Immunization (IPS)

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

Describes the event of a patient being administered a vaccine or a record of an immunization as reported by a patient, a clinician or another party.

Short
Immunization event information


Control
0..*


Is Modifier
false


Summary
false


Invariants
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())

dom-3: 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 (contained.where(((‘#’+id in (%resource.descendants().reference | %resource.descendants().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(canonical) = ‘#’).exists()).not()).trace(‘unmatched’, id).empty())

dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())

dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())

dom-6: A resource should have narrative for robust management (text.`div`.exists())

2. Immunization.implicitRules


Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Short
A set of rules under which this content was created


Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. 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.

Control
0..1


Type
uri


Is Modifier
true because 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


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Summary
true


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


4. Immunization.modifierExtension


Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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).

Short
Extensions that cannot be ignored


Comments

There can be no stigma associated with the use of extensions by any application, project, or standard – regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control
0..*


Type
Extension


Is Modifier
true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them


Summary
false


Requirements

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.

Alternate Names
extensions, user content


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())

6. Immunization.status


Definition

Indicates the current status of the immunization event.

Short
completed | entered-in-error | not-done


Comments

Will generally be set to show that the immunization has been completed or not done. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Control
1..1


Binding
The codes SHALL be taken from ImmunizationStatusCodeshttp://hl7.org/fhir/ValueSet/immunization-status|4.0.1

(required to

http://hl7.org/fhir/ValueSet/immunization-status|4.0.1)

A set of codes indicating the current status of an Immunization.

Type
code


Is Modifier
true because This element is labeled as a modifier because it is a status element that contains statuses entered-in-error and not-done which means that the resource should not be treated as valid


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Must Support
true


Obligations


Summary
true


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


8. Immunization.vaccineCode


Definition

Vaccine that was administered or was to be administered. Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunized is provided; or the known absent / unknown.

Other coded information can be provided as well as:

The value sets used for the PhPID, MPID and PCID identifiers are provisional and include only few equivalent concepts used for exemplification purposes, they will be updated with real IDMP identifiers when they will become available.

Vaccine that was administered or was to be administered.

Short
Vaccine that was administered or was to be administered.Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent / unknown code. Other coded information can be provided as well as: the IDMP Pharmaceutical Product Identifiers (PhPID), Medicinal Product Identifier (MPID), Packaged Medicinal Product Identifier (PCID), when available, or equivalent coded concepts; the WHO ATC codes; or any other kind of code that that identifies, classifies or cluster the administered product.Vaccine product administered


Control
1..1


Binding
The codes SHOULD be taken from For example codes, see Vaccines – IPShttp://hl7.org/fhir/ValueSet/vaccine-code|4.0.1

(preferred to

http://hl7.org/fhir/uv/ips/ValueSet/vaccines-uv-ips)

The type of vaccine for particular disease or diseases against which the patient has been immunised, or a code for absent/unknown immunization.

The code for vaccine product administered.

Type
CodeableConcept(Codeable Concept (IPS))


Is Modifier
false


Must Support
true


Obligations


Summary
true


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


10. Immunization.patient


Definition

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

Short
Who was immunized


Control
1..1


Type
Reference(Patient (IPS), Patient)


Is Modifier
false


Must Support
true


Obligations


Summary
true


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


12. Immunization.patient.reference


Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with ‘#’) refer to contained resources.

Short
Literal reference, Relative, internal or absolute URL


Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure “/[type]/[id]” then it should be assumed that the reference is to a FHIR RESTful server.

Control
10..1

This element is affected by the following invariants: ref-1

Type
string


Is Modifier
false


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Must Support
true


Obligations


Summary
true


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


14. Immunization.occurrence[x]


Definition

Date vaccine administered or was to be administered.

Short
Vaccine administration date


Comments

When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given. An exact date is always preferable, but the use of the String data type is acceptable when an exact date is not known. A small number of vaccines (e.g. live oral typhoid vaccine) are given as a series of patient self-administered dose over a span of time. In cases like this, often, only the first dose (typically a provider supervised dose) is recorded with the occurrence indicating the date/time of the first dose.

