definition value="Patient Information that supports the status and recommendation.  This includes patient
       observations, adverse reactions and allergy/intolerance information."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Request.supportingInfo"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX If OBX is associated with ( RXA : RXA-5-administered code = '998^No vaccine administered^CVX'),
         could contain the reason the vaccine was not administered"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=RSON].target[classCode=OBS, moodCode=EVN]"/> 
      </mapping> 
    </element> 
  </differential> 
</StructureDefinition> 

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.