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11.7 Resource Immunization - Content

Responsible Owner: Public Health icon Work Group Maturity Level : 5   Trial Use Security Category : Patient Compartments : Patient , Practitioner

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.

11.7.1 Scope and Usage

The Immunization resource is intended to cover the recording of current and historical administration of vaccines to patients across all healthcare disciplines in all care settings and all regions. This includes immunization of both humans and animals but does not include the administration of non-vaccine agents, even those that may have or claim to have immunological effects. While the terms "immunization" and "vaccination" are not clinically identical, for the purposes of the FHIR resources, the terms are used synonymously.

Additionally, the Immunization resource is expected to cover key concepts related to the creation, revision and querying of a patient's immunization history. This resource - through consultation with the Public Health work group - is believed to meet key use cases and information requirements as defined in the existing HL7 V2 icon immunization implementation guide, HL7 v3 icon POIZ domain and Immunization Domain Analysis Model.

11.7.2 Boundaries and Relationships

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

While the Immunization and MedicationAdministration resources are distinct, they are both able to capture specific details of the administered product. The Immunization resource uses Immunization.vaccineCode to indicate the nature of the vaccine administered to the patient. The Immunization.administeredProduct may additionally be used to identify the specific product used (either as a coded value or as a reference to a Medication resource). The Immunization resource also contains data about the administered vaccine including the manufacturer, lot number and expiration date. However, the data elements contained within Immunization are expected to only be used when Immunization.administeredProduct does not reference a Medication resource which contains the same information about the product.

Similarly, MedicationAdministration.medication references a Medication resource which is used to identify the administered product. Medication.marketingAuthorizationHolder, Medication.batch.lotNumber and Medication.batch.expirationDate are all analogous to the Immunization resource elements and are similarly used to capture details of the administered product.

Immunization.reaction may be an indication of an allergy or intolerance. If this is deemed to be the case, a separate AllergyIntolerance resource instance should be created to indicate it, as most systems will not query against past Immunization.reaction.

Some workflows may require documenting that specific educational materials were presented to the patient (or other responsible party) at the time of or before the immunization event. Conveyance of this information should be accomplished using the Communication resource. This resource can be linked to an Immunization resource and indicate the timing and nature of the educational material provided. The Communication resource may be a standalone resource or may be contained within the Immunization resource as appropriate. Feedback on this approach is welcome.

11.7.3 References to this Resource

11.7.4 Resource Content

Structure

Name Flags Card. Type Description & Constraints      Filter: Filters doco
. . Immunization TU DomainResource Immunization event information

Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier 0..* Identifier Business identifier

. . . basedOn Σ 0..* Reference ( CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation ) Authority that the immunization event is based on

. . . status ?! Σ 1..1 code completed | entered-in-error | not-done
Binding: Immunization Status Codes ( Required )
. . . statusReason 0..1 CodeableConcept Reason for current status
Binding: Immunization Status Reason Codes ( Example )
. . . vaccineCode Σ 1..1 CodeableConcept Vaccine administered
Binding: Vaccine Administered Value Set ( Example )
. . . administeredProduct 0..1 CodeableReference ( Medication ) Product that was administered
. . . manufacturer 0..1 CodeableReference ( Organization ) Vaccine manufacturer
. . . lotNumber 0..1 string Vaccine lot number
. . . expirationDate 0..1 date Vaccine expiration date
. . . patient Σ 1..1 Reference ( Patient ) Who was immunized
. . . encounter 0..1 Reference ( Encounter ) Encounter immunization was part of
. . . supportingInformation 0..* Reference ( Any ) Additional information in support of the immunization

. . . occurrence[x] Σ 1..1 Vaccine administration date
. . . . occurrenceDateTime dateTime
. . . . occurrenceString string
. . . primarySource Σ 0..1 boolean Indicates context the data was captured in
. . . informationSource 0..1 CodeableReference ( Patient | Practitioner | PractitionerRole | RelatedPerson | Organization ) Indicates the source of a reported record
Binding: Immunization Origin Codes ( Example )
. . . location 0..1 Reference ( Location ) The service delivery location
. . . site 0..1 CodeableConcept Body site vaccine was administered
Binding: Codes for Immunization Site of Administration ( Example )
. . . route 0..1 CodeableConcept How vaccine entered body
Binding: Immunization Route Codes ( Example )
. . . doseQuantity 0..1 SimpleQuantity Amount of vaccine administered
. . . performer Σ 0..* BackboneElement Who performed event

. . . . function Σ 0..1 CodeableConcept Type of performance
Binding: Immunization Function Codes ( Extensible )
. . . . actor Σ 1..1 Reference ( Practitioner | PractitionerRole | Organization | Patient | RelatedPerson ) Individual or organization who was performing performed the event
. . . note Σ 0..* Annotation Additional immunization notes

. . . reason 0..* CodeableReference ( Condition | Observation | DiagnosticReport ) Why immunization occurred
Binding: Immunization Reason Codes ( Example )

. . . isSubpotent ?! Σ 0..1 boolean Dose potency
. . . subpotentReason 0..* CodeableConcept Reason for being subpotent
Binding: Immunization Subpotent Reason icon ( Example )

. . . programEligibility 0..* BackboneElement Patient eligibility for a specific vaccination program

. . . . program 1..1 CodeableConcept The program that eligibility is declared for
Binding: Vaccine Funding Programs ( Example )
. . . . programStatus 1..1 CodeableConcept The patient's eligibility status for the program
Binding: Immunization Program Eligibility icon ( Example )
. . . fundingSource 0..1 CodeableConcept Funding source for the vaccine
Binding: Immunization Funding Source icon ( Example )
. . . reaction 0..* BackboneElement Details of a reaction that follows followed the immunization

. . . . date 0..1 dateTime When reaction started
. . . . manifestation 0..1 CodeableReference ( Observation ) Additional information on reaction
. . . . reported 0..1 boolean Indicates self-reported reaction
. . . protocolApplied 0..* BackboneElement Protocol followed by the provider

. . . . series 0..1 string Name of vaccine series
. . . . authority 0..1 Reference ( Organization ) Who is responsible for publishing the recommendations
. . . . targetDisease 0..* CodeableConcept Vaccine preventatable preventable disease being targeted
Binding: Immunization Target Disease Codes ( Example )