Control
1..1


Type
Choice of: dateTime, string


[x] Note
SeeChoice of Data Typesfor further information about how to use [x]


Is Modifier
false


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Must Support
true


Must Support Types
No must-support rules about the choice of types/profiles


Obligations


Summary
true


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


Slicing
This element introduces a set of slices on Immunization.occurrence[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:


16. Immunization.occurrence[x]:occurrenceDateTime


Slice Name
occurrenceDateTime


Definition

Date vaccine administered or was to be administered.

Short
Vaccine administration date


Comments

When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given. An exact date is always preferable, but the use of the String data type is acceptable when an exact date is not known. A small number of vaccines (e.g. live oral typhoid vaccine) are given as a series of patient self-administered dose over a span of time. In cases like this, often, only the first dose (typically a provider supervised dose) is recorded with the occurrence indicating the date/time of the first dose.

Control
01..1


Type
dateTime, string


[x] Note
SeeChoice of Data Typesfor further information about how to use [x]


Is Modifier
false


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Must Support
true


Obligations


Summary
true


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


18. Immunization.site


Definition

Body site where vaccine was administered.

Short
Body site vaccine was administered


Control
0..1


Binding
The codes SHOULD be taken from For example codes, see SNOMEDCTBodyStructureshttp://hl7.org/fhir/ValueSet/immunization-site|4.0.1

(preferred to

http://hl7.org/fhir/ValueSet/body-site)


Type
CodeableConcept


Is Modifier
false


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


20. Immunization.route


Definition

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

Short
How vaccine entered body


Control
0..1


Binding
The codes SHOULD be taken from For example codes, see SNOMEDCTRouteCodeshttp://hl7.org/fhir/ValueSet/immunization-route|4.0.1

(preferred to

http://hl7.org/fhir/ValueSet/route-codes)

SNOMED Route Terms

The route by which the vaccine was administered.

Type
CodeableConcept


Is Modifier
false


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


22. Immunization.isSubpotent


Definition

Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent.

Short
Dose potency


Comments

Typically, the recognition of the dose being sub-potent is retrospective, after the administration (ex. notification of a manufacturer recall after administration). However, in the case of a partial administration (the patient moves unexpectedly and only some of the dose is actually administered), subpotency may be recognized immediately, but it is still important to record the event.

Control
0..1


Type
boolean


Is Modifier
true because This element is labeled as a modifier because an immunization event with a subpotent vaccine doesn’t protect the patient the same way as a potent dose.


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Summary
true


Meaning if Missing
By default, a dose should be considered to be potent.


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

2. Immunization.status


Must Support
true


Obligations


4. Immunization.vaccineCode


Definition

Vaccine that was administered or was to be administered. Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunized is provided; or the known absent / unknown.

Other coded information can be provided as well as:

The value sets used for the PhPID, MPID and PCID identifiers are provisional and include only few equivalent concepts used for exemplification purposes, they will be updated with real IDMP identifiers when they will become available.

Short
Vaccine that was administered or was to be administered.Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent / unknown code. Other coded information can be provided as well as: the IDMP Pharmaceutical Product Identifiers (PhPID), Medicinal Product Identifier (MPID), Packaged Medicinal Product Identifier (PCID), when available, or equivalent coded concepts; the WHO ATC codes; or any other kind of code that that identifies, classifies or cluster the administered product.


Binding
The codes SHOULD be taken from Vaccines – IPS

(preferred to

http://hl7.org/fhir/uv/ips/ValueSet/vaccines-uv-ips)

The type of vaccine for particular disease or diseases against which the patient has been immunised, or a code for absent/unknown immunization.

Type
CodeableConcept(Codeable Concept (IPS))


Must Support
true


Obligations


6. Immunization.patient


Type
Reference(Patient (IPS))


Must Support
true


Obligations


8. Immunization.patient.reference


Control
1..?


