STU3 Candidate

This page is part of the FHIR Specification (v1.8.0: STU 3 Draft). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

11.7 Resource ImmunizationRecommendation - Content

Public Health and Emergency Response Work Group Maturity Level : 1 Compartments : Patient

A patient's point-in-time immunization and recommendation (i.e. forecasting a patient's immunization eligibility according to a published schedule) with optional supporting justification.

11.7.1 Scope and Usage

The ImmunizationRecommendation resource is intended to cover communication of a specified patient's immunization recommendations and status across all healthcare disciplines in all care settings and all regions.

Additionally, the ImmunizationRecommendation resource is expected to cover key concepts related to the querying of a patient's immunization recommendations and status. This resource - through consultation with the PHER work group - is believed to meet key use cases and information requirements as defined in the existing HL7 v3 POIZ domain and Immunization Domain Analysis Model.

11.7.2 Boundaries and Relationships

This resource references the following resources:

  • Allergy/Intolerance
  • Patient
  • Organization
  • Immunization
  • Observation

One of the considerations for this resource is if it is better for this resource to be a profile of the CarePlan resource, or if it is more appropriate for this to be a separate resource due to the number of immunization profile-specific data elements.

11.7.3 Resource Content

Structure

Name Flags Card. Type Description & Constraints doco
. . ImmunizationRecommendation DomainResource Guidance or advice relating to an immunization
. . . identifier Σ 0..* Identifier Business identifier
. . . patient Σ 1..1 Reference ( Patient ) Who this profile is for
. . . recommendation Σ 1..* BackboneElement Vaccine administration recommendations
. . . . date Σ 1..1 dateTime Date recommendation created
. . . . vaccineCode Σ 1..1 CodeableConcept Vaccine recommendation applies to
Vaccine Administered Value Set ( Example )
. . . . doseNumber Σ 0..1 positiveInt Recommended dose number
. . . . forecastStatus Σ 1..1 CodeableConcept Vaccine administration status
Immunization Recommendation Status Codes ( Example )
. . . . dateCriterion 0..* BackboneElement Dates governing proposed immunization
. . . . . code 1..1 CodeableConcept Type of date
Immunization Recommendation Date Criterion Codes ( Example )
. . . . . value 1..1 dateTime Recommended date
. . . . protocol 0..1 BackboneElement Protocol used by recommendation
. . . . . doseSequence 0..1 positiveInt Dose number within sequence
. . . . . description 0..1 string Protocol details
. . . . . authority 0..1 Reference ( Organization ) Who is responsible for protocol
. . . . . series 0..1 string Name of vaccination series
. . . . supportingImmunization 0..* Reference ( Immunization ) Past immunizations supporting recommendation
. . . . supportingPatientInformation 0..* Reference ( Observation | AllergyIntolerance ) Patient observations supporting recommendation

doco Documentation for this format

UML Diagram ( Legend )

ImmunizationRecommendation ( DomainResource ) A unique identifier assigned to this particular recommendation record identifier : Identifier [0..*] The patient for whom the recommendations are for patient : Reference [1..1] « Patient » Recommendation The date the immunization recommendation was created date : dateTime [1..1] Vaccine that pertains to the recommendation vaccineCode : CodeableConcept [1..1] « The type of vaccine administered (Strength=Example) Vaccine Administered Value Set ?? » This indicates the next recommended dose number (e.g. dose 2 is the next recommended dose) doseNumber : positiveInt [0..1] Vaccine administration status forecastStatus : CodeableConcept [1..1] « The patient's status with respect to a vaccination protocol (Strength=Example) Immunization Recommendation S... ?? » Immunization event history that supports the status and recommendation supportingImmunization : Reference [0..*] « Immunization » Patient Information that supports the status and recommendation. This includes patient observations, adverse reactions and allergy/intolerance information supportingPatientInformation : Reference [0..*] « Observation | AllergyIntolerance » DateCriterion Date classification of recommendation. For example, earliest date to give, latest date to give, etc code : CodeableConcept [1..1] « Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.) (Strength=Example) Immunization Recommendation D... ?? » The date whose meaning is specified by dateCriterion.code value : dateTime [1..1] Protocol Indicates the nominal position in a series of the next dose. This is the recommended dose number as per a specified protocol doseSequence : positiveInt [0..1] Contains the description about the protocol under which the vaccine was administered description : string [0..1] Indicates the authority who published the protocol. For example, ACIP authority : Reference [0..1] « Organization » One possible path to achieve presumed immunity against a disease - within the context of an authority series : string [0..1] Vaccine date recommendations. For example, earliest date to administer, latest date to administer, etc dateCriterion [0..*] Contains information about the protocol under which the vaccine was administered protocol [0..1] Vaccine administration recommendations recommendation [1..*]

