Release 4B 5 Ballot

This page is part of the FHIR Specification (v4.3.0: R4B (v5.0.0-ballot: R5 Ballot - STU see ballot notes ). 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

Immunization-example.json

Example Immunization/example (JSON)

Public Health and Emergency Response Work Group Maturity Level : N/A Standards Status : Informative Compartments : Patient , Practitioner

Raw JSON ( canonical form + also see JSON Format Specification )

Example of Immunization 

{
  "resourceType": "Immunization",
  "id": "example",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource &quot;example&quot; </p></div><p><b>identifier</b>: id: urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234</p><p><b>status</b>: completed</p><p><b>vaccineCode</b>: Fluvax (Influenza) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (unknown#FLUVAX)</span></p><p><b>patient</b>: <a href=\"patient-example.html\">Patient/example</a> &quot;Peter CHALMERS&quot;</p><p><b>encounter</b>: <a href=\"encounter-example.html\">Encounter/example</a></p><p><b>occurrence</b>: 2013-01-10</p><p><b>primarySource</b>: true</p><p><b>location</b>: <a href=\"location-1.html\">Location/1</a> &quot;South Wing, second floor&quot;</p><p><b>manufacturer</b>: <a href=\"organization-hl7.html\">Organization/hl7</a> &quot;Health Level Seven International&quot;</p><p><b>lotNumber</b>: AAJN11K</p><p><b>expirationDate</b>: 2015-02-15</p><p><b>site</b>: left arm <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-ActSite.html\">ActSite</a>#LA)</span></p><p><b>route</b>: Injection, intramuscular <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-RouteOfAdministration.html\">RouteOfAdministration</a>#IM)</span></p><p><b>doseQuantity</b>: 5 mg<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code mg = 'mg')</span></p><blockquote><p><b>performer</b></p><p><b>function</b>: Ordering Provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v2-0443.html\">providerRole</a>#OP)</span></p><p><b>actor</b>: <a href=\"practitioner-example.html\">Practitioner/example</a> &quot;Adam CAREFUL&quot;</p></blockquote><blockquote><p><b>performer</b></p><p><b>function</b>: Administering Provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v2-0443.html\">providerRole</a>#AP)</span></p><p><b>actor</b>: <a href=\"practitioner-example.html\">Practitioner/example</a> &quot;Adam CAREFUL&quot;</p></blockquote><p><b>note</b>: Notes on adminstration of vaccine</p><p><b>reasonCode</b>: Procedure to meet occupational requirement <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#429060002)</span></p><p><b>isSubpotent</b>: true</p><h3>Educations</h3><table class=\"grid\"><tr><td>-</td><td><b>DocumentType</b></td><td><b>PublicationDate</b></td><td><b>PresentationDate</b></td></tr><tr><td>*</td><td>253088698300010311120702</td><td>2012-07-02</td><td>2013-01-10</td></tr></table><p><b>programEligibility</b>: Not Eligible <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"codesystem-immunization-program-eligibility.html\">Immunization Event Program Eligibility</a>#ineligible)</span></p><p><b>fundingSource</b>: Private <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"codesystem-immunization-funding-source.html\">Immunization Event Funding Source</a>#private)</span></p></div>"

