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4.13 Resource Immunization - Content

Immunization event information.

4.13.1 Scope and Usage

The immunization resource is intended to cover the 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 immunological effects.

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 PHER work group - is believed to meet key use cases and information requirements as defined in the existing HL7 v2.x immunization implementation guide, HL7 v3 POIZ domain and Immunization Domain Analysis Model.

4.13.2 Boundaries and Relationships

This resource references the following resources:

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.

4.13.3 Resource Content

Immunization ( Resource ) A unique identifier assigned to this adverse reaction record identifier : Identifier 0..* Date vaccine administered or was to be administered date : dateTime 1..1 Vaccine that was administered or was to be administered vaccineType : CodeableConcept 1..1 << The type of vaccine administered VaccineType >> The patient to whom the vaccine was to be administered subject : Resource ( Patient ) 1..1 Indicates if the vaccination was refused refusedIndicator : boolean 1..1 True if this administration was reported rather than directly administered reported : boolean 1..1 Clinician who administered the vaccine performer : Resource ( Practitioner ) 0..1 Clinician who ordered the vaccination requester : Resource ( Practitioner ) 0..1 Name of vaccine manufacturer manufacturer : Resource ( Organization ) 0..1 The service delivery location where the vaccine administration occurred location : Resource ( Location ) 0..1 Lot number of the vaccine product lotNumber : string 0..1 Date vaccine batch expires expirationDate : date 0..1 Body site where vaccine was administered site : CodeableConcept 0..1 << The site at which the vaccine was administered ImmunizationSite >> The path by which the vaccine product is taken into the body route : CodeableConcept 0..1 << The route by which the vaccine was administered ImmunizationRoute >> The quantity of vaccine product that was administered doseQuantity : Quantity 0..1 Explanation Reasons why a vaccine was administered reason : CodeableConcept 0..* << The reason why a vaccine was administered ImmunizationReason >> Refusal or exemption reasons refusalReason : CodeableConcept 0..* << The reason why a vaccine administration was refused NoImmunizationReason >> Reaction Date of reaction to the immunization date : dateTime 0..1 Details of the reaction detail : Resource ( AdverseReaction | Observation ) 0..1 Self-reported indicator reported : boolean 0..1 VaccinationProtocol Nominal position in a series doseSequence : integer 1..1 Contains the description about the protocol under which the vaccine was administered description : string 0..1 Indicates the authority who published the protocol? E.g. ACIP authority : Resource ( Organization ) 0..1 One possible path to achieve presumed immunity against a disease - within the context of an authority series : string 0..1 The recommended number of doses to achieve immunity seriesDoses : integer 0..1 The targeted disease doseTarget : CodeableConcept 1..1 << The disease target of the vaccination protocol VaccinationProtocolDoseTarget >> Indicates if the immunization event should "count" against the protocol doseStatus : CodeableConcept 1..1 << The status of the vaccination protocol (i.e. should this count) VaccinationProtocolDoseStatus >> Provides an explanation as to why a immunization event should or should not count against the protocol doseStatusReason : CodeableConcept 0..1 << The reason for the determining if a vaccination should count or why vaccination should not count. VaccinationProtocolDoseStatusReason >> Reasons why a vaccine was administered or refused explanation 0..1 Categorical data indicating that an adverse event is associated in time to an immunization reaction 0..* Contains information about the protocol(s) under which the vaccine was administered vaccinationProtocol 0..*

This resource is referenced by Condition , ImmunizationRecommendation and Procedure 

