R4 Ballot #1 #2 (Mixed Normative/Trial use)

This page is part of the FHIR Specification (v3.3.0: (v3.5.0: R4 Ballot 2). #2). 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

Public Health and Emergency Response Work Group Maturity Level : 3   Trial Use 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.

Control 1..1
Type DomainResource
Immunization.identifier
Element Id Immunization.identifier
Definition

A unique identifier assigned to this immunization record.

Note This is a business identifer, not a resource identifier (see discussion )
Control 0..*
Type Identifier
Immunization.status
Element Id Immunization.status
Definition

Indicates the current status of the immunization event.

Control 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 means that the resource should not be treated as valid)
Summary true
Comments

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

Immunization.statusReason
Element Id Immunization.statusReason
Definition

Indicates the reason the immunization event was not performed.

Control 0..1
Terminology Binding Immunization Status Reason Codes ( Example )
Type CodeableConcept
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.

Control 1..1
Terminology Binding Vaccine Administered Value Set ( Example )
Type CodeableConcept
Summary true
Immunization.patient
Element Id Immunization.patient
Definition

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

Control 1..1
Type Reference ( Patient )
Summary true
Immunization.encounter
Element Id Immunization.encounter
Definition

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

Control 0..1
Type Reference ( Encounter )
Immunization.date Immunization.occurrence[x]
Element Id Immunization.date Immunization.occurrence[x]
Definition

Date vaccine administered or was to be administered.

Control 0..1 1..1
Type dateTime | string
[x] Note See Choice of Data Types for further information about how to use [x]
Summary true
Comments

When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known.  Although 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.

Immunization.recorded
Element Id Immunization.recorded
Definition

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

Control 0..1
Type dateTime
Summary false
Immunization.primarySource
Element Id Immunization.primarySource
Definition

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

Control 1..1 0..1
Type boolean
Summary true
Comments

Reflects the “reliability” of the content.

Immunization.reportOrigin
Element Id Immunization.reportOrigin
Definition

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

Control 0..1
Terminology Binding Immunization Origin Codes ( Example )
Type CodeableConcept
Comments

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

Immunization.location
Element Id Immunization.location
Definition

The service delivery location where the vaccine administration occurred.

Control 0..1
Type Reference ( Location )
Immunization.manufacturer
Element Id Immunization.manufacturer
Definition

Name of vaccine manufacturer.

Control 0..1
Type Reference ( Organization )
Immunization.lotNumber
Element Id Immunization.lotNumber
Definition

Lot number of the vaccine product.

Control 0..1
Type string
Immunization.expirationDate
Element Id Immunization.expirationDate
Definition

Date vaccine batch expires.

Control 0..1
Type date
Immunization.site
Element Id Immunization.site
Definition

Body site where vaccine was administered.

Control 0..1
Terminology Binding Codes for Immunization Site of Administration ( Example )
Type CodeableConcept
Immunization.route
Element Id Immunization.route
Definition

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

Control 0..1
Terminology Binding Immunization Route Codes ( Example )
Type CodeableConcept
Immunization.doseQuantity
Element Id Immunization.doseQuantity
Definition

The quantity of vaccine product that was administered.

Control 0..1
Type SimpleQuantity
Immunization.performer
Element Id Immunization.performer
Definition

Indicates who performed the immunization event.

Control 0..*
Summary true
Immunization.performer.function
Element Id Immunization.performer.function
Definition

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

Control 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.

Control 1..1
Type Reference ( Practitioner | PractitionerRole | Organization )
Summary true
Comments

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

Immunization.note
Element Id Immunization.note
Definition

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

Control 0..*
Type Annotation
Summary true
Immunization.reasonCode
Element Id Immunization.reasonCode
Definition

Reasons why the vaccine was administered.

Control 0..*
Terminology Binding Immunization Reason Codes ( Example )
Type CodeableConcept
Immunization.reasonReference
Element Id Immunization.reasonReference
Definition

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

Control 0..*
Type Reference ( Condition | Observation | DiagnosticReport )
Immunization.isPotent Immunization.isSubpotent
Element Id Immunization.isPotent Immunization.isSubpotent
Definition

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

Control 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
Immunization.subpotentReason
Element Id Immunization.subpotentReason
Definition

Reason why a dose is considered to be subpotent.

Control 0..*
Terminology Binding Immunization Subpotent Reason ( Example )
Type CodeableConcept
Immunization.education
Element Id Immunization.education
Definition

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

Control 0..*
Invariants :
Defined on this element
imm-1 : Rule One of documentType or reference SHALL be present ( expression documentType.exists() or reference.exists(), xpath: exists(f:documentType) or exists(f:reference)) reference.exists()
Immunization.education.documentType
Element Id Immunization.education.documentType
Definition

Identifier of the material presented to the patient.

Control 0..1
Type string
Immunization.education.reference
Element Id Immunization.education.reference
Definition

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

Control 0..1
Type uri
Immunization.education.publicationDate
Element Id Immunization.education.publicationDate
Definition

Date the educational material was published.

Control 0..1
Type dateTime
Immunization.education.presentationDate
Element Id Immunization.education.presentationDate
Definition

Date the educational material was given to the patient.

Control 0..1
Type dateTime
Immunization.programEligibility
Element Id Immunization.programEligibility
Definition

Indicates a patient's eligibility for a funding program.

Control 0..*
Terminology Binding Immunization Program Eligibility ( Example )
Type CodeableConcept
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 publically purchased vaccine but due to inventory issues, vaccine purchased with private funds was actually administered).

Control 0..1
Terminology Binding Immunization Funding Source ( Example )
Type CodeableConcept
Immunization.protocolApplied
Element Id Immunization.protocolApplied
Definition

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

Control 0..*
Immunization.protocolApplied.series
Element Id Immunization.protocolApplied.series
Definition

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

Control 0..1
Type string
Immunization.protocolApplied.authority
Element Id Immunization.protocolApplied.authority
Definition

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

Control 0..1
Type Reference ( Organization )
Immunization.protocolApplied.targetDisease
Element Id Immunization.protocolApplied.targetDisease
Definition

The vaccine preventable disease the dose is being administered against.

Control 1..1
Terminology Binding Immunization Target Disease Codes ( Example )
Type CodeableConcept
Immunization.protocolApplied.doseNumber[x]
Element Id Immunization.protocolApplied.doseNumber[x]
Definition

Nominal position in a series.

Control 1..1
Type positiveInt | string
[x] Note See Choice of Data Types for further information about how to use [x]
Comments

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