. . . . doseNumber 0..1 CodeableConcept Dose number within series
Binding: DoseNumber ( Example )
. . . . seriesDoses 0..1 CodeableConcept Recommended number of doses for immunity
Binding: SeriesDoses ( Example )

doco Documentation for this format icon

See the Extensions for this resource

UML Diagram ( Legend )

Immunization ( DomainResource ) A unique identifier assigned to this immunization record identifier : Identifier [0..*] A plan, order or recommendation fulfilled in whole or in part by this immunization basedOn : Reference [0..*] « CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation » Indicates the current status of the immunization event (this element modifies the meaning of other elements) status : code [1..1] « A set of codes indicating the current status of an Immunization. (Strength=Required) ImmunizationStatusCodes ! » Indicates the reason the immunization event was not performed statusReason : CodeableConcept [0..1] « The reason why a vaccine was not administered. (Strength=Example) ImmunizationStatusReasonCodes ?? » Vaccine that was administered or was to be administered vaccineCode : CodeableConcept [1..1] « The code for vaccine product administered. (Strength=Example) VaccineAdministeredValueSet ?? » An indication of which product was administered to the patient. This is typically a more detailed representation of the concept conveyed by the vaccineCode data element. If a Medication resource is referenced, it may be to a stand-alone resource or a contained resource within the Immunization resource administeredProduct : CodeableReference [0..1] « Medication » Name of vaccine manufacturer manufacturer : CodeableReference [0..1] « Organization » Lot number of the vaccine product lotNumber : string [0..1] Date vaccine batch expires expirationDate : date [0..1] The patient who either received or did not receive the immunization patient : Reference [1..1] « Patient » The visit or admission or other contact between patient and health care provider the immunization was performed as part of encounter : Reference [0..1] « Encounter » 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 supportingInformation : Reference [0..*] « Any » Date vaccine administered or was to be administered occurrence[x] : PrimitiveType [1..1] « dateTime | string » 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 primarySource : boolean [0..1] 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 informationSource : CodeableReference [0..1] « Patient | Practitioner | PractitionerRole | RelatedPerson | Organization ; The source of the data for a record which is not from a primary source. (Strength=Example) ImmunizationOriginCodes ?? » The service delivery location where the vaccine administration occurred location : Reference [0..1] « Location » Body site where vaccine was administered site : CodeableConcept [0..1] « The site at which the vaccine was administered. (Strength=Example) CodesForImmunizationSiteOfAdm... ?? » The path by which the vaccine product is taken into the body route : CodeableConcept [0..1] « The route by which the vaccine was administered. (Strength=Example) ImmunizationRouteCodes ?? » The quantity of vaccine product that was administered doseQuantity : Quantity ( SimpleQuantity ) [0..1] Extra information about the immunization that is not conveyed by the other attributes note : Annotation [0..*] Describes why the immunization occurred in coded or textual form, or Indicates indicates another resource (Condition, Observation or DiagnosticReport) whose existence justifies this immunization reason : CodeableReference [0..*] « Condition | Observation | DiagnosticReport ; The reason why a vaccine was administered. (Strength=Example) ImmunizationReasonCodes ?? » Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent (this element modifies the meaning of other elements) isSubpotent : boolean [0..1] Reason why a dose is considered to be subpotent subpotentReason : CodeableConcept [0..*] « null (Strength=Example) ImmunizationSubpotentReason ?? » 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 publicly purchased vaccine but due to inventory issues, vaccine purchased with private funds was actually administered) fundingSource : CodeableConcept [0..1] « The source of funding used to purchase the vaccine administered. (Strength=Example) ImmunizationFundingSource ?? » Performer Describes the function played by the performer in the immunization event (e.g. ordering provider, administering provider, etc.) function : CodeableConcept [0..1] « The role a practitioner or organization plays in the immunization event. (Strength=Extensible) ImmunizationFunctionCodes + » The practitioner or organization who performed the action actor : Reference [1..1] « Practitioner | PractitionerRole | Organization | Patient | RelatedPerson » ProgramEligibility Indicates which program the patient had their eligility eligibility evaluated for program : CodeableConcept [1..1] « The vaccation funding program a patient may be eligible for. (Strength=Example) CodesForVaccineFundingPrograms ?? » Indicates the patient's eligility eligibility status for for a specific payment program programStatus : CodeableConcept [1..1] « The patient's eligibility for a vaccation program. (Strength=Example) ImmunizationProgramEligibility ?? » Reaction Date of reaction to the immunization date : dateTime [0..1] Details of the reaction manifestation : CodeableReference [0..1] « Observation » Self-reported indicator reported : boolean [0..1] ProtocolApplied One possible path to achieve presumed immunity against a disease - within the context of an authority series : string [0..1] Indicates the authority who published the protocol (e.g. ACIP) that is being followed authority : Reference [0..1] « Organization » The vaccine preventable disease the dose is being administered against targetDisease : CodeableConcept [0..*] « The vaccine preventable disease the dose is being administered for. (Strength=Example) ImmunizationTargetDiseaseCodes ?? » Nominal position in a series as intended by the practitioner administering the dose doseNumber : CodeableConcept [0..1] « null (Strength=Example) DoseNumber?? » The recommended number of doses to achieve immunity as intended by the practitioner administering the dose seriesDoses : CodeableConcept [0..1] « null (Strength=Example) SeriesDoses?? » Indicates who performed the immunization event performer [0..*] Indicates a patient's eligibility for a funding program programEligibility [0..*] Categorical data indicating that an adverse event is associated in time to an immunization reaction [0..*] The protocol (set of recommendations) being followed by the provider who administered the dose protocolApplied [0..*]

XML Template 

<Immunization xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business identifier --></identifier>
 <|
   </basedOn>

 <basedOn><!-- 0..* Reference(CarePlan|MedicationRequest|ServiceRequest) Authority that the immunization event is based on --></basedOn>

