This
page
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part
of
the
Continuous
Integration
Build
of
FHIR
Specification
(v4.0.1:
R4
(will
be
incorrect/inconsistent
at
times).
See
the
Directory
of
published
versions

Responsible
Owner:
Public
Health
Work
Group
|
Normative
|
Security Category : Patient | Compartments : Patient , Practitioner |
Detailed Descriptions for the elements in the Immunization resource.
| Immunization | |
| Element Id | Immunization |
| Definition | 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 Display | Immunization event information |
| Cardinality | 0..* |
| Type | DomainResource |
| Summary | false |
| Immunization.identifier | |
| Element Id | Immunization.identifier |
| Definition | A unique identifier assigned to this immunization record. |
| Short Display | Business identifier |
| Note | This is a business identifier, not a resource identifier (see discussion ) |
| Cardinality | 0..* |
| Type | Identifier |
| Summary | false |
| Immunization.basedOn | |
| Element Id | Immunization.basedOn |
| Definition |
A
plan,
order
or
recommendation
fulfilled
in
|
| Short Display | Authority that the immunization event is based on |
| Cardinality | 0..* |
| Type | Reference ( CarePlan | MedicationRequest | ServiceRequest ) |
| Summary | true |
| Comments | Allows tracing of an authorization for the Immunization. |
| Immunization.status | |
| Element Id | Immunization.status |
| Definition |
Indicates
the
current
|
| Short Display | completed | entered-in-error | not-done |
| Cardinality | 1..1 |
| Terminology Binding | Immunization Status Codes ( Required ) |
| Type | code |
| Is Modifier |
true
(Reason:
This
element
is
labeled
as
a
modifier
because
it
is
a
status
element
that
contains
statuses
entered-in-error
and
not-done
which
|
| Summary | true |
| Comments |
Will
generally
be
set
to
show
that
the
immunization
has
been
completed
or
not
done.
This
element
is
|
| Immunization.statusReason | |
| Element Id | Immunization.statusReason |
| Definition | Indicates the reason the immunization event was not performed. |
| Short Display | Reason for current status |
| Cardinality | 0..1 |
| Terminology Binding | Immunization Status Reason Codes ( Example ) |
| Type | CodeableConcept |
| Summary | false |
| 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. |
| Immunization.vaccineCode | |
| Element Id | Immunization.vaccineCode |
| Definition | Vaccine that was administered or was to be administered. |
| Short Display | Vaccine administered |
| Cardinality | 1..1 |
| Terminology Binding | Vaccine Administered Value Set ( Example ) |
| Type | CodeableConcept |
| Summary | true |
| Comments |
The
code
for
the
administered
vaccine
may
be
reported
at
various
levels
of
granularity
from
a
very
generic
code
for
a
general
type
of
vaccine
(e.g.
the
SNOMED
or
CVX
code
for
the
flu
vaccine)
to
a
very
discrete
code
for
a
specific
product
including
the
form
and
packaging
(e.g.
an
NDC
code).
Because
vaccineCode
uses
the
CodeableConcept
data
type,
multiple
codes
at
different
levels
of
granularity
may
be
reported
for
a
single
immunization
event
provided
that
all
codes
are
appropriate
for
the
same
vaccine.