Must Support
true


Obligations


10. Immunization.occurrence[x]


[x] Note
SeeChoice of Data Typesfor further information about how to use [x]


Must Support
true


Obligations


Slicing
This element introduces a set of slices on Immunization.occurrence[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:


12. Immunization.occurrence[x]:occurrenceDateTime


Slice Name
occurrenceDateTime


Control
0..1


Type
dateTime


[x] Note
SeeChoice of Data Typesfor further information about how to use [x]


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Must Support
true


Obligations


14. Immunization.site


Binding
The codes SHOULD be taken from SNOMEDCTBodyStructures

(preferred to

http://hl7.org/fhir/ValueSet/body-site)


16. Immunization.route


Binding
The codes SHOULD be taken from SNOMEDCTRouteCodes

(preferred to

http://hl7.org/fhir/ValueSet/route-codes)

SNOMED Route Terms

18. Immunization.protocolApplied


20. Immunization.protocolApplied.targetDisease


Definition

The particular disease against which the patient has been immunized.

Additional conformance bindings provided for use for this element in specific (jurisdictional or other) contexts include (these bindings are represented in the StructureDefinition as instances of the elementdefinition-additionalBinding extension):

Short
Vaccine preventable disease being targeted


Binding
The codes SHOULD be taken from Vaccine Target Diseases – IPS

(preferred to

http://hl7.org/fhir/uv/ips/ValueSet/target-diseases-uv-ips)

The particular disease or diseases against which the patient has been immunized.

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

Short
Immunization event information


Control
0..*


Is Modifier
false


Summary
false


Invariants
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())

dom-3: 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 (

contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().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(canonical) = '#').exists()).not()).trace('unmatched', id).empty())

dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (

contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())

dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (

contained.meta.security.empty())

dom-6: A resource should have narrative for robust management (

text.`div`.exists())


2. Immunization.id


Definition

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

Short
Logical id of this artifact


Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control
0..1


Type
id


Is Modifier
false


Summary
true


4. Immunization.meta


Definition

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.

Short
Metadata about the resource


Control
0..1


Type
Meta


Is Modifier
false


Summary
true


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


6. Immunization.implicitRules


Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Short
A set of rules under which this content was created


Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. 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.

Control
0..1


Type
uri


Is Modifier
true because 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


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Summary
true


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


8. Immunization.language


Definition

The base language in which the resource is written.

Short
Language of the resource content


Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Control
0..1


Binding
The codes SHOULD be taken from CommonLanguages

(preferred to

http://hl7.org/fhir/ValueSet/languages|4.0.1)

A human language.

Type
code


Is Modifier
false


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


10. Immunization.text


Definition

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 “clinically safe” for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Short
Text summary of the resource, for human interpretation


Comments

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 “text blob” or where text is additionally entered raw or narrated and encoded information is added later.

Control
0..1


Type
Narrative


Is Modifier
false


Summary
false


Alternate Names
narrative, html, xhtml, display


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


12. Immunization.contained


Definition

These resources do not have an independent existence apart from the resource that contains them – they cannot be identified independently, and nor can they have their own independent transaction scope.

Short
Contained, inline Resources


Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Control
0..*


Type
Resource


Is Modifier
false


Summary
false


Alternate Names
inline resources, anonymous resources, contained resources


14. Immunization.extension


Definition

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.

Short
Additional content defined by implementations


Comments

There can be no stigma associated with the use of extensions by any application, project, or standard – regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control
0..*


Type
Extension


Is Modifier
false


Summary
false


Alternate Names
extensions, user content


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

ext-1: Must have either extensions or value[x], not both (

extension.exists() != value.exists())


16. Immunization.modifierExtension


Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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).

Short
Extensions that cannot be ignored


Comments

There can be no stigma associated with the use of extensions by any application, project, or standard – regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control
0..*


Type
Extension


Is Modifier
true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them


Summary
false


Requirements

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.

Alternate Names
extensions, user content


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

ext-1: Must have either extensions or value[x], not both (

extension.exists() != value.exists())


18. Immunization.identifier


Definition

A unique identifier assigned to this immunization record.