<Immunization xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: extension, modifierExtension, language, text, and contained -->
 <identifier><!-- 0..* Identifier Business identifier --></identifier>
 <date value="[dateTime]"/><!-- 1..1 Vaccination administration date -->
 <vaccineType><!-- 1..1 CodeableConcept Vaccine product administered --></vaccineType>
 <subject><!-- 1..1 Resource(Patient) Who was immunized? --></subject>
 <refusedIndicator value="[boolean]"/><!-- 1..1 Was immunization refused? -->
 <reported value="[boolean]"/><!-- 1..1 Is this a self-reported record? -->
 <performer><!-- 0..1 Resource(Practitioner) Who administered vaccine? --></performer>
 <requester><!-- 0..1 Resource(Practitioner) Who ordered vaccination? --></requester>
 <manufacturer><!-- 0..1 Resource(Organization) Vaccine manufacturer --></manufacturer>
 <location><!-- 0..1 Resource(Location) Where did vaccination occur? --></location>
 <lotNumber value="[string]"/><!-- 0..1 Vaccine lot number -->
 <expirationDate value="[date]"/><!-- 0..1 Vaccine expiration date -->
 <site><!-- 0..1 CodeableConcept Body site vaccine  was administered --></site>
 <route><!-- 0..1 CodeableConcept How vaccine entered body --></route>
 <doseQuantity><!-- 0..1 Quantity Amount of vaccine administered --></doseQuantity>
 <explanation>  <!-- 0..1 Administration / refusal reasons -->
  <reason><!-- 0..* CodeableConcept Why immunization occurred --></reason>
  <refusalReason><!-- 0..* CodeableConcept Why immunization did not occur --></refusalReason>
 </explanation>
 <reaction>  <!-- 0..* Details of a reaction that follows immunization -->
  <date value="[dateTime]"/><!-- 0..1 When did reaction start? -->
  <detail><!-- 0..1 Resource(AdverseReaction|Observation) Additional information on reaction --></detail>
  <reported value="[boolean]"/><!-- 0..1 Was reaction self-reported? -->
 </reaction>
 <vaccinationProtocol>  <!-- 0..* What protocol was followed -->
  <doseSequence value="[integer]"/><!-- 1..1 What dose number within series? -->
  <description value="[string]"/><!-- 0..1 Details of vaccine protocol -->
  <authority><!-- 0..1 Resource(Organization) Who is responsible for protocol --></authority>
  <series value="[string]"/><!-- 0..1 Name of vaccine series -->
  <seriesDoses value="[integer]"/><!-- 0..1 Recommended number of doses for immunity -->
  <doseTarget><!-- 1..1 CodeableConcept Disease immunized against --></doseTarget>
  <doseStatus><!-- 1..1 CodeableConcept Does dose count towards immunity? --></doseStatus>
  <doseStatusReason><!-- 0..1 CodeableConcept Why does does count/not count? --></doseStatusReason>
 </vaccinationProtocol>
</Immunization>

Alternate definitions: Schema / Schematron , Resource Profile

4.13.3.1 Terminology Bindings

Path Definition Type Reference
Immunization.vaccineType The type of vaccine administered Example http://hl7.org/fhir/v3/vs/VaccineType
Immunization.site The site at which the vaccine was administered Example http://hl7.org/fhir/vs/immunization-site
Immunization.route The route by which the vaccine was administered Example http://hl7.org/fhir/vs/immunization-route
Immunization.explanation.reason The reason why a vaccine was administered Example http://hl7.org/fhir/vs/immunization-reason
Immunization.explanation.refusalReason The reason why a vaccine administration was refused Example http://hl7.org/fhir/vs/no-immunization-reason
Immunization.vaccinationProtocol.doseTarget The disease target of the vaccination protocol Example http://hl7.org/fhir/vs/vaccination-protocol-dose-target
Immunization.vaccinationProtocol.doseStatus The status of the vaccination protocol (i.e. should this count) Example http://hl7.org/fhir/vs/vaccination-protocol-dose-status
Immunization.vaccinationProtocol.doseStatusReason The reason for the determining if a vaccination should count or why vaccination should not count. Example http://hl7.org/fhir/vs/vaccination-protocol-dose-status-reason

4.13.4 Search Parameters

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

Name Type Description Paths
_id token The logical resource id associated with the resource (must be supported by all servers)
_language token The language of the resource
date date Vaccination Administration / Refusal Date Immunization.date
dose-sequence number What dose number within series? Immunization.vaccinationProtocol.doseSequence
identifier token Business identifier Immunization.identifier
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
( Organization )
performer reference The practitioner who administered the vaccination Immunization.performer
( Practitioner )
reaction reference Additional information on reaction Immunization.reaction.detail
( Observation , AdverseReaction )
reaction-date date When did reaction start? Immunization.reaction.date
reason token Why immunization occurred Immunization.explanation.reason
refusal-reason token Explanation of refusal / exemption Immunization.explanation.refusalReason
refused token Was immunization refused? Immunization.refusedIndicator
requester reference The practitioner who ordered the vaccination Immunization.requester
( Practitioner )
subject reference The subject of the vaccination event / refusal Immunization.subject
( Patient )
vaccine-type token Vaccine Product Type Administered Immunization.vaccineType
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