FHIR Release 3 (STU) 4

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11.6 11.7 Resource Immunization - Content

Public Health and Emergency Response Work Group Maturity Level : 3   Trial Use Security Category : Patient Compartments : Patient , Practitioner

Describes the event of a patient being administered a vaccination vaccine or a record of a vaccination an immunization as reported by a patient, a clinician or another party and may include vaccine reaction information and what vaccination protocol was followed. party.

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

11.6.2 11.7.2 Boundaries and Relationships

This resource references the following resources: Patient Practitioner Organization Location Observation Encounter 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.

AllergyIntolerance and Immunization.reaction 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.

This resource is referenced by AdverseEvent , ChargeItem , ImmunizationEvaluation , ImmunizationRecommendation and ImmunizationRecommendation Observation

11.6.3 11.7.3 Resource Content

Structure

?! Σ 1..1 Flag for whether immunization was given Vaccination Why immunization occurred What protocol was Details of vaccine protocol string Name of vaccine CodeableConcept Disease immunized against CodeableConcept Vaccination Protocol Dose Status codes ( Example
Name Flags Card. Type Description & Constraints doco
. . Immunization I TU DomainResource Immunization event information
+ If immunization was administered (notGiven=false) then explanation.reasonNotGiven SHALL be absent. + If immunization was not administered (notGiven=true) then there SHALL be no reaction nor explanation.reason present Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier 0..* Identifier Business identifier
. . . status ?! Σ 1..1 code completed | entered-in-error | not-done
Immunization Status Codes ( Required )
. . notGiven . statusReason 0..1 boolean CodeableConcept Reason not done
Immunization Status Reason Codes ( Example )
. . . vaccineCode Σ 1..1 CodeableConcept Vaccine product administered
Vaccine Administered Value Set ( Example )
. . . patient Σ 1..1 Reference ( Patient ) Who was immunized
. . . encounter 0..1 Reference ( Encounter ) Encounter administered as immunization was part of
. . . occurrence[x] Σ 1..1 Vaccine administration date
.... occurrenceDateTime dateTime
.... occurrenceString string
. . . date recorded 0..1 dateTime Vaccination administration date When the immunization was first captured in the subject's record
. . . primarySource Σ 1..1 0..1 boolean Indicates context the data was recorded in
. . . reportOrigin 0..1 CodeableConcept Indicates the source of a secondarily reported record
Immunization Origin Codes ( Example )
. . . location 0..1 Reference ( Location ) Where vaccination immunization occurred
. . . manufacturer 0..1 Reference ( Organization ) Vaccine manufacturer
. . . lotNumber 0..1 string Vaccine lot number
. . . expirationDate 0..1 date Vaccine expiration date
. . . site 0..1 CodeableConcept Body site vaccine was administered
Codes for Immunization Site of Administration ( Example )
. . . route 0..1 CodeableConcept How vaccine entered body
Immunization Route Codes ( Example )
. . . doseQuantity 0..1 SimpleQuantity Amount of vaccine administered
. . . practitioner performer Σ 0..* BackboneElement Who performed event
. . . role . function Σ 0..1 CodeableConcept What type of performance was done
Immunization Role Function Codes ( Extensible )
. . . . actor Σ 1..1 Reference ( Practitioner | PractitionerRole | Organization ) Individual or organization who was performing
. . . note Σ 0..* Annotation Additional immunization notes
. . . reasonCode 0..* CodeableConcept Why immunization occurred
Immunization Reason Codes ( Example )
... reasonReference 0..* Reference ( Condition | Observation | DiagnosticReport ) Why immunization occurred
... isSubpotent ?! Σ 0..1 boolean Dose potency
... subpotentReason 0..* CodeableConcept Reason for being subpotent
Immunization Subpotent Reason ( Example )
. . . explanation education I 0..1 0..* BackboneElement Administration/non-administration reasons Educational material presented to patient
+ Rule: One of documentType or reference SHALL be present
.... documentType 0..1 string Educational material document identifier
. . . reason . reference 0..* 0..1 uri Educational material reference pointer
.... publicationDate 0..1 dateTime Educational material publication date
.... presentationDate 0..1 dateTime Educational material presentation date
... programEligibility 0..* CodeableConcept Patient eligibility for a vaccination program
Immunization Reason Codes Program Eligibility ( Example )
. . . reasonNotGiven fundingSource 0..* 0..1 CodeableConcept Why immunization did not occur Funding source for the vaccine
Immunization Reasons for Not Immunizing Codes Funding Source ( Example )
. . . reaction 0..* BackboneElement Details of a reaction that follows immunization
. . . . date 0..1 dateTime When reaction started
. . . . detail 0..1 Reference ( Observation ) Additional information on reaction
. . . . reported 0..1 boolean Indicates self-reported reaction
. . vaccinationProtocol . protocolApplied 0..* BackboneElement Protocol followed by the provider
. . . . doseSequence series 0..1 positiveInt string Dose number within Name of vaccine series
. . . description . authority 0..1 string Reference ( Organization ) Who is responsible for publishing the recommendations
. . . authority . targetDisease 0..1 0..* Reference CodeableConcept Vaccine preventatable disease being targetted
Immunization Target Disease Codes ( Organization Example )
Who is responsible for protocol
. . . series . doseNumber[x] 0..1 1..1 Dose number within series
. . . . . seriesDoses doseNumberPositiveInt 0..1 positiveInt Recommended number of doses for immunity
. . . targetDisease . . doseNumberString 1..* Vaccination Protocol Dose Target Codes ( Example string )
. . . doseStatus . seriesDoses[x] 1..1 0..1 Indicates if dose counts towards Recommended number of doses for immunity
. . . . . seriesDosesPositiveInt positiveInt )
. . . doseStatusReason . . seriesDosesString 0..1 CodeableConcept string Why dose does (not) count Vaccination Protocol Dose Status Reason codes ( Example )