Short
Business identifier


Note
This is a business identifier, not a resource identifier (see discussion)


Control
0..*


Type
Identifier


Is Modifier
false


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


20. Immunization.status


Definition

Indicates the current status of the immunization event.

Short
completed | entered-in-error | not-done


Comments

Will generally be set to show that the immunization has been completed or not done. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Control
1..1


Binding
The codes SHALL be taken from ImmunizationStatusCodes

(required to

http://hl7.org/fhir/ValueSet/immunization-status|4.0.1)

A set of codes indicating the current status of an Immunization.

Type
code


Is Modifier
true because This element is labeled as a modifier because it is a status element that contains statuses entered-in-error and not-done which means that the resource should not be treated as valid


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Must Support
true


Obligations


Summary
true


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


22. Immunization.statusReason


Definition

Indicates the reason the immunization event was not performed.

Short
Reason not done


Comments

This is generally only used for the status of “not-done”. The reason for performing the immunization event is captured in reasonCode, not here.

Control
0..1


Binding
For example codes, see ImmunizationStatusReasonCodes

(example to

http://hl7.org/fhir/ValueSet/immunization-status-reason|4.0.1)

The reason why a vaccine was not administered.

Type
CodeableConcept


Is Modifier
false


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


24. Immunization.vaccineCode


Definition

Vaccine that was administered or was to be administered. Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunized is provided; or the known absent / unknown.

Other coded information can be provided as well as:

The value sets used for the PhPID, MPID and PCID identifiers are provisional and include only few equivalent concepts used for exemplification purposes, they will be updated with real IDMP identifiers when they will become available.

Short
Vaccine that was administered or was to be administered.Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent / unknown code. Other coded information can be provided as well as: the IDMP Pharmaceutical Product Identifiers (PhPID), Medicinal Product Identifier (MPID), Packaged Medicinal Product Identifier (PCID), when available, or equivalent coded concepts; the WHO ATC codes; or any other kind of code that that identifies, classifies or cluster the administered product.


Control
1..1


Binding
The codes SHOULD be taken from Vaccines – IPS

(preferred to

http://hl7.org/fhir/uv/ips/ValueSet/vaccines-uv-ips)

The type of vaccine for particular disease or diseases against which the patient has been immunised, or a code for absent/unknown immunization.

Type
CodeableConcept(Codeable Concept (IPS))


Is Modifier
false


Must Support
true


Obligations


Summary
true


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


26. Immunization.patient


Definition

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

Short
Who was immunized


Control
1..1


Type
Reference(Patient (IPS))


Is Modifier
false


Must Support
true


Obligations


Summary
true


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


28. Immunization.patient.id


Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short
Unique id for inter-element referencing


Control
0..1


Type
string


Is Modifier
false


XML Format
In the XML format, this property is represented as an attribute.


Summary
false


30. Immunization.patient.extension


Definition

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.

Short
Additional content defined by implementations


Comments

There can be no stigma associated with the use of extensions by any application, project, or standard – regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control
0..*


Type
Extension


Is Modifier
false


Summary
false


Alternate Names
extensions, user content


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

ext-1: Must have either extensions or value[x], not both (

extension.exists() != value.exists())


Slicing
This element introduces a set of slices on Immunization.patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:


32. Immunization.patient.reference


Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with ‘#’) refer to contained resources.

Short
Literal reference, Relative, internal or absolute URL


Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure “/[type]/[id]” then it should be assumed that the reference is to a FHIR RESTful server.

Control
1..1

This element is affected by the following invariants: ref-1

Type
string


Is Modifier
false


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Must Support
true


Obligations


Summary
true


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


34. Immunization.patient.type


Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. “Patient” is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

Short
Type the reference refers to (e.g. “Patient”)


Comments

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Control
0..1


Binding
Unless not suitable, these codes SHALL be taken from ResourceType

(extensible to

http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

Aa resource (or, for logical models, the URI of the logical model).