For
example,
both
NDC
and
CVX
codes
may
be
provided
for
a
|
| Immunization.administeredProduct | |
| Element Id | Immunization.administeredProduct |
| Definition |
An
indication
of
|
| Short Display | Product that was administered |
| Cardinality | 0..1 |
| Type | CodeableReference ( Medication ) |
| Summary | false |
|
|
|
| Element Id | Immunization.manufacturer |
| Definition | Name of vaccine manufacturer. |
| Short Display | Vaccine manufacturer |
| Cardinality | 0..1 |
| Type | CodeableReference ( Organization ) |
| Summary | false |
| Immunization.lotNumber | |
| Element Id | Immunization.lotNumber |
| Definition | Lot number of the vaccine product. |
| Short Display | Vaccine lot number |
| Cardinality | 0..1 |
| Type | string |
| Summary | false |
| Immunization.expirationDate | |
| Element Id | Immunization.expirationDate |
| Definition | Date vaccine batch expires. |
| Short Display | Vaccine expiration date |
| Cardinality | 0..1 |
| Type | date |
| Summary | false |
| Immunization.patient | |
| Element Id | Immunization.patient |
| Definition | The patient who either received or did not receive the immunization. |
| Short Display | Who was immunized |
| Cardinality | 1..1 |
| Type | Reference ( Patient ) |
| Summary | true |
| Immunization.encounter | |
| Element Id | Immunization.encounter |
| Definition |
The
visit
or
admission
or
other
contact
between
patient
and
|
| Short Display | Encounter immunization was part of |
|
Cardinality
|
0..1 |
|
|
Reference ( Encounter ) |
| Summary | false |
| Immunization.supportingInformation | |
| Element Id | Immunization.supportingInformation |
| Definition | Additional information that is relevant to the immunization (e.g. for a vaccine recipient who is pregnant, the gestational age of the fetus). The reason why a vaccine was given (e.g. occupation, underlying medical condition) should be conveyed in Immunization.reason, not as supporting information. The reason why a vaccine was not given (e.g. contraindication) should be conveyed in Immunization.statusReason, not as supporting information. |
| Short Display | Additional information in support of the immunization |
| Cardinality | 0..* |
| Type | Reference ( Any ) |
| Summary | false |
| Immunization.occurrence[x] | |
| Element Id | Immunization.occurrence[x] |
| Definition |
|
| Short Display | Vaccine administration date |
| Cardinality | 1..1 |
| Type | dateTime | string |
| [x] Note | See Choice of Datatypes for further information about how to use [x] |
| Summary | true |
| Comments | When immunizations are given, a specific date and time should always be recorded if known. If the time is not known, it should not be included. However, systems primarily rely on the date component of the immunization record for determining dose validity and future dose forecasting. For this reason, immunization records should preserve the immunization date as recorded for the time zone where the dose was administered. Care should be taken when recording and transmitting time and time zone information, as adjustments based on time zone can shift the recorded date. Additionally, because Patient.birthDate does not include a time component, systems should ensure that comparisons between occurrence date and birth date do not introduce inconsistencies in determining patient age at vaccination. 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. |
| Immunization.primarySource | |
| Element Id | Immunization.primarySource |
| Definition | Indicates whether the data contained in the resource was captured by the individual/organization which was responsible for the administration of the vaccine rather than as 'secondary reported' data documented by a third party. A value of 'true' means this data originated with the individual/organization which was responsible for the administration of the vaccine. |
| Short Display | Indicates context the data was captured in |
| Cardinality | 0..1 |
| Type | boolean |
| Summary | true |
| Comments | Reflects the “reliability” of the content. |
| Immunization.informationSource | |
| Element Id | Immunization.informationSource |
| Definition | Typically 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 Display | Indicates the source of a reported record |
| Cardinality | 0..1 |
| Terminology Binding |
Immunization
Origin
Codes
(
|
| Type | CodeableReference ( Patient | Practitioner | PractitionerRole | RelatedPerson | Organization ) |
| Summary | false |