doco Documentation for this format

UML Diagram ( Legend )

Immunization ( DomainResource ) A unique identifier assigned to this immunization record identifier : Identifier [0..*] Indicates the current status of the vaccination 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 Immunization. (Strength=Required) Immunization Status ImmunizationStatusCodes ! » Indicates if the vaccination was or reason the immunization event was not given (this element modifies the meaning of other elements) performed notGiven statusReason : boolean CodeableConcept [1..1] [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 administered. (Strength=Example) Vaccine Administered Value Set VaccineAdministeredValueSet ?? » 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 » Date vaccine administered or was to be administered occurrence[x] : Type [1..1] « dateTime | string » The date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event recorded : dateTime [0..1] 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 primarySource : boolean [1..1] [0..1] The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine reportOrigin : CodeableConcept [0..1] « The source of the data for a record which is not from a primary source. (Strength=Example) Immunization Origin ImmunizationOriginCodes ?? » The service delivery location where the vaccine administration occurred location : Reference [0..1] « Location » Name of vaccine manufacturer manufacturer : Reference [0..1] « Organization » 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 administered. (Strength=Example) Codes for Immunization Site o... 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 administered. (Strength=Example) Immunization Route 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..*] Reasons why the vaccine was administered reasonCode : CodeableConcept [0..*] « Practitioner The reason why a vaccine was administered. (Strength=Example) ImmunizationReasonCodes ?? » Condition, Observation or DiagnosticReport that supports why the immunization was administered reasonReference : Reference [0..*] « Condition | Observation | DiagnosticReport » 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..*] « The reason why a dose is considered to be subpotent. (Strength=Example) ImmunizationSubpotentReason ?? » Indicates a patient's eligibility for a funding program programEligibility : CodeableConcept [0..*] « The patient's eligibility for a vaccation program. (Strength=Example) ImmunizationProgramEligibility ?? » 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) fundingSource : CodeableConcept [0..1] « The source of funding used to purchase the vaccine administered. (Strength=Example) ImmunizationFundingSource ?? » Performer Describes the type of performance (e.g. ordering provider, administering provider, etc.) role function : CodeableConcept [0..1] « The role a practitioner or organization plays in the immunization event event. (Strength=Extensible) Immunization Role ImmunizationFunctionCodes + » The device, practitioner, etc. practitioner or organization who performed the action actor : Reference [1..1] « Practitioner | PractitionerRole | Organization » Explanation Education Reasons why a vaccine was administered Identifier of the material presented to the patient reason documentType : CodeableConcept string [0..*] [0..1] The reason why a vaccine Reference pointer to the educational material given to the patient if the information was administered (Strength=Example) on line Immunization Reason reference ?? : uri [0..1] Reason why a vaccine Date the educational material was not administered published reasonNotGiven publicationDate : CodeableConcept dateTime [0..*] [0..1] The reason why a vaccine Date the educational material was not administered (Strength=Example) given to the patient Immunization Reasons for presentationDate Not ... : dateTime ?? [0..1] Reaction Date of reaction to the immunization date : dateTime [0..1] Details of the reaction detail : Reference [0..1] « Observation » Self-reported indicator reported : boolean [0..1] VaccinationProtocol Nominal position in a series 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. E.g. ACIP authority : Reference [0..1] Organization ProtocolApplied 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 Indicates the authority who published the protocol (e.g. ACIP) that is being followed seriesDoses authority : positiveInt Reference [0..1] « Organization » The targeted vaccine preventable disease the dose is being administered against targetDisease : CodeableConcept [1..*] [0..*] « The vaccine preventable disease target of the vaccination protocol dose is being administered for. (Strength=Example) Vaccination Protocol Dose Tar... ImmunizationTargetDiseaseCodes ?? » Indicates if the immunization event should "count" against the protocol Nominal position in a series doseStatus doseNumber[x] : CodeableConcept Type [1..1] The status of the vaccination protocol (i.e. should this count) (Strength=Example) Vaccination Protocol Dose « positiveInt Sta... | string ?? » Provides an explanation as The recommended number of doses to why an immunization event should or should not count against the protocol achieve immunity doseStatusReason seriesDoses[x] : CodeableConcept Type [0..1] The reason for the determining if a vaccination should count or why vaccination should not count. (Strength=Example) Vaccination Protocol « positiveInt Dose Sta... | string ?? » Indicates who or what performed the immunization event practitioner performer [0..*] Reasons why a Educational material presented to the patient (or guardian) at the time of vaccine was or was not administered administration explanation education [0..1] [0..*] 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 protocol (set of recommendations) being followed by the vaccine was provider who administered the dose vaccinationProtocol 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>
 <
 <