Type
uri


Is Modifier
false


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Summary
true


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


36. Immunization.patient.identifier


Definition

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

Short
Logical reference, when literal reference is not known


Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it – see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed – but not required – to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance – except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Note
This is a business identifier, not a resource identifier (see discussion)


Control
0..1


Type
Identifier


Is Modifier
false


Summary
true


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


38. Immunization.patient.display


Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Short
Text alternative for the resource


Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what’s being referenced, not to fully describe it.

Control
0..1


Type
string


Is Modifier
false


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Summary
true


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


40. Immunization.encounter


Definition

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

Short
Encounter immunization was part of


Control
0..1


Type
Reference(Encounter)


Is Modifier
false


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


42. Immunization.occurrence[x]


Definition

Date vaccine administered or was to be administered.

Short
Vaccine administration date


Comments

When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given. An exact date is always preferable, but the use of the String data type is acceptable when an exact date is not known. A small number of vaccines (e.g. live oral typhoid vaccine) are given as a series of patient self-administered dose over a span of time. In cases like this, often, only the first dose (typically a provider supervised dose) is recorded with the occurrence indicating the date/time of the first dose.

Control
1..1


Type
Choice of: dateTime, string


[x] Note
SeeChoice of Data Typesfor further information about how to use [x]


Is Modifier
false


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Must Support
true


Must Support Types
No must-support rules about the choice of types/profiles


Obligations


Summary
true


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


Slicing
This element introduces a set of slices on Immunization.occurrence[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:


44. Immunization.occurrence[x]:occurrenceDateTime


Slice Name
occurrenceDateTime


Definition

Date vaccine administered or was to be administered.

Short
Vaccine administration date


Comments

When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given. An exact date is always preferable, but the use of the String data type is acceptable when an exact date is not known. A small number of vaccines (e.g. live oral typhoid vaccine) are given as a series of patient self-administered dose over a span of time. In cases like this, often, only the first dose (typically a provider supervised dose) is recorded with the occurrence indicating the date/time of the first dose.

Control
0..1


Type
dateTime


[x] Note
SeeChoice of Data Typesfor further information about how to use [x]


Is Modifier
false


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Must Support
true


Obligations


Summary
true


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


46. Immunization.recorded


Definition

The date the occurrence of the immunization was first captured in the record – potentially significantly after the occurrence of the event.

Short
When the immunization was first captured in the subject’s record


Control
0..1


Type
dateTime


Is Modifier
false


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


48. Immunization.primarySource


Definition

An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded.

Short
Indicates context the data was recorded in


Comments

Reflects the “reliability” of the content.

Control
0..1


Type
boolean


Is Modifier
false


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Summary
true


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


50. Immunization.reportOrigin


Definition

The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.

Short
Indicates the source of a secondarily reported record


Comments

Should not be populated if primarySource = True, not required even if primarySource = False.

Control
0..1


Binding
For example codes, see ImmunizationOriginCodes

(example to

http://hl7.org/fhir/ValueSet/immunization-origin|4.0.1)

The source of the data for a record which is not from a primary source.

Type
CodeableConcept


Is Modifier
false


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


52. Immunization.location


Definition

The service delivery location where the vaccine administration occurred.

Short
Where immunization occurred


Control
0..1


Type
Reference(Location)


Is Modifier
false


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


54. Immunization.manufacturer


Definition

Name of vaccine manufacturer.

Short
Vaccine manufacturer


Control
0..1


Type
Reference(Organization)


Is Modifier
false


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


56. Immunization.lotNumber


Definition

Lot number of the vaccine product.

Short
Vaccine lot number


Control
0..1


Type
string


Is Modifier
false


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


58. Immunization.expirationDate


Definition

Date vaccine batch expires.

Short
Vaccine expiration date


Control
0..1


Type
date


Is Modifier
false


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


60. Immunization.site


Definition

Body site where vaccine was administered.