 <status value="[code]"/><!-- 1..1 completed | entered-in-error | not-done -->
 <statusReason><!-- 0..1 CodeableConcept Reason for current status --></statusReason>
 <vaccineCode><!-- 1..1 CodeableConcept Vaccine administered --></vaccineCode>
 <administeredProduct><!-- 0..1 CodeableReference(Medication) Product that was administered --></administeredProduct>
 <manufacturer><!-- 0..1 CodeableReference(Organization) Vaccine manufacturer --></manufacturer>
 <lotNumber value="[string]"/><!-- 0..1 Vaccine lot number -->
 <expirationDate value="[date]"/><!-- 0..1 Vaccine expiration date -->
 <patient><!-- 1..1 Reference(Patient) Who was immunized --></patient>
 <encounter><!-- 0..1 Reference(Encounter) Encounter immunization was part of --></encounter>
 <supportingInformation><!-- 0..* Reference(Any) Additional information in support of the immunization --></supportingInformation>
 <occurrence[x]><!-- 1..1 dateTime|string Vaccine administration date --></occurrence[x]>
 <primarySource value="[boolean]"/><!-- 0..1 Indicates context the data was captured in -->
 <informationSource><!-- 0..1 CodeableReference(Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Indicates the source of a  reported record --></informationSource>
 <location><!-- 0..1 Reference(Location) The service delivery location --></location>
 <site><!-- 0..1 CodeableConcept Body site vaccine  was administered --></site>
 <route><!-- 0..1 CodeableConcept How vaccine entered body --></route>
 <doseQuantity><!-- 0..1 Quantity(SimpleQuantity) Amount of vaccine administered --></doseQuantity>
 <performer>  <!-- 0..* Who performed event -->
  <function><!-- 0..1 CodeableConcept Type of performance --></function>
  <actor><!-- 1..1 Reference(Organization|Patient|Practitioner|PractitionerRole|
    </actor>

    RelatedPerson) Individual or organization who performed the event --></actor>
 </performer>
 <note><!-- 0..* Annotation Additional immunization notes --></note>
 <</reason>

 <reason><!-- 0..* CodeableReference(Condition|DiagnosticReport|Observation) Why immunization occurred --></reason>

 <isSubpotent value="[boolean]"/><!-- 0..1 Dose potency -->
 <</subpotentReason>

 <subpotentReason><!-- 0..* CodeableConcept Reason for being subpotent icon --></subpotentReason>

 <programEligibility>  <!-- 0..* Patient eligibility for a specific vaccination program -->
  <</program>
  <</programStatus>

  <program><!-- 1..1 CodeableConcept The program that eligibility is declared for --></program>
  <programStatus><!-- 1..1 CodeableConcept The patient's eligibility status for the program icon --></programStatus>

 </programEligibility>
 <</fundingSource>
 <

 <fundingSource><!-- 0..1 CodeableConcept Funding source for the vaccine icon --></fundingSource>
 <reaction>  <!-- 0..* Details of a reaction that followed the immunization -->

  <date value="[dateTime]"/><!-- 0..1 When reaction started -->
  <manifestation><!-- 0..1 CodeableReference(Observation) Additional information on reaction --></manifestation>
  <reported value="[boolean]"/><!-- 0..1 Indicates self-reported reaction -->
 </reaction>
 <protocolApplied>  <!-- 0..* Protocol followed by the provider -->
  <series value="[string]"/><!-- 0..1 Name of vaccine series -->
  <authority><!-- 0..1 Reference(Organization) Who is responsible for publishing the recommendations --></authority>
  <</targetDisease>

  <targetDisease><!-- 0..* CodeableConcept Vaccine preventable disease being targeted --></targetDisease>

  <doseNumber><!-- 0..1 CodeableConcept Dose number within series --></doseNumber>
  <seriesDoses><!-- 0..1 CodeableConcept Recommended number of doses for immunity --></seriesDoses>
 </protocolApplied>
</Immunization>

JSON Template 

{doco
  "resourceType" : "Immunization",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business identifier
  "|
   

  "basedOn" : [{ Reference(CarePlan|MedicationRequest|ServiceRequest) }], // Authority that the immunization event is based on

  "status" : "<code>", // R!  completed | entered-in-error | not-done
  "statusReason" : { CodeableConcept }, // Reason for current status
  "vaccineCode" : { CodeableConcept }, // R!  Vaccine administered
  "administeredProduct" : { CodeableReference(Medication) }, // Product that was administered
  "manufacturer" : { CodeableReference(Organization) }, // Vaccine manufacturer
  "lotNumber" : "<string>", // Vaccine lot number
  "expirationDate" : "<date>", // Vaccine expiration date
  "patient" : { Reference(Patient) }, // R!  Who was immunized
  "encounter" : { Reference(Encounter) }, // Encounter immunization was part of
  "supportingInformation" : [{ Reference(Any) }], // Additional information in support of the immunization
  // occurrence[x]: Vaccine administration date. One of these 2:
  "occurrenceDateTime" : "<dateTime>",
  "occurrenceString" : "<string>",
  "primarySource" : <boolean>, // Indicates context the data was captured in
  "informationSource" : { CodeableReference(Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }, // Indicates the source of a  reported record
  "location" : { Reference(Location) }, // The service delivery location
  "site" : { CodeableConcept }, // Body site vaccine  was administered
  "route" : { CodeableConcept }, // How vaccine entered body
  "doseQuantity" : { Quantity(SimpleQuantity) }, // Amount of vaccine administered
  "performer" : [{ // Who performed event
    "function" : { CodeableConcept }, // Type of performance
    "actor" : { Reference(Organization|Patient|Practitioner|PractitionerRole|
    

    RelatedPerson) } // R!  Individual or organization who performed the event
  }],
  "note" : [{ Annotation }], // Additional immunization notes
  "

  "reason" : [{ CodeableReference(Condition|DiagnosticReport|Observation) }], // Why immunization occurred

  "isSubpotent" : <boolean>, // Dose potency
  "

  "subpotentReason" : [{ CodeableConcept }], // Reason for being subpotent icon

  "programEligibility" : [{ // Patient eligibility for a specific vaccination program
    "
    "

    "program" : { CodeableConcept }, // R!  The program that eligibility is declared for
    "programStatus" : { CodeableConcept } // R!  The patient's eligibility status for the program icon

  }],
  "
  "

  "fundingSource" : { CodeableConcept }, // Funding source for the vaccine icon
  "reaction" : [{ // Details of a reaction that followed the immunization

    "date" : "<dateTime>", // When reaction started
    "manifestation" : { CodeableReference(Observation) }, // Additional information on reaction
    "reported" : <boolean> // Indicates self-reported reaction
  }],
  "protocolApplied" : [{ // Protocol followed by the provider
    "series" : "<string>", // Name of vaccine series
    "authority" : { Reference(Organization) }, // Who is responsible for publishing the recommendations
    "

    "targetDisease" : [{ CodeableConcept }], // Vaccine preventable disease being targeted

    "doseNumber" : { CodeableConcept }, // Dose number within series
    "seriesDoses" : { CodeableConcept } // Recommended number of doses for immunity
  }]
}