 <status value="[code]"/><!-- 1..1 completed | entered-in-error | not-done -->
 <statusReason><!-- 0..1 CodeableConcept Reason not done --></statusReason>

 <vaccineCode><!-- 1..1 CodeableConcept Vaccine product administered --></vaccineCode>
 <patient><!-- 1..1 Reference(Patient) Who was immunized --></patient>
 <</encounter>
 <
 <

 <encounter><!-- 0..1 Reference(Encounter) Encounter immunization was part of --></encounter>
 <occurrence[x]><!-- 1..1 dateTime|string Vaccine administration date --></occurrence[x]>
 <recorded value="[dateTime]"/><!-- 0..1 When the immunization was first captured in the subject's record -->
 <primarySource value="[boolean]"/><!-- 0..1 Indicates context the data was recorded in -->

 <reportOrigin><!-- 0..1 CodeableConcept Indicates the source of a secondarily reported record --></reportOrigin>
 <</location>

 <location><!-- 0..1 Reference(Location) Where immunization occurred --></location>

 <manufacturer><!-- 0..1 Reference(Organization) Vaccine manufacturer --></manufacturer>
 <
 <

 <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(SimpleQuantity) Amount of vaccine administered --></doseQuantity>
 <
  <</role>
  <</actor>
 </practitioner>
 <</note>
 <
  <</reason>
  <</reasonNotGiven>
 </explanation>

 <performer>  <!-- 0..* Who performed event -->
  <function><!-- 0..1 CodeableConcept What type of performance was done --></function>
  <actor><!-- 1..1 Reference(Practitioner|PractitionerRole|Organization) Individual or organization who was performing --></actor>
 </performer>
 <note><!-- 0..* Annotation Additional immunization notes --></note>
 <reasonCode><!-- 0..* CodeableConcept Why immunization occurred --></reasonCode>
 <reasonReference><!-- 0..* Reference(Condition|Observation|DiagnosticReport) Why immunization occurred --></reasonReference>
 <isSubpotent value="[boolean]"/><!-- 0..1 Dose potency -->
 <subpotentReason><!-- 0..* CodeableConcept Reason for being subpotent --></subpotentReason>
 <education>  <!-- 0..* Educational material presented to patient -->
  <documentType value="[string]"/><!-- 0..1 Educational material document identifier -->
  <reference value="[uri]"/><!-- 0..1 Educational material reference pointer -->
  <publicationDate value="[dateTime]"/><!-- 0..1 Educational material publication date -->
  <presentationDate value="[dateTime]"/><!-- 0..1 Educational material presentation date -->
 </education>
 <programEligibility><!-- 0..* CodeableConcept Patient eligibility for a vaccination program --></programEligibility>
 <fundingSource><!-- 0..1 CodeableConcept Funding source for the vaccine --></fundingSource>