Short
Body site vaccine was administered


Control
0..1


Binding
The codes SHOULD be taken from SNOMEDCTBodyStructures

(preferred to

http://hl7.org/fhir/ValueSet/body-site)


Type
CodeableConcept


Is Modifier
false


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


62. Immunization.route


Definition

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

Short
How vaccine entered body


Control
0..1


Binding
The codes SHOULD be taken from SNOMEDCTRouteCodes

(preferred to

http://hl7.org/fhir/ValueSet/route-codes)

SNOMED Route Terms

Type
CodeableConcept


Is Modifier
false


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


64. Immunization.doseQuantity


Definition

The quantity of vaccine product that was administered.

Short
Amount of vaccine administered


Control
0..1


Type
Quantity(SimpleQuantity)


Is Modifier
false


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


66. Immunization.performer


Definition

Indicates who performed the immunization event.

Short
Who performed event


Control
0..*


Type
BackboneElement


Is Modifier
false


Summary
true


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


68. Immunization.performer.id


Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short
Unique id for inter-element referencing


Control
0..1


Type
string


Is Modifier
false


XML Format
In the XML format, this property is represented as an attribute.


Summary
false


70. Immunization.performer.extension


Definition

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.

Short
Additional content defined by implementations


Comments

There can be no stigma associated with the use of extensions by any application, project, or standard – regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control
0..*


Type
Extension


Is Modifier
false


Summary
false


Alternate Names
extensions, user content


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

ext-1: Must have either extensions or value[x], not both (

extension.exists() != value.exists())


72. Immunization.performer.modifierExtension


Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element 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).

Short
Extensions that cannot be ignored even if unrecognized


Comments

There can be no stigma associated with the use of extensions by any application, project, or standard – regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control
0..*


Type
Extension


Is Modifier
true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them


Summary
true


Requirements

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.

Alternate Names
extensions, user content, modifiers


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

ext-1: Must have either extensions or value[x], not both (

extension.exists() != value.exists())


74. Immunization.performer.function


Definition

Describes the type of performance (e.g. ordering provider, administering provider, etc.).

Short
What type of performance was done


Control
0..1


Binding
Unless not suitable, these codes SHALL be taken from ImmunizationFunctionCodes

(extensible to

http://hl7.org/fhir/ValueSet/immunization-function|4.0.1)

The role a practitioner or organization plays in the immunization event.

Type
CodeableConcept


Is Modifier
false


Summary
true


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


76. Immunization.performer.actor


Definition

The practitioner or organization who performed the action.

Short
Individual or organization who was performing


Comments

When the individual practitioner who performed the action is known, it is best to send.

Control
1..1


Type
Reference(Practitioner, PractitionerRole, Organization)


Is Modifier
false


Summary
true


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


78. Immunization.note


Definition

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

Short
Additional immunization notes


Control
0..*


Type
Annotation


Is Modifier
false


Summary
true


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


80. Immunization.reasonCode


Definition

Reasons why the vaccine was administered.

Short
Why immunization occurred


Control
0..*


Binding
For example codes, see ImmunizationReasonCodes

(example to

http://hl7.org/fhir/ValueSet/immunization-reason|4.0.1)

The reason why a vaccine was administered.

Type
CodeableConcept


Is Modifier
false


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


82. Immunization.reasonReference


Definition

Condition, Observation or DiagnosticReport that supports why the immunization was administered.

Short
Why immunization occurred


Control
0..*


Type
Reference(Condition, Observation, DiagnosticReport)


Is Modifier
false


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


84. Immunization.isSubpotent


Definition

Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent.

Short
Dose potency


Comments

Typically, the recognition of the dose being sub-potent is retrospective, after the administration (ex. notification of a manufacturer recall after administration). However, in the case of a partial administration (the patient moves unexpectedly and only some of the dose is actually administered), subpotency may be recognized immediately, but it is still important to record the event.

Control
0..1


Type
boolean


Is Modifier
true because This element is labeled as a modifier because an immunization event with a subpotent vaccine doesn’t protect the patient the same way as a potent dose.


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Summary
true


Meaning if Missing
By default, a dose should be considered to be potent.


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


86. Immunization.subpotentReason


Definition

Reason why a dose is considered to be subpotent.