| Comments | Typically will not be populated if primarySource = True, not required even if primarySource = False. |
| Immunization.location | |
| Element Id | Immunization.location |
| Definition |
|
| Short Display | The service delivery location |
| Cardinality | 0..1 |
| Type | Reference ( Location ) |
| Summary | false |
|
Immunization.site
|
|
| Element Id | Immunization.site |
| Definition | Body site where vaccine was administered. |
| Short Display | Body site vaccine was administered |
| Cardinality | 0..1 |
| Terminology Binding | Codes for Immunization Site of Administration ( Example ) |
| Type | CodeableConcept |
| Summary | false |
| Immunization.route | |
| Element Id | Immunization.route |
| Definition |
|
| Short Display | How vaccine entered body |
| Cardinality | 0..1 |
| Terminology Binding | Immunization Route Codes ( Example ) |
| Type | CodeableConcept |
| Summary | false |
| Immunization.doseQuantity | |
| Element Id | Immunization.doseQuantity |
| Definition | The quantity of vaccine product that was administered. |
| Short Display | Amount of vaccine administered |
| Cardinality | 0..1 |
| Type | SimpleQuantity |
| Summary | false |
| Immunization.performer | |
| Element Id | Immunization.performer |
| Definition | Indicates who performed the immunization event. |
| Short Display | Who performed event |
| Cardinality | 0..* |
| Summary | true |
| Immunization.performer.function | |
| Element Id | Immunization.performer.function |
| Definition | Describes the function played by the performer in the immunization event (e.g. ordering provider, administering provider, etc.). |
| Short Display | Type of performance |
| Cardinality | 0..1 |
| Terminology Binding | Immunization Function Codes ( Extensible ) |
| Type | CodeableConcept |
| Summary | true |
| Immunization.performer.actor | |
| Element Id | Immunization.performer.actor |
| Definition | The practitioner or organization who performed the action. |
| Short Display | Individual or organization who performed the event |
| Cardinality | 1..1 |
| Type | Reference ( Practitioner | PractitionerRole | Organization | Patient | RelatedPerson ) |
| Summary | true |
| Comments |
When
the
individual
practitioner
who
performed
the
action
is
known,
it
is
best
to
|
| Immunization.note | |
| Element Id | Immunization.note |
| Definition |
Extra
information
about
the
immunization
that
is
not
conveyed
by
the
|
| Short Display | Additional immunization notes |
| Cardinality | 0..* |
| Type | Annotation |
| Summary | true |
| Immunization.reason | |
| Element Id | Immunization.reason |
| Definition | Describes why the immunization occurred in coded or textual form, or indicates another resource (Condition, Observation or DiagnosticReport) whose existence justifies this immunization. |
| Short Display | Why immunization occurred |
| Cardinality | 0..* |
| Terminology Binding | Immunization Reason Codes ( Example ) |
| Type | CodeableReference ( Condition | Observation | DiagnosticReport ) |
| Summary | false |
| Immunization.isSubpotent | |
| Element Id | Immunization.isSubpotent |
| Definition | Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent. |
| Short Display | Dose potency |
| Cardinality | 0..1 |
| Type | boolean |
| Is Modifier | true (Reason: 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.) |
| Meaning if Missing | By default, a dose should be considered to be potent. |
| Summary | true |
| 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
|
| Immunization.subpotentReason | |
| Element Id | Immunization.subpotentReason |
| Definition | Reason why a dose is considered to be subpotent. |
| Short Display | Reason for being subpotent |
| Cardinality | 0..* |
| Terminology Binding |
Immunization
Subpotent
Reason
(
Example
)
|
| Type | CodeableConcept |
| Summary | false |
| Immunization.programEligibility | |
| Element Id | Immunization.programEligibility |
| Definition | Indicates a patient's eligibility for a funding program. |
| Short Display | Patient eligibility for a specific vaccination program |
| Cardinality | 0..* |
| Summary | false |
| Immunization.programEligibility.program | |
| Element Id | Immunization.programEligibility.program |
| Definition | Indicates which program the patient had their eligibility evaluated for. |
| Short Display | The program that eligibility is declared for |
| Cardinality | 1..1 |
| Terminology Binding | Vaccine Funding Programs ( Example ) |