 <reaction>  <!-- 0..* Details of a reaction that follows immunization -->
  <

  <date value="[dateTime]"/><!-- 0..1 When reaction started -->

  <detail><!-- 0..1 Reference(Observation) Additional information on reaction --></detail>
  <

  <reported value="[boolean]"/><!-- 0..1 Indicates self-reported reaction -->

 </reaction>
 <
  <
  <
  <</authority>
  <
  <
  <</targetDisease>
  <</doseStatus>
  <</doseStatusReason>
 </vaccinationProtocol>

 <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><!-- 0..* CodeableConcept Vaccine preventatable disease being targetted --></targetDisease>
  <doseNumber[x]><!-- 1..1 positiveInt|string Dose number within series --></doseNumber[x]>
  <seriesDoses[x]><!-- 0..1 positiveInt|string Recommended number of doses for immunity --></seriesDoses[x]>
 </protocolApplied>

</Immunization>

JSON Template 

{doco
  "resourceType" : "",

  "resourceType" : "Immunization",

  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "
  "
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  "
  "
  "
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  "
  "
  "
  "
  "
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  "
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    "
    "

  "identifier" : [{ Identifier }], // Business identifier
  "status" : "<code>", // R!  completed | entered-in-error | not-done
  "statusReason" : { CodeableConcept }, // Reason not done
  "vaccineCode" : { CodeableConcept }, // R!  Vaccine product administered
  "patient" : { Reference(Patient) }, // R!  Who was immunized
  "encounter" : { Reference(Encounter) }, // Encounter immunization was part of
  // occurrence[x]: Vaccine administration date. One of these 2:

  "occurrenceDateTime" : "<dateTime>",
  "occurrenceString" : "<string>",
  "recorded" : "<dateTime>", // When the immunization was first captured in the subject's record
  "primarySource" : <boolean>, // Indicates context the data was recorded in
  "reportOrigin" : { CodeableConcept }, // Indicates the source of a secondarily reported record
  "location" : { Reference(Location) }, // Where immunization occurred
  "manufacturer" : { Reference(Organization) }, // Vaccine manufacturer
  "lotNumber" : "<string>", // Vaccine lot number
  "expirationDate" : "<date>", // Vaccine expiration date
  "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 }, // What type of performance was done
    "actor" : { Reference(Practitioner|PractitionerRole|Organization) } // R!  Individual or organization who was performing

  }],
  "
  "
    "
    "
  },
  "
    "
    "
    "

  "note" : [{ Annotation }], // Additional immunization notes
  "reasonCode" : [{ CodeableConcept }], // Why immunization occurred
  "reasonReference" : [{ Reference(Condition|Observation|DiagnosticReport) }], // Why immunization occurred
  "isSubpotent" : <boolean>, // Dose potency
  "subpotentReason" : [{ CodeableConcept }], // Reason for being subpotent
  "education" : [{ // Educational material presented to patient
    "documentType" : "<string>", // Educational material document identifier
    "reference" : "<uri>", // Educational material reference pointer
    "publicationDate" : "<dateTime>", // Educational material publication date
    "presentationDate" : "<dateTime>" // Educational material presentation date

  }],
  "
    "
    "
    "
    "
    "
    "
    "
    "

  "programEligibility" : [{ CodeableConcept }], // Patient eligibility for a vaccination program
  "fundingSource" : { CodeableConcept }, // Funding source for the vaccine
  "reaction" : [{ // Details of a reaction that follows immunization
    "date" : "<dateTime>", // When reaction started
    "detail" : { Reference(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 preventatable disease being targetted
    // doseNumber[x]: Dose number within series. One of these 2:

    "doseNumberPositiveInt" : "<positiveInt>",
    "doseNumberString" : "<string>",
    // seriesDoses[x]: Recommended number of doses for immunity. One of these 2:

    "seriesDosesPositiveInt" : "<positiveInt>"
    "seriesDosesString" : "<string>"

  }]
}

Turtle Template 

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


[ a fhir:;

[ a fhir:Immunization;