Turtle Template 

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Immunization;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from 
  # from 

  # from Resource: fhir:id, fhir:meta, fhir:implicitRules, and fhir:language
  # from DomainResource: fhir:text, fhir:contained, fhir:extension, and fhir:modifierExtension

  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Business identifier
  fhir:

  fhir:basedOn  ( [ Reference(CarePlan|MedicationRequest|ServiceRequest) ] ... ) ; # 0..* Authority that the immunization event is based on

  fhir:status [ code ] ; # 1..1 completed | entered-in-error | not-done
  fhir:statusReason [ CodeableConcept ] ; # 0..1 Reason for current status
  fhir:vaccineCode [ CodeableConcept ] ; # 1..1 Vaccine administered
  fhir:administeredProduct [ CodeableReference(Medication) ] ; # 0..1 Product that was administered
  fhir:manufacturer [ CodeableReference(Organization) ] ; # 0..1 Vaccine manufacturer
  fhir:lotNumber [ string ] ; # 0..1 Vaccine lot number
  fhir:expirationDate [ date ] ; # 0..1 Vaccine expiration date
  fhir:patient [ Reference(Patient) ] ; # 1..1 Who was immunized
  fhir:encounter [ Reference(Encounter) ] ; # 0..1 Encounter immunization was part of
  fhir:supportingInformation  ( [ Reference(Any) ] ... ) ; # 0..* Additional information in support of the immunization
  # occurrence[x] : 1..1 Vaccine administration date. One of these 2
    fhir: ]
    fhir: ]

    fhir:occurrence [  a fhir:DateTime ; dateTime ]
    fhir:occurrence [  a fhir:String ; string ]

  fhir:primarySource [ boolean ] ; # 0..1 Indicates context the data was captured in
  fhir:informationSource [ CodeableReference(Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 Indicates the source of a  reported record
  fhir:location [ Reference(Location) ] ; # 0..1 The service delivery location
  fhir:site [ CodeableConcept ] ; # 0..1 Body site vaccine  was administered
  fhir:route [ CodeableConcept ] ; # 0..1 How vaccine entered body
  fhir:doseQuantity [ Quantity(SimpleQuantity) ] ; # 0..1 Amount of vaccine administered
  fhir:performer ( [ # 0..* Who performed event
    fhir:function [ CodeableConcept ] ; # 0..1 Type of performance
    fhir:

    fhir:actor [ Reference(Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 1..1 Individual or organization who performed the event

  ] ... ) ;
  fhir:note  ( [ Annotation ] ... ) ; # 0..* Additional immunization notes
  fhir:

  fhir:reason  ( [ CodeableReference(Condition|DiagnosticReport|Observation) ] ... ) ; # 0..* Why immunization occurred

  fhir:isSubpotent [ boolean ] ; # 0..1 Dose potency
  fhir:subpotentReason  ( [ CodeableConcept ] ... ) ; # 0..* Reason for being subpotent
  fhir:programEligibility ( [ # 0..* Patient eligibility for a specific vaccination program
    fhir:
    fhir:

    fhir:program [ CodeableConcept ] ; # 1..1 The program that eligibility is declared for
    fhir:programStatus [ CodeableConcept ] ; # 1..1 The patient's eligibility status for the program

  ] ... ) ;
  fhir:
  fhir:

  fhir:fundingSource [ CodeableConcept ] ; # 0..1 Funding source for the vaccine
  fhir:reaction ( [ # 0..* Details of a reaction that followed the immunization

    fhir:date [ dateTime ] ; # 0..1 When reaction started
    fhir:manifestation [ CodeableReference(Observation) ] ; # 0..1 Additional information on reaction
    fhir:reported [ boolean ] ; # 0..1 Indicates self-reported reaction
  ] ... ) ;
  fhir:protocolApplied ( [ # 0..* Protocol followed by the provider
    fhir:series [ string ] ; # 0..1 Name of vaccine series
    fhir:authority [ Reference(Organization) ] ; # 0..1 Who is responsible for publishing the recommendations
    fhir:

    fhir:targetDisease  ( [ CodeableConcept ] ... ) ; # 0..* Vaccine preventable disease being targeted

    fhir:doseNumber [ CodeableConcept ] ; # 0..1 Dose number within series
    fhir:seriesDoses [ CodeableConcept ] ; # 0..1 Recommended number of doses for immunity
  ] ... ) ;
]

Changes from both R4 and R4B

Immunization
Immunization.basedOn
  • Added Element
Immunization.administeredProduct
  • Added Element
Immunization.manufacturer
  • Type changed from Reference(Organization) to CodeableReference
Immunization.supportingInformation
  • Added Element
Immunization.informationSource
  • Added Element
Immunization.performer.actor
  • Type Reference: Added Target Types Patient, RelatedPerson
Immunization.reason
  • Added Element
Immunization.programEligibility
  • Type changed from CodeableConcept to BackboneElement
Immunization.programEligibility.program
  • Added Mandatory Element
Immunization.programEligibility.programStatus
  • Added Mandatory Element
Immunization.reaction.manifestation
  • Added Element
Immunization.protocolApplied.doseNumber
  • Renamed from doseNumber[x] to doseNumber
  • Min Cardinality changed from 1 to 0
  • Add Type CodeableConcept
  • Remove Types positiveInt, string
Immunization.protocolApplied.seriesDoses
  • Renamed from seriesDoses[x] to seriesDoses
  • Add Type CodeableConcept
  • Remove Types positiveInt, string
Immunization.recorded
  • Deleted
Immunization.reportOrigin
  • Deleted
Immunization.reasonCode
  • Deleted (-> reason)
Immunization.reasonReference
  • Deleted (-> reason)
Immunization.education
  • Deleted
Immunization.reaction.detail
  • Deleted

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON .

Structure

Name Flags Card. Type Description & Constraints      Filter: Filters doco
. . Immunization TU DomainResource Immunization event information

Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier 0..* Identifier Business identifier

. . . basedOn Σ 0..* Reference ( CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation ) Authority that the immunization event is based on

. . . status ?! Σ 1..1 code completed | entered-in-error | not-done
Binding: Immunization Status Codes ( Required )
. . . statusReason 0..1 CodeableConcept Reason for current status
Binding: Immunization Status Reason Codes ( Example )
. . . vaccineCode Σ 1..1 CodeableConcept Vaccine administered
Binding: Vaccine Administered Value Set ( Example )
. . . administeredProduct 0..1 CodeableReference ( Medication ) Product that was administered
. . . manufacturer 0..1 CodeableReference ( Organization ) Vaccine manufacturer
. . . lotNumber 0..1 string Vaccine lot number
. . . expirationDate 0..1 date Vaccine expiration date
. . . patient Σ 1..1 Reference ( Patient ) Who was immunized
. . . encounter 0..1 Reference ( Encounter ) Encounter immunization was part of
. . . supportingInformation 0..* Reference ( Any ) Additional information in support of the immunization

. . . occurrence[x] Σ 1..1 Vaccine administration date
. . . . occurrenceDateTime dateTime
. . . . occurrenceString string
. . . primarySource Σ 0..1 boolean Indicates context the data was captured in
. . . informationSource 0..1 CodeableReference ( Patient | Practitioner | PractitionerRole | RelatedPerson | Organization ) Indicates the source of a reported record
Binding: Immunization Origin Codes ( Example )
. . . location 0..1 Reference ( Location ) The service delivery location
. . . site 0..1 CodeableConcept Body site vaccine was administered
Binding: Codes for Immunization Site of Administration ( Example )
. . . route 0..1 CodeableConcept How vaccine entered body
Binding: Immunization Route Codes ( Example )
. . . doseQuantity 0..1 SimpleQuantity Amount of vaccine administered
. . . performer Σ 0..* BackboneElement Who performed event

. . . . function Σ 0..1 CodeableConcept Type of performance
Binding: Immunization Function Codes ( Extensible )
. . . . actor Σ 1..1 Reference ( Practitioner | PractitionerRole | Organization | Patient | RelatedPerson ) Individual or organization who was performing performed the event
. . . note Σ 0..* Annotation Additional immunization notes

. . . reason 0..* CodeableReference ( Condition | Observation | DiagnosticReport ) Why immunization occurred
Binding: Immunization Reason Codes ( Example )

. . . isSubpotent ?! Σ 0..1 boolean Dose potency
. . . subpotentReason 0..* CodeableConcept Reason for being subpotent
Binding: Immunization Subpotent Reason icon ( Example )

. . . programEligibility 0..* BackboneElement Patient eligibility for a specific vaccination program

. . . . program 1..1 CodeableConcept The program that eligibility is declared for
Binding: Vaccine Funding Programs ( Example )
. . . . programStatus 1..1 CodeableConcept The patient's eligibility status for the program
Binding: Immunization Program Eligibility icon ( Example )
. . . fundingSource 0..1 CodeableConcept Funding source for the vaccine
Binding: Immunization Funding Source icon ( Example )
. . . reaction 0..* BackboneElement Details of a reaction that follows followed the immunization

. . . . date 0..1 dateTime When reaction started
. . . . manifestation 0..1 CodeableReference ( Observation ) Additional information on reaction
. . . . reported 0..1 boolean Indicates self-reported reaction
. . . protocolApplied 0..* BackboneElement Protocol followed by the provider

. . . . series 0..1 string Name of vaccine series
. . . . authority 0..1 Reference ( Organization ) Who is responsible for publishing the recommendations
. . . . targetDisease 0..* CodeableConcept Vaccine preventatable preventable disease being targeted
Binding: Immunization Target Disease Codes ( Example )

. . . . doseNumber 0..1 CodeableConcept Dose number within series
Binding: DoseNumber ( Example )
. . . . seriesDoses 0..1 CodeableConcept Recommended number of doses for immunity
Binding: SeriesDoses ( Example )

doco Documentation for this format icon

See the Extensions for this resource

UML Diagram ( Legend )

Immunization ( DomainResource ) A unique identifier assigned to this immunization record identifier : Identifier [0..*] A plan, order or recommendation fulfilled in whole or in part by this immunization basedOn : Reference [0..*] « CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation » Indicates the current status of the immunization event (this element modifies the meaning of other elements) status : code [1..1] « A set of codes indicating the current status of an Immunization. (Strength=Required) ImmunizationStatusCodes ! » Indicates the reason the immunization event was not performed statusReason : CodeableConcept [0..1] « The reason why a vaccine was not administered. (Strength=Example) ImmunizationStatusReasonCodes ?? » Vaccine that was administered or was to be administered vaccineCode : CodeableConcept [1..1] « The code for vaccine product administered. (Strength=Example) VaccineAdministeredValueSet ?? » An indication of which product was administered to the patient. This is typically a more detailed representation of the concept conveyed by the vaccineCode data element. If a Medication resource is referenced, it may be to a stand-alone resource or a contained resource within the Immunization resource administeredProduct : CodeableReference [0..1] « Medication » Name of vaccine manufacturer manufacturer : CodeableReference [0..1] « Organization » Lot number of the vaccine product lotNumber : string [0..1] Date vaccine batch expires expirationDate : date [0..1] The patient who either received or did not receive the immunization patient : Reference [1..1] « Patient » The visit or admission or other contact between patient and health care provider the immunization was performed as part of encounter : Reference [0..1] « Encounter » 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 supportingInformation : Reference [0..*] « Any » Date vaccine administered or was to be administered occurrence[x] : PrimitiveType [1..1] « dateTime | string » 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 primarySource : boolean [0..1] 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 informationSource : CodeableReference [0..1] « Patient | Practitioner | PractitionerRole | RelatedPerson | Organization ; The source of the data for a record which is not from a primary source. (Strength=Example) ImmunizationOriginCodes ?? » The service delivery location where the vaccine administration occurred location : Reference [0..1] « Location » Body site where vaccine was administered site : CodeableConcept [0..1] « The site at which the vaccine was administered. (Strength=Example) CodesForImmunizationSiteOfAdm... ?? » The path by which the vaccine product is taken into the body route : CodeableConcept [0..1] « The route by which the vaccine was administered. (Strength=Example) ImmunizationRouteCodes ?? » The quantity of vaccine product that was administered doseQuantity : Quantity ( SimpleQuantity ) [0..1] Extra information about the immunization that is not conveyed by the other attributes note : Annotation [0..*] Describes why the immunization occurred in coded or textual form, or Indicates indicates another resource (Condition, Observation or DiagnosticReport) whose existence justifies this immunization reason : CodeableReference [0..*] « Condition | Observation | DiagnosticReport ; The reason why a vaccine was administered. (Strength=Example) ImmunizationReasonCodes ?? » Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent (this element modifies the meaning of other elements) isSubpotent : boolean [0..1] Reason why a dose is considered to be subpotent subpotentReason : CodeableConcept [0..*] « null (Strength=Example) ImmunizationSubpotentReason ?? » 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 publicly purchased vaccine but due to inventory issues, vaccine purchased with private funds was actually administered) fundingSource : CodeableConcept [0..1] « The source of funding used to purchase the vaccine administered. (Strength=Example) ImmunizationFundingSource ?? » Performer Describes the function played by the performer in the immunization event (e.g. ordering provider, administering provider, etc.) function : CodeableConcept [0..1] « The role a practitioner or organization plays in the immunization event. (Strength=Extensible) ImmunizationFunctionCodes + » The practitioner or organization who performed the action actor : Reference [1..1] « Practitioner | PractitionerRole | Organization | Patient | RelatedPerson » ProgramEligibility Indicates which program the patient had their eligility eligibility evaluated for program : CodeableConcept [1..1] « The vaccation funding program a patient may be eligible for. (Strength=Example) CodesForVaccineFundingPrograms ?? » Indicates the patient's eligility eligibility status for for a specific payment program programStatus : CodeableConcept [1..1] « The patient's eligibility for a vaccation program. (Strength=Example) ImmunizationProgramEligibility ?? » Reaction Date of reaction to the immunization date : dateTime [0..1] Details of the reaction manifestation : CodeableReference [0..1] « Observation » Self-reported indicator reported : boolean [0..1] ProtocolApplied One possible path to achieve presumed immunity against a disease - within the context of an authority series : string [0..1] Indicates the authority who published the protocol (e.g. ACIP) that is being followed authority : Reference [0..1] « Organization » The vaccine preventable disease the dose is being administered against targetDisease : CodeableConcept [0..*] « The vaccine preventable disease the dose is being administered for. (Strength=Example) ImmunizationTargetDiseaseCodes ?? » Nominal position in a series as intended by the practitioner administering the dose doseNumber : CodeableConcept [0..1] « null (Strength=Example) DoseNumber?? » The recommended number of doses to achieve immunity as intended by the practitioner administering the dose seriesDoses : CodeableConcept [0..1] « null (Strength=Example) SeriesDoses?? » Indicates who performed the immunization event performer [0..*] Indicates a patient's eligibility for a funding program programEligibility [0..*] Categorical data indicating that an adverse event is associated in time to an immunization reaction [0..*] The protocol (set of recommendations) being followed by the provider who administered the dose protocolApplied [0..*]