    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Immunization</b><a name=\"example\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Immunization &quot;example&quot; </p></div><p><b>identifier</b>: id: urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234</p><p><b>status</b>: completed</p><p><b>vaccineCode</b>: Flucelvax (Influenza) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (unknown#FLUCEL VAX)</span></p><h3>AdministeredProducts</h3><table class=\"grid\"><tr><td>-</td><td><b>Concept</b></td></tr><tr><td>*</td><td>Flucelvax (Influenza, injectable, MDCK, preservative free, quadrivalent) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (unknown#70461-0321-03)</span></td></tr></table><h3>Manufacturers</h3><table class=\"grid\"><tr><td>-</td><td><b>Reference</b></td></tr><tr><td>*</td><td><a href=\"organization-example.html\">Organization/hl7</a> &quot;Health Level Seven International&quot;</td></tr></table><p><b>lotNumber</b>: AAJN11K</p><p><b>expirationDate</b>: 2015-02-15</p><p><b>patient</b>: <a href=\"patient-example.html\">Patient/example</a> &quot;Peter CHALMERS&quot;</p><p><b>encounter</b>: <a href=\"encounter-example.html\">Encounter/example</a></p><p><b>occurrence</b>: 2013-01-10</p><p><b>primarySource</b>: true</p><p><b>location</b>: <a href=\"location-example.html\">Location/1</a> &quot;South Wing, second floor&quot;</p><p><b>site</b>: left arm <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-ActSite.html\">ActSite</a>#LA)</span></p><p><b>route</b>: Injection, intramuscular <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-RouteOfAdministration.html\">RouteOfAdministration</a>#IM)</span></p><p><b>doseQuantity</b>: 5 mg<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code mg = 'mg')</span></p><blockquote><p><b>performer</b></p><p><b>function</b>: Ordering Provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v2-0443.html\">providerRole</a>#OP)</span></p><p><b>actor</b>: <a href=\"practitioner-example.html\">Practitioner/example</a> &quot;Adam CAREFUL&quot;</p></blockquote><blockquote><p><b>performer</b></p><p><b>function</b>: Administering Provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v2-0443.html\">providerRole</a>#AP)</span></p><p><b>actor</b>: <a href=\"practitioner-example.html\">Practitioner/example</a> &quot;Adam CAREFUL&quot;</p></blockquote><p><b>note</b>: Notes on adminstration of vaccine</p><h3>Reasons</h3><table class=\"grid\"><tr><td>-</td><td><b>Concept</b></td></tr><tr><td>*</td><td>Procedure to meet occupational requirement <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#429060002)</span></td></tr></table><p><b>isSubpotent</b>: true</p><h3>ProgramEligibilities</h3><table class=\"grid\"><tr><td>-</td><td><b>Program</b></td><td><b>ProgramStatus</b></td></tr><tr><td>*</td><td>VFC <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></td><td>Uninsured <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-immunization-program-eligibility.html\">Immunization Program Eligibility</a>#uninsured)</span></td></tr></table><p><b>fundingSource</b>: Private <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-immunization-funding-source.html\">Immunization Funding Source</a>#private)</span></p></div>"

  },
  "identifier": [
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234"
    }
  ],
  "status": "completed",
  "vaccineCode": {
    "coding": [
      {
        "system": "urn:oid:1.2.36.1.2001.1005.17",
        "code": "FLUVAX"

        "code": "FLUCEL VAX"

      }
    ],
    "text": "Fluvax (Influenza)"

    "text": "Flucelvax (Influenza)"

  },
  "administeredProduct": {
    "concept": {
      "coding": [
        {
          "system": "urn:oid:2.16.840.1.113883.6.69",
          "code": "70461-0321-03"
        }
      ],
      "text": "Flucelvax (Influenza, injectable, MDCK, preservative free, quadrivalent)"
    }
  },
  "manufacturer": {
    "reference": {
      "reference": "Organization/hl7"
    }
  },
  "lotNumber": "AAJN11K",
  "expirationDate": "2015-02-15",

  "patient": {
    "reference": "Patient/example"
  },
  "encounter": {
    "reference": "Encounter/example"
  },
  "occurrenceDateTime": "2013-01-10",
  "primarySource": true,
  "location": {
    "reference": "Location/1"
  },
  "manufacturer": {
    "reference": "Organization/hl7"
  },
  "lotNumber": "AAJN11K",
  "expirationDate": "2015-02-15",

  "site": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActSite",
        "code": "LA",
        "display": "left arm"
      }
    ]
  },
  "route": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-RouteOfAdministration",
        "code": "IM",
        "display": "Injection, intramuscular"
      }
    ]
  },
  "doseQuantity": {
    "value": 5,
    "system": "http://unitsofmeasure.org",
    "code": "mg"
  },
  "performer": [
    {
      "function": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0443",
            "code": "OP"
          }
        ]
      },
      "actor": {
        "reference": "Practitioner/example"
      }
    },
    {
      "function": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0443",
            "code": "AP"
          }
        ]
      },
      "actor": {
        "reference": "Practitioner/example"
      }
    }
  ],
  "note": [
    {
      "text": "Notes on adminstration of vaccine"
    }
  ],
  "reasonCode": [

  "reason": [

    {
      "coding": [
        {
          "system": "http://snomed.info/sct",
          "code": "429060002"
        }
      ]

      "concept": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "429060002"
          }
        ]
      }

    }
  ],
  "isSubpotent": true,
  "education": [
    {
      "documentType": "253088698300010311120702",
      "publicationDate": "2012-07-02",
      "presentationDate": "2013-01-10"
    }
  ],

  "programEligibility": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/immunization-program-eligibility",
          "code": "ineligible"
        }
      ]

      "program": {
        "text": "VFC"
      },
      "programStatus": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/immunization-program-eligibility",
            "code": "uninsured"
          }
        ]
      }

    }
  ],
  "fundingSource": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/immunization-funding-source",
        "code": "private"
      }
    ]
  }
}

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.