Short
Reason for being subpotent


Control
0..*


Binding
For example codes, see ImmunizationSubpotentReason

(example to

http://hl7.org/fhir/ValueSet/immunization-subpotent-reason|4.0.1)

The reason why a dose is considered to be subpotent.

Type
CodeableConcept


Is Modifier
false


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


88. Immunization.education


Definition

Educational material presented to the patient (or guardian) at the time of vaccine administration.

Short
Educational material presented to patient


Control
0..*


Type
BackboneElement


Is Modifier
false


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

imm-1: One of documentType or reference SHALL be present (

documentType.exists() or reference.exists())


90. Immunization.education.id


Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short
Unique id for inter-element referencing


Control
0..1


Type
string


Is Modifier
false


XML Format
In the XML format, this property is represented as an attribute.


Summary
false


92. Immunization.education.extension


Definition

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.

Short
Additional content defined by implementations


Comments

There can be no stigma associated with the use of extensions by any application, project, or standard – regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control
0..*


Type
Extension


Is Modifier
false


Summary
false


Alternate Names
extensions, user content


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

ext-1: Must have either extensions or value[x], not both (

extension.exists() != value.exists())


94. Immunization.education.modifierExtension


Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element 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).

Short
Extensions that cannot be ignored even if unrecognized


Comments

There can be no stigma associated with the use of extensions by any application, project, or standard – regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control
0..*


Type
Extension


Is Modifier
true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them


Summary
true


Requirements

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.

Alternate Names
extensions, user content, modifiers


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

ext-1: Must have either extensions or value[x], not both (

extension.exists() != value.exists())


96. Immunization.education.documentType


Definition

Identifier of the material presented to the patient.

Short
Educational material document identifier


Control
0..1


Type
string


Is Modifier
false


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


98. Immunization.education.reference


Definition

Reference pointer to the educational material given to the patient if the information was on line.

Short
Educational material reference pointer


Control
0..1


Type
uri


Is Modifier
false


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


100. Immunization.education.publicationDate


Definition

Date the educational material was published.

Short
Educational material publication date


Control
0..1


Type
dateTime


Is Modifier
false


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


102. Immunization.education.presentationDate


Definition

Date the educational material was given to the patient.

Short
Educational material presentation date


Control
0..1


Type
dateTime


Is Modifier
false


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


104. Immunization.programEligibility


Definition

Indicates a patient’s eligibility for a funding program.

Short
Patient eligibility for a vaccination program


Control
0..*


Binding
For example codes, see ImmunizationProgramEligibility

(example to

http://hl7.org/fhir/ValueSet/immunization-program-eligibility|4.0.1)

The patient’s eligibility for a vaccation program.

Type
CodeableConcept


Is Modifier
false


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


106. Immunization.fundingSource


Definition

Indicates the source of the vaccine actually administered. This may be different than the patient eligibility (e.g. the patient may be eligible for a publically purchased vaccine but due to inventory issues, vaccine purchased with private funds was actually administered).

Short
Funding source for the vaccine


Control
0..1


Binding
For example codes, see ImmunizationFundingSource

(example to

http://hl7.org/fhir/ValueSet/immunization-funding-source|4.0.1)

The source of funding used to purchase the vaccine administered.

Type
CodeableConcept


Is Modifier
false


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


108. Immunization.reaction


Definition

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

Short
Details of a reaction that follows immunization


Comments

A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case, it should be recorded as a new AllergyIntolerance resource instance as most systems will not query against past Immunization.reaction elements.

Control
0..*


Type
BackboneElement


Is Modifier
false


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


110. Immunization.reaction.id


Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short
Unique id for inter-element referencing


Control
0..1


Type
string


Is Modifier
false


XML Format
In the XML format, this property is represented as an attribute.


Summary
false


112. Immunization.reaction.extension


Definition

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.

Short
Additional content defined by implementations


Comments

There can be no stigma associated with the use of extensions by any application, project, or standard – regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control
0..*


Type
Extension


Is Modifier
false


Summary
false


Alternate Names
extensions, user content


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

ext-1: Must have either extensions or value[x], not both (

extension.exists() != value.exists())


114. Immunization.reaction.modifierExtension


Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element 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).