XML Template 

<Immunization xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business identifier --></identifier>
 <|
   </basedOn>

 <basedOn><!-- 0..* Reference(CarePlan|MedicationRequest|ServiceRequest) Authority that the immunization event is based on --></basedOn>

 <status value="[code]"/><!-- 1..1 completed | entered-in-error | not-done -->
 <statusReason><!-- 0..1 CodeableConcept Reason for current status --></statusReason>
 <vaccineCode><!-- 1..1 CodeableConcept Vaccine administered --></vaccineCode>
 <administeredProduct><!-- 0..1 CodeableReference(Medication) Product that was administered --></administeredProduct>
 <manufacturer><!-- 0..1 CodeableReference(Organization) Vaccine manufacturer --></manufacturer>
 <lotNumber value="[string]"/><!-- 0..1 Vaccine lot number -->
 <expirationDate value="[date]"/><!-- 0..1 Vaccine expiration date -->
 <patient><!-- 1..1 Reference(Patient) Who was immunized --></patient>
 <encounter><!-- 0..1 Reference(Encounter) Encounter immunization was part of --></encounter>
 <supportingInformation><!-- 0..* Reference(Any) Additional information in support of the immunization --></supportingInformation>
 <occurrence[x]><!-- 1..1 dateTime|string Vaccine administration date --></occurrence[x]>
 <primarySource value="[boolean]"/><!-- 0..1 Indicates context the data was captured in -->
 <informationSource><!-- 0..1 CodeableReference(Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Indicates the source of a  reported record --></informationSource>
 <location><!-- 0..1 Reference(Location) The service delivery location --></location>
 <site><!-- 0..1 CodeableConcept Body site vaccine  was administered --></site>
 <route><!-- 0..1 CodeableConcept How vaccine entered body --></route>
 <doseQuantity><!-- 0..1 Quantity(SimpleQuantity) Amount of vaccine administered --></doseQuantity>
 <performer>  <!-- 0..* Who performed event -->
  <function><!-- 0..1 CodeableConcept Type of performance --></function>
  <actor><!-- 1..1 Reference(Organization|Patient|Practitioner|PractitionerRole|
    </actor>

    RelatedPerson) Individual or organization who performed the event --></actor>
 </performer>
 <note><!-- 0..* Annotation Additional immunization notes --></note>
 <</reason>

 <reason><!-- 0..* CodeableReference(Condition|DiagnosticReport|Observation) Why immunization occurred --></reason>

 <isSubpotent value="[boolean]"/><!-- 0..1 Dose potency -->
 <</subpotentReason>

 <subpotentReason><!-- 0..* CodeableConcept Reason for being subpotent icon --></subpotentReason>

 <programEligibility>  <!-- 0..* Patient eligibility for a specific vaccination program -->
  <</program>
  <</programStatus>

  <program><!-- 1..1 CodeableConcept The program that eligibility is declared for --></program>
  <programStatus><!-- 1..1 CodeableConcept The patient's eligibility status for the program icon --></programStatus>

 </programEligibility>
 <</fundingSource>
 <

 <fundingSource><!-- 0..1 CodeableConcept Funding source for the vaccine icon --></fundingSource>
 <reaction>  <!-- 0..* Details of a reaction that followed the immunization -->

  <date value="[dateTime]"/><!-- 0..1 When reaction started -->
  <manifestation><!-- 0..1 CodeableReference(Observation) Additional information on reaction --></manifestation>
  <reported value="[boolean]"/><!-- 0..1 Indicates self-reported reaction -->
 </reaction>
 <protocolApplied>  <!-- 0..* Protocol followed by the provider -->
  <series value="[string]"/><!-- 0..1 Name of vaccine series -->
  <authority><!-- 0..1 Reference(Organization) Who is responsible for publishing the recommendations --></authority>
  <</targetDisease>

  <targetDisease><!-- 0..* CodeableConcept Vaccine preventable disease being targeted --></targetDisease>

  <doseNumber><!-- 0..1 CodeableConcept Dose number within series --></doseNumber>
  <seriesDoses><!-- 0..1 CodeableConcept Recommended number of doses for immunity --></seriesDoses>
 </protocolApplied>
</Immunization>