XML Template 

<ImmunizationRecommendation 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>
 <patient><!-- 1..1 Reference(Patient) Who this profile is for --></patient>
 <recommendation>  <!-- 1..* Vaccine administration recommendations -->
  <date value="[dateTime]"/><!-- 1..1 Date recommendation created -->
  <vaccineCode><!-- 1..1 CodeableConcept Vaccine recommendation applies to --></vaccineCode>
  <doseNumber value="[positiveInt]"/><!-- 0..1 Recommended dose number -->
  <forecastStatus><!-- 1..1 CodeableConcept Vaccine administration status --></forecastStatus>
  <dateCriterion>  <!-- 0..* Dates governing proposed immunization -->
   <code><!-- 1..1 CodeableConcept Type of date --></code>
   <value value="[dateTime]"/><!-- 1..1 Recommended date -->
  </dateCriterion>
  <protocol>  <!-- 0..1 Protocol used by recommendation -->
   <doseSequence value="[positiveInt]"/><!-- 0..1 Dose number within sequence -->
   <description value="[string]"/><!-- 0..1 Protocol details -->
   <authority><!-- 0..1 Reference(Organization) Who is responsible for protocol --></authority>
   <series value="[string]"/><!-- 0..1 Name of vaccination series -->
  </protocol>
  <supportingImmunization><!-- 0..* Reference(Immunization) Past immunizations supporting recommendation --></supportingImmunization>
  <supportingPatientInformation><!-- 0..* Reference(Observation|
    AllergyIntolerance) Patient observations supporting recommendation --></supportingPatientInformation>
 </recommendation>
</ImmunizationRecommendation>

Turtle Template 

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


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

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:ImmunizationRecommendation.identifier [ Identifier ], ... ; # 0..* Business identifier
  fhir:ImmunizationRecommendation.patient [ Reference(Patient) ]; # 1..1 Who this profile is for
  fhir:ImmunizationRecommendation.recommendation [ # 1..* Vaccine administration recommendations
    fhir:ImmunizationRecommendation.recommendation.date [ dateTime ]; # 1..1 Date recommendation created
    fhir:ImmunizationRecommendation.recommendation.vaccineCode [ CodeableConcept ]; # 1..1 Vaccine recommendation applies to
    fhir:ImmunizationRecommendation.recommendation.doseNumber [ positiveInt ]; # 0..1 Recommended dose number
    fhir:ImmunizationRecommendation.recommendation.forecastStatus [ CodeableConcept ]; # 1..1 Vaccine administration status
    fhir:ImmunizationRecommendation.recommendation.dateCriterion [ # 0..* Dates governing proposed immunization
      fhir:ImmunizationRecommendation.recommendation.dateCriterion.code [ CodeableConcept ]; # 1..1 Type of date
      fhir:ImmunizationRecommendation.recommendation.dateCriterion.value [ dateTime ]; # 1..1 Recommended date
    ], ...;
    fhir:ImmunizationRecommendation.recommendation.protocol [ # 0..1 Protocol used by recommendation
      fhir:ImmunizationRecommendation.recommendation.protocol.doseSequence [ positiveInt ]; # 0..1 Dose number within sequence
      fhir:ImmunizationRecommendation.recommendation.protocol.description [ string ]; # 0..1 Protocol details
      fhir:ImmunizationRecommendation.recommendation.protocol.authority [ Reference(Organization) ]; # 0..1 Who is responsible for protocol
      fhir:ImmunizationRecommendation.recommendation.protocol.series [ string ]; # 0..1 Name of vaccination series
    ];
    fhir:ImmunizationRecommendation.recommendation.supportingImmunization [ Reference(Immunization) ], ... ; # 0..* Past immunizations supporting recommendation
    fhir:ImmunizationRecommendation.recommendation.supportingPatientInformation [ Reference(Observation|AllergyIntolerance) ], ... ; # 0..* Patient observations supporting recommendation
  ], ...;
]

Changes since DSTU2

ImmunizationRecommendation
ImmunizationRecommendation.recommendation.protocol.doseSequence Type changed from integer to positiveInt