Short
Extensions that cannot be ignored even if unrecognized


Comments

There can be no stigma associated with the use of extensions by any application, project, or standard – regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control
0..*


Type
Extension


Is Modifier
true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them


Summary
true


Requirements

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.

Alternate Names
extensions, user content, modifiers


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

ext-1: Must have either extensions or value[x], not both (

extension.exists() != value.exists())


116. Immunization.reaction.date


Definition

Date of reaction to the immunization.

Short
When reaction started


Control
0..1


Type
dateTime


Is Modifier
false


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


118. Immunization.reaction.detail


Definition

Details of the reaction.

Short
Additional information on reaction


Control
0..1


Type
Reference(Observation)


Is Modifier
false


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


120. Immunization.reaction.reported


Definition

Self-reported indicator.

Short
Indicates self-reported reaction


Control
0..1


Type
boolean


Is Modifier
false


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


122. Immunization.protocolApplied


Definition

The protocol (set of recommendations) being followed by the provider who administered the dose.

Short
Protocol followed by the provider


Control
0..*


Type
BackboneElement


Is Modifier
false


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


124. Immunization.protocolApplied.id


Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short
Unique id for inter-element referencing


Control
0..1


Type
string


Is Modifier
false


XML Format
In the XML format, this property is represented as an attribute.


Summary
false


126. Immunization.protocolApplied.extension


Definition

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.

Short
Additional content defined by implementations


Comments

There can be no stigma associated with the use of extensions by any application, project, or standard – regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control
0..*


Type
Extension


Is Modifier
false


Summary
false


Alternate Names
extensions, user content


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

ext-1: Must have either extensions or value[x], not both (

extension.exists() != value.exists())


128. Immunization.protocolApplied.modifierExtension


Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element 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).

Short
Extensions that cannot be ignored even if unrecognized


Comments

There can be no stigma associated with the use of extensions by any application, project, or standard – regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control
0..*


Type
Extension


Is Modifier
true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them


Summary
true


Requirements

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.

Alternate Names
extensions, user content, modifiers


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

ext-1: Must have either extensions or value[x], not both (

extension.exists() != value.exists())


130. Immunization.protocolApplied.series


Definition

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

Short
Name of vaccine series


Control
0..1


Type
string


Is Modifier
false


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


132. Immunization.protocolApplied.authority


Definition

Indicates the authority who published the protocol (e.g. ACIP) that is being followed.

Short
Who is responsible for publishing the recommendations


Control
0..1


Type
Reference(Organization)


Is Modifier
false


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


134. Immunization.protocolApplied.targetDisease


Definition

The particular disease against which the patient has been immunized.

Additional conformance bindings provided for use for this element in specific (jurisdictional or other) contexts include (these bindings are represented in the StructureDefinition as instances of the elementdefinition-additionalBinding extension):

Short
Vaccine preventable disease being targeted


Control
0..*


Binding
The codes SHOULD be taken from Vaccine Target Diseases – IPS

(preferred to

http://hl7.org/fhir/uv/ips/ValueSet/target-diseases-uv-ips)

The particular disease or diseases against which the patient has been immunized.

Type
CodeableConcept


Is Modifier
false


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


136. Immunization.protocolApplied.doseNumber[x]


Definition

Nominal position in a series.

Short
Dose number within series


Comments

The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).

Control
1..1


Type
Choice of: positiveInt, string


[x] Note
SeeChoice of Data Typesfor further information about how to use [x]


Is Modifier
false


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))


138. Immunization.protocolApplied.seriesDoses[x]


Definition

The recommended number of doses to achieve immunity.

Short
Recommended number of doses for immunity


Comments

The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).

Control
0..1


Type
Choice of: positiveInt, string


[x] Note
SeeChoice of Data Typesfor further information about how to use [x]


Is Modifier
false


Primitive Value
This primitive element may be present, or absent, or replaced by an extension


Summary
false


Invariants
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))