JSON Template 

{doco
  "resourceType" : "Immunization",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business identifier
  "|
   

  "basedOn" : [{ Reference(CarePlan|MedicationRequest|ServiceRequest) }], // Authority that the immunization event is based on

  "status" : "<code>", // R!  completed | entered-in-error | not-done
  "statusReason" : { CodeableConcept }, // Reason for current status
  "vaccineCode" : { CodeableConcept }, // R!  Vaccine administered
  "administeredProduct" : { CodeableReference(Medication) }, // Product that was administered
  "manufacturer" : { CodeableReference(Organization) }, // Vaccine manufacturer
  "lotNumber" : "<string>", // Vaccine lot number
  "expirationDate" : "<date>", // Vaccine expiration date
  "patient" : { Reference(Patient) }, // R!  Who was immunized
  "encounter" : { Reference(Encounter) }, // Encounter immunization was part of
  "supportingInformation" : [{ Reference(Any) }], // Additional information in support of the immunization
  // occurrence[x]: Vaccine administration date. One of these 2:
  "occurrenceDateTime" : "<dateTime>",
  "occurrenceString" : "<string>",
  "primarySource" : <boolean>, // Indicates context the data was captured in
  "informationSource" : { CodeableReference(Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }, // Indicates the source of a  reported record
  "location" : { Reference(Location) }, // The service delivery location
  "site" : { CodeableConcept }, // Body site vaccine  was administered
  "route" : { CodeableConcept }, // How vaccine entered body
  "doseQuantity" : { Quantity(SimpleQuantity) }, // Amount of vaccine administered
  "performer" : [{ // Who performed event
    "function" : { CodeableConcept }, // Type of performance
    "actor" : { Reference(Organization|Patient|Practitioner|PractitionerRole|
    

    RelatedPerson) } // R!  Individual or organization who performed the event
  }],
  "note" : [{ Annotation }], // Additional immunization notes
  "

  "reason" : [{ CodeableReference(Condition|DiagnosticReport|Observation) }], // Why immunization occurred

  "isSubpotent" : <boolean>, // Dose potency
  "

  "subpotentReason" : [{ CodeableConcept }], // Reason for being subpotent icon

  "programEligibility" : [{ // Patient eligibility for a specific vaccination program
    "
    "

    "program" : { CodeableConcept }, // R!  The program that eligibility is declared for
    "programStatus" : { CodeableConcept } // R!  The patient's eligibility status for the program icon

  }],
  "
  "

  "fundingSource" : { CodeableConcept }, // Funding source for the vaccine icon
  "reaction" : [{ // Details of a reaction that followed the immunization

    "date" : "<dateTime>", // When reaction started
    "manifestation" : { CodeableReference(Observation) }, // Additional information on reaction
    "reported" : <boolean> // Indicates self-reported reaction
  }],
  "protocolApplied" : [{ // Protocol followed by the provider
    "series" : "<string>", // Name of vaccine series
    "authority" : { Reference(Organization) }, // Who is responsible for publishing the recommendations
    "

    "targetDisease" : [{ CodeableConcept }], // Vaccine preventable disease being targeted

    "doseNumber" : { CodeableConcept }, // Dose number within series
    "seriesDoses" : { CodeableConcept } // Recommended number of doses for immunity
  }]
}

Turtle Template 

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Immunization;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from 
  # from 

  # from Resource: fhir:id, fhir:meta, fhir:implicitRules, and fhir:language
  # from DomainResource: fhir:text, fhir:contained, fhir:extension, and fhir:modifierExtension

  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Business identifier
  fhir:

  fhir:basedOn  ( [ Reference(CarePlan|MedicationRequest|ServiceRequest) ] ... ) ; # 0..* Authority that the immunization event is based on

  fhir:status [ code ] ; # 1..1 completed | entered-in-error | not-done
  fhir:statusReason [ CodeableConcept ] ; # 0..1 Reason for current status
  fhir:vaccineCode [ CodeableConcept ] ; # 1..1 Vaccine administered
  fhir:administeredProduct [ CodeableReference(Medication) ] ; # 0..1 Product that was administered
  fhir:manufacturer [ CodeableReference(Organization) ] ; # 0..1 Vaccine manufacturer
  fhir:lotNumber [ string ] ; # 0..1 Vaccine lot number
  fhir:expirationDate [ date ] ; # 0..1 Vaccine expiration date
  fhir:patient [ Reference(Patient) ] ; # 1..1 Who was immunized
  fhir:encounter [ Reference(Encounter) ] ; # 0..1 Encounter immunization was part of
  fhir:supportingInformation  ( [ Reference(Any) ] ... ) ; # 0..* Additional information in support of the immunization
  # occurrence[x] : 1..1 Vaccine administration date. One of these 2
    fhir: ]
    fhir: ]

    fhir:occurrence [  a fhir:DateTime ; dateTime ]
    fhir:occurrence [  a fhir:String ; string ]

  fhir:primarySource [ boolean ] ; # 0..1 Indicates context the data was captured in
  fhir:informationSource [ CodeableReference(Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 Indicates the source of a  reported record
  fhir:location [ Reference(Location) ] ; # 0..1 The service delivery location
  fhir:site [ CodeableConcept ] ; # 0..1 Body site vaccine  was administered
  fhir:route [ CodeableConcept ] ; # 0..1 How vaccine entered body
  fhir:doseQuantity [ Quantity(SimpleQuantity) ] ; # 0..1 Amount of vaccine administered
  fhir:performer ( [ # 0..* Who performed event
    fhir:function [ CodeableConcept ] ; # 0..1 Type of performance
    fhir:

    fhir:actor [ Reference(Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 1..1 Individual or organization who performed the event

  ] ... ) ;
  fhir:note  ( [ Annotation ] ... ) ; # 0..* Additional immunization notes
  fhir:

  fhir:reason  ( [ CodeableReference(Condition|DiagnosticReport|Observation) ] ... ) ; # 0..* Why immunization occurred

  fhir:isSubpotent [ boolean ] ; # 0..1 Dose potency
  fhir:subpotentReason  ( [ CodeableConcept ] ... ) ; # 0..* Reason for being subpotent
  fhir:programEligibility ( [ # 0..* Patient eligibility for a specific vaccination program
    fhir:
    fhir:

    fhir:program [ CodeableConcept ] ; # 1..1 The program that eligibility is declared for
    fhir:programStatus [ CodeableConcept ] ; # 1..1 The patient's eligibility status for the program