See the Full Difference for further information

Structure

Name Flags Card. Type Description & Constraints doco
. . ImmunizationRecommendation DomainResource Guidance or advice relating to an immunization
. . . identifier Σ 0..* Identifier Business identifier
. . . patient Σ 1..1 Reference ( Patient ) Who this profile is for
. . . recommendation Σ 1..* BackboneElement Vaccine administration recommendations
. . . . date Σ 1..1 dateTime Date recommendation created
. . . . vaccineCode Σ 1..1 CodeableConcept Vaccine recommendation applies to
Vaccine Administered Value Set ( Example )
. . . . doseNumber Σ 0..1 positiveInt Recommended dose number
. . . . forecastStatus Σ 1..1 CodeableConcept Vaccine administration status
Immunization Recommendation Status Codes ( Example )
. . . . dateCriterion 0..* BackboneElement Dates governing proposed immunization
. . . . . code 1..1 CodeableConcept Type of date
Immunization Recommendation Date Criterion Codes ( Example )
. . . . . value 1..1 dateTime Recommended date
. . . . protocol 0..1 BackboneElement Protocol used by recommendation
. . . . . doseSequence 0..1 positiveInt Dose number within sequence
. . . . . description 0..1 string Protocol details
. . . . . authority 0..1 Reference ( Organization ) Who is responsible for protocol
. . . . . series 0..1 string Name of vaccination series
. . . . supportingImmunization 0..* Reference ( Immunization ) Past immunizations supporting recommendation
. . . . supportingPatientInformation 0..* Reference ( Observation | AllergyIntolerance ) Patient observations supporting recommendation

doco Documentation for this format

UML Diagram ( Legend )

ImmunizationRecommendation ( DomainResource ) A unique identifier assigned to this particular recommendation record identifier : Identifier [0..*] The patient for whom the recommendations are for patient : Reference [1..1] « Patient » Recommendation The date the immunization recommendation was created date : dateTime [1..1] Vaccine that pertains to the recommendation vaccineCode : CodeableConcept [1..1] « The type of vaccine administered (Strength=Example) Vaccine Administered Value Set ?? » This indicates the next recommended dose number (e.g. dose 2 is the next recommended dose) doseNumber : positiveInt [0..1] Vaccine administration status forecastStatus : CodeableConcept [1..1] « The patient's status with respect to a vaccination protocol (Strength=Example) Immunization Recommendation S... ?? » Immunization event history that supports the status and recommendation supportingImmunization : Reference [0..*] « Immunization » Patient Information that supports the status and recommendation. This includes patient observations, adverse reactions and allergy/intolerance information supportingPatientInformation : Reference [0..*] « Observation | AllergyIntolerance » DateCriterion Date classification of recommendation. For example, earliest date to give, latest date to give, etc code : CodeableConcept [1..1] « Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.) (Strength=Example) Immunization Recommendation D... ?? » The date whose meaning is specified by dateCriterion.code value : dateTime [1..1] Protocol Indicates the nominal position in a series of the next dose. This is the recommended dose number as per a specified protocol doseSequence : positiveInt [0..1] Contains the description about the protocol under which the vaccine was administered description : string [0..1] Indicates the authority who published the protocol. For example, ACIP authority : Reference [0..1] « Organization » One possible path to achieve presumed immunity against a disease - within the context of an authority series : string [0..1] Vaccine date recommendations. For example, earliest date to administer, latest date to administer, etc dateCriterion [0..*] Contains information about the protocol under which the vaccine was administered protocol [0..1] Vaccine administration recommendations recommendation [1..*]

XML Template 

<ImmunizationRecommendation 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>
 <patient><!-- 1..1 Reference(Patient) Who this profile is for --></patient>
 <recommendation>  <!-- 1..* Vaccine administration recommendations -->
  <date value="[dateTime]"/><!-- 1..1 Date recommendation created -->
  <vaccineCode><!-- 1..1 CodeableConcept Vaccine recommendation applies to --></vaccineCode>
  <doseNumber value="[positiveInt]"/><!-- 0..1 Recommended dose number -->
  <forecastStatus><!-- 1..1 CodeableConcept Vaccine administration status --></forecastStatus>
  <dateCriterion>  <!-- 0..* Dates governing proposed immunization -->
   <code><!-- 1..1 CodeableConcept Type of date --></code>
   <value value="[dateTime]"/><!-- 1..1 Recommended date -->
  </dateCriterion>
  <protocol>  <!-- 0..1 Protocol used by recommendation -->
   <doseSequence value="[positiveInt]"/><!-- 0..1 Dose number within sequence -->
   <description value="[string]"/><!-- 0..1 Protocol details -->
   <authority><!-- 0..1 Reference(Organization) Who is responsible for protocol --></authority>
   <series value="[string]"/><!-- 0..1 Name of vaccination series -->
  </protocol>
  <supportingImmunization><!-- 0..* Reference(Immunization) Past immunizations supporting recommendation --></supportingImmunization>
  <supportingPatientInformation><!-- 0..* Reference(Observation|
    AllergyIntolerance) Patient observations supporting recommendation --></supportingPatientInformation>
 </recommendation>
</ImmunizationRecommendation>