| Type | CodeableConcept |
| Summary | false |
| Immunization.programEligibility.programStatus | |
| Element Id | Immunization.programEligibility.programStatus |
| Definition | Indicates the patient's eligibility status for a specific payment program. |
| Short Display | The patient's eligibility status for the program |
| Cardinality | 1..1 |
| Terminology Binding |
Immunization
Program
Eligibility
(
Example
)
|
| Type | CodeableConcept |
| Summary | false |
| Immunization.fundingSource | |
| Element Id | 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 publicly purchased vaccine but due to inventory issues, vaccine purchased with private funds was actually administered). |
| Short Display | Funding source for the vaccine |
| Cardinality | 0..1 |
| Terminology Binding |
Immunization
Funding
Source
(
Example
)
|
| Type | CodeableConcept |
| Summary | false |
| Immunization.reaction | |
| Element Id | Immunization.reaction |
| Definition | Categorical data indicating that an adverse event is associated in time to an immunization. |
| Short Display | Details of a reaction that followed the immunization |
| Cardinality | 0..* |
| Summary | false |
| Comments | A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case, it should be recorded as a new AllergyIntolerance resource instance as most systems will not query against past Immunization.reaction elements. |
| Immunization.reaction.date | |
| Element Id | Immunization.reaction.date |
| Definition | Date of reaction to the immunization. |
| Short Display | When reaction started |
| Cardinality | 0..1 |
| Type | dateTime |
| Summary | false |
| Immunization.reaction.manifestation | |
| Element Id | Immunization.reaction.manifestation |
| Definition | Details of the reaction. |
| Short Display | Additional information on reaction |
| Cardinality | 0..1 |
| Type | CodeableReference ( Observation ) |
| Summary | false |
| Immunization.reaction.reported | |
| Element Id | Immunization.reaction.reported |
| Definition | Self-reported indicator. |
| Short Display | Indicates self-reported reaction |
| Cardinality | 0..1 |
| Type | boolean |
| Summary | false |
| Immunization.protocolApplied | |
| Element Id | Immunization.protocolApplied |
| Definition | The protocol (set of recommendations) being followed by the provider who administered the dose. |
| Short Display | Protocol followed by the provider |
| Cardinality | 0..* |
| Summary | false |
| Immunization.protocolApplied.series | |
| Element Id | Immunization.protocolApplied.series |
| Definition |
One
possible
path
to
achieve
presumed
immunity
against
a
|
| Short Display | Name of vaccine series |
| Cardinality | 0..1 |
| Type | string |
| Summary | false |
| Immunization.protocolApplied.authority | |
| Element Id | Immunization.protocolApplied.authority |
| Definition |
Indicates
the
|
| Short Display | Who is responsible for publishing the recommendations |
| Cardinality | 0..1 |
| Type | Reference ( Organization ) |
| Summary | false |
| Immunization.protocolApplied.targetDisease | |
| Element Id | Immunization.protocolApplied.targetDisease |
| Definition | The vaccine preventable disease the dose is being administered against. |
| Short Display | Vaccine preventable disease being targeted |
| Cardinality | 0..* |
| Terminology Binding | Immunization Target Disease Codes ( Example ) |
| Type | CodeableConcept |
| Summary | false |
| Immunization.protocolApplied.doseNumber | |
| Element Id | Immunization.protocolApplied.doseNumber |
| Definition | Nominal position in a series as intended by the practitioner administering the dose. |
| Short Display | Dose number within series |
| Cardinality | 0..1 |
| Terminology Binding | DoseNumber : |
| Type | CodeableConcept |
| Summary | false |
| Comments | The dose number may be communicated as either a coded concept (for example Dose 1, Dose 2 or Booster) or as free text as needed by the use case. |
| Immunization.protocolApplied.seriesDoses | |
| Element Id | Immunization.protocolApplied.seriesDoses |
| Definition | The recommended number of doses to achieve immunity as intended by the practitioner administering the dose. |
| Short Display | Recommended number of doses for immunity |
| Cardinality | 0..1 |
| Terminology Binding | SeriesDoses : |
| Type | CodeableConcept |
| Summary | false |
| Comments | The number of doses in a series may be communicated as either a coded concept or as free text as needed by the use case. |