  ] ... ) ;
  fhir:
  fhir:

  fhir:fundingSource [ CodeableConcept ] ; # 0..1 Funding source for the vaccine
  fhir:reaction ( [ # 0..* Details of a reaction that followed the immunization

    fhir:date [ dateTime ] ; # 0..1 When reaction started
    fhir:manifestation [ CodeableReference(Observation) ] ; # 0..1 Additional information on reaction
    fhir:reported [ boolean ] ; # 0..1 Indicates self-reported reaction
  ] ... ) ;
  fhir:protocolApplied ( [ # 0..* Protocol followed by the provider
    fhir:series [ string ] ; # 0..1 Name of vaccine series
    fhir:authority [ Reference(Organization) ] ; # 0..1 Who is responsible for publishing the recommendations
    fhir:

    fhir:targetDisease  ( [ CodeableConcept ] ... ) ; # 0..* Vaccine preventable disease being targeted

    fhir:doseNumber [ CodeableConcept ] ; # 0..1 Dose number within series
    fhir:seriesDoses [ CodeableConcept ] ; # 0..1 Recommended number of doses for immunity
  ] ... ) ;
]

Changes from both R4 and R4B

Immunization
Immunization.basedOn
  • Added Element
Immunization.administeredProduct
  • Added Element
Immunization.manufacturer
  • Type changed from Reference(Organization) to CodeableReference
Immunization.supportingInformation
  • Added Element
Immunization.informationSource
  • Added Element
Immunization.performer.actor
  • Type Reference: Added Target Types Patient, RelatedPerson
Immunization.reason
  • Added Element
Immunization.programEligibility
  • Type changed from CodeableConcept to BackboneElement
Immunization.programEligibility.program
  • Added Mandatory Element
Immunization.programEligibility.programStatus
  • Added Mandatory Element
Immunization.reaction.manifestation
  • Added Element
Immunization.protocolApplied.doseNumber
  • Renamed from doseNumber[x] to doseNumber
  • Min Cardinality changed from 1 to 0
  • Add Type CodeableConcept
  • Remove Types positiveInt, string
Immunization.protocolApplied.seriesDoses
  • Renamed from seriesDoses[x] to seriesDoses
  • Add Type CodeableConcept
  • Remove Types positiveInt, string
Immunization.recorded
  • Deleted
Immunization.reportOrigin
  • Deleted
Immunization.reasonCode
  • Deleted (-> reason)
Immunization.reasonReference
  • Deleted (-> reason)
Immunization.education
  • Deleted
Immunization.reaction.detail
  • Deleted

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON .

 

Additional definitions: Master Definition XML + JSON , XML Schema / Schematron + JSON Schema , ShEx (for Turtle ) + see the extensions , the spreadsheet version & the dependency analysis

11.7.4.1 Terminology Bindings

Path ValueSet Type Documentation
Immunization.status ImmunizationStatusCodes Required

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the current status of the administered dose of vaccine.

Immunization.statusReason ImmunizationStatusReasonCodes Example

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the reason why a dose of vaccine was not administered. This value set is provided as a suggestive example.

Immunization.vaccineCode VaccineAdministeredValueSet Example

This identifies the vaccine substance administered - CVX codes.

Immunization.informationSource ImmunizationOriginCodes Example

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the source of the data when the report of the immunization event is not based on information from the person, entity or organization who administered the vaccine. This value set is provided as a suggestive example.

Immunization.site CodesForImmunizationSiteOfAdministration Example

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the body site where the vaccination occurred. This value set is provided as a suggestive example.

Immunization.route ImmunizationRouteCodes Example

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the administrative routes used during vaccination. This value set is provided as a suggestive example.

Immunization.performer.function ImmunizationFunctionCodes Extensible

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the function a practitioner or organization may play in the immunization event. This value set is provided as a suggestive example.

Immunization.reason ImmunizationReasonCodes Example

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the reason why a dose of vaccine was administered. This value set is provided as a suggestive example.

Immunization.subpotentReason ImmunizationSubpotentReason icon Example

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the reason why a dose is considered to be subpotent. This value set is provided as a suggestive example.

Immunization.programEligibility.program CodesForVaccineFundingPrograms Example

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing programs that a patient may be eligible for to cover vaccine administration costs. This value set is provided as a suggestive example.

Immunization.programEligibility.programStatus ImmunizationProgramEligibility icon Example

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the patient's eligibility for a vaccination program. This value set is provided as a suggestive example.

Immunization.fundingSource ImmunizationFundingSource icon Example

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the source of the vaccine administered. This value set is provided as a suggestive example.

Immunization.protocolApplied.targetDisease ImmunizationTargetDiseaseCodes Example

The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the disease that the dose is being administered against. This value set is provided as a suggestive example and includes SNOMED CT concepts from the 64572001 (Disease) hierarchy.

Immunization.protocolApplied.doseNumber Example
Immunization.protocolApplied.seriesDoses Example

11.7.5 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource , and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Expression In Common
date date Vaccination (non)-Administration Date (Immunization.occurrence.ofType(dateTime)) 25 23 Resources
encounter reference The Encounter this Immunization was part of Immunization.encounter
( Encounter )
identifier token Business identifier Immunization.identifier 64 59 Resources
location reference The service delivery location or facility in which the vaccine was / was to be administered Immunization.location
( Location )
lot-number string Vaccine Lot Number Immunization.lotNumber
manufacturer reference Vaccine Manufacturer Immunization.manufacturer.reference
patient reference The patient for the vaccination record Immunization.patient
( Patient ) 		64 61 Resources
performer reference The practitioner, individual or organization who played a role in the vaccination Immunization.performer.actor
( Practitioner , Organization , Patient , PractitionerRole , RelatedPerson )
reaction reference Additional information on reaction Immunization.reaction.manifestation.reference
reaction-date date When reaction started Immunization.reaction.date
reason-code token Reason why the vaccine was administered Immunization.reason.concept
reason-reference reference Reference to a resource (by instance) Immunization.reason.reference
series string The series being followed by the provider Immunization.protocolApplied.series
status token Immunization event status Immunization.status
status-reason token Reason why the vaccine was not administered Immunization.statusReason
target-disease token The target disease the dose is being administered against Immunization.protocolApplied.targetDisease
vaccine-code token Vaccine Product Administered Immunization.vaccineCode