Turtle Template 

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


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

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:ImmunizationRecommendation.identifier [ Identifier ], ... ; # 0..* Business identifier
  fhir:ImmunizationRecommendation.patient [ Reference(Patient) ]; # 1..1 Who this profile is for
  fhir:ImmunizationRecommendation.recommendation [ # 1..* Vaccine administration recommendations
    fhir:ImmunizationRecommendation.recommendation.date [ dateTime ]; # 1..1 Date recommendation created
    fhir:ImmunizationRecommendation.recommendation.vaccineCode [ CodeableConcept ]; # 1..1 Vaccine recommendation applies to
    fhir:ImmunizationRecommendation.recommendation.doseNumber [ positiveInt ]; # 0..1 Recommended dose number
    fhir:ImmunizationRecommendation.recommendation.forecastStatus [ CodeableConcept ]; # 1..1 Vaccine administration status
    fhir:ImmunizationRecommendation.recommendation.dateCriterion [ # 0..* Dates governing proposed immunization
      fhir:ImmunizationRecommendation.recommendation.dateCriterion.code [ CodeableConcept ]; # 1..1 Type of date
      fhir:ImmunizationRecommendation.recommendation.dateCriterion.value [ dateTime ]; # 1..1 Recommended date
    ], ...;
    fhir:ImmunizationRecommendation.recommendation.protocol [ # 0..1 Protocol used by recommendation
      fhir:ImmunizationRecommendation.recommendation.protocol.doseSequence [ positiveInt ]; # 0..1 Dose number within sequence
      fhir:ImmunizationRecommendation.recommendation.protocol.description [ string ]; # 0..1 Protocol details
      fhir:ImmunizationRecommendation.recommendation.protocol.authority [ Reference(Organization) ]; # 0..1 Who is responsible for protocol
      fhir:ImmunizationRecommendation.recommendation.protocol.series [ string ]; # 0..1 Name of vaccination series
    ];
    fhir:ImmunizationRecommendation.recommendation.supportingImmunization [ Reference(Immunization) ], ... ; # 0..* Past immunizations supporting recommendation
    fhir:ImmunizationRecommendation.recommendation.supportingPatientInformation [ Reference(Observation|AllergyIntolerance) ], ... ; # 0..* Patient observations supporting recommendation
  ], ...;
]

Changes since DSTU2

ImmunizationRecommendation
ImmunizationRecommendation.recommendation.protocol.doseSequence Type changed from integer to positiveInt

See the Full Difference for further information

 

Alternate definitions: Master Definition ( XML , JSON ), XML Schema / Schematron (for ) + JSON Schema , ShEx (for Turtle ), JSON-LD (for RDF as JSON-LD ),

11.7.3.1 Terminology Bindings

Path Definition Type Reference
ImmunizationRecommendation.recommendation.vaccineCode The type of vaccine administered Example Vaccine Administered Value Set
ImmunizationRecommendation.recommendation.forecastStatus The patient's status with respect to a vaccination protocol Example Immunization Recommendation Status Codes
ImmunizationRecommendation.recommendation.dateCriterion.code Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.) Example Immunization Recommendation Date Criterion Codes

11.7.4 Search Parameters

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

Name Type Description Paths In Common
date date Date recommendation created ImmunizationRecommendation.recommendation.date
dose-number number Recommended dose number ImmunizationRecommendation.recommendation.doseNumber
dose-sequence number Dose number within sequence ImmunizationRecommendation.recommendation.protocol.doseSequence
identifier token Business identifier ImmunizationRecommendation.identifier
information reference Patient observations supporting recommendation ImmunizationRecommendation.recommendation.supportingPatientInformation
( AllergyIntolerance , Observation )
patient reference Who this profile is for ImmunizationRecommendation.patient
( Patient )
status token Vaccine administration status ImmunizationRecommendation.recommendation.forecastStatus
support reference Past immunizations supporting recommendation ImmunizationRecommendation.recommendation.supportingImmunization
( Immunization )
vaccine-type token Vaccine recommendation applies to ImmunizationRecommendation.recommendation.vaccineCode