  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:Immunization.identifier [ Identifier ], ... ; # 0..* Business identifier
  fhir:
  fhir:

  fhir:Immunization.status [ code ]; # 1..1 completed | entered-in-error | not-done
  fhir:Immunization.statusReason [ CodeableConcept ]; # 0..1 Reason not done

  fhir:Immunization.vaccineCode [ CodeableConcept ]; # 1..1 Vaccine product administered
  fhir:Immunization.patient [ Reference(Patient) ]; # 1..1 Who was immunized
  fhir:
  fhir:
  fhir:

  fhir:Immunization.encounter [ Reference(Encounter) ]; # 0..1 Encounter immunization was part of
  # Immunization.occurrence[x] : 1..1 Vaccine administration date. One of these 2
    fhir:Immunization.occurrenceDateTime [ dateTime ]
    fhir:Immunization.occurrenceString [ string ]
  fhir:Immunization.recorded [ dateTime ]; # 0..1 When the immunization was first captured in the subject's record
  fhir:Immunization.primarySource [ boolean ]; # 0..1 Indicates context the data was recorded in

  fhir:Immunization.reportOrigin [ CodeableConcept ]; # 0..1 Indicates the source of a secondarily reported record
  fhir:

  fhir:Immunization.location [ Reference(Location) ]; # 0..1 Where immunization occurred

  fhir:Immunization.manufacturer [ Reference(Organization) ]; # 0..1 Vaccine manufacturer
  fhir:Immunization.lotNumber [ string ]; # 0..1 Vaccine lot number
  fhir:Immunization.expirationDate [ date ]; # 0..1 Vaccine expiration date
  fhir:Immunization.site [ CodeableConcept ]; # 0..1 Body site vaccine  was administered
  fhir:Immunization.route [ CodeableConcept ]; # 0..1 How vaccine entered body
  fhir:Immunization.doseQuantity [ Quantity(SimpleQuantity) ]; # 0..1 Amount of vaccine administered
  fhir:
    fhir:
    fhir:

  fhir:Immunization.performer [ # 0..* Who performed event
    fhir:Immunization.performer.function [ CodeableConcept ]; # 0..1 What type of performance was done
    fhir:Immunization.performer.actor [ Reference(Practitioner|PractitionerRole|Organization) ]; # 1..1 Individual or organization who was performing

  ], ...;
  fhir:
  fhir:
    fhir:
    fhir:
  ];

  fhir:Immunization.note [ Annotation ], ... ; # 0..* Additional immunization notes
  fhir:Immunization.reasonCode [ CodeableConcept ], ... ; # 0..* Why immunization occurred
  fhir:Immunization.reasonReference [ Reference(Condition|Observation|DiagnosticReport) ], ... ; # 0..* Why immunization occurred
  fhir:Immunization.isSubpotent [ boolean ]; # 0..1 Dose potency
  fhir:Immunization.subpotentReason [ CodeableConcept ], ... ; # 0..* Reason for being subpotent
  fhir:Immunization.education [ # 0..* Educational material presented to patient
    fhir:Immunization.education.documentType [ string ]; # 0..1 Educational material document identifier
    fhir:Immunization.education.reference [ uri ]; # 0..1 Educational material reference pointer
    fhir:Immunization.education.publicationDate [ dateTime ]; # 0..1 Educational material publication date
    fhir:Immunization.education.presentationDate [ dateTime ]; # 0..1 Educational material presentation date
  ], ...;
  fhir:Immunization.programEligibility [ CodeableConcept ], ... ; # 0..* Patient eligibility for a vaccination program
  fhir:Immunization.fundingSource [ CodeableConcept ]; # 0..1 Funding source for the vaccine

  fhir:Immunization.reaction [ # 0..* Details of a reaction that follows immunization
    fhir:Immunization.reaction.date [ dateTime ]; # 0..1 When reaction started
    fhir:Immunization.reaction.detail [ Reference(Observation) ]; # 0..1 Additional information on reaction
    fhir:Immunization.reaction.reported [ boolean ]; # 0..1 Indicates self-reported reaction
  ], ...;
  fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:

  fhir:Immunization.protocolApplied [ # 0..* Protocol followed by the provider
    fhir:Immunization.protocolApplied.series [ string ]; # 0..1 Name of vaccine series
    fhir:Immunization.protocolApplied.authority [ Reference(Organization) ]; # 0..1 Who is responsible for publishing the recommendations
    fhir:Immunization.protocolApplied.targetDisease [ CodeableConcept ], ... ; # 0..* Vaccine preventatable disease being targetted
    # Immunization.protocolApplied.doseNumber[x] : 1..1 Dose number within series. One of these 2
      fhir:Immunization.protocolApplied.doseNumberPositiveInt [ positiveInt ]
      fhir:Immunization.protocolApplied.doseNumberString [ string ]
    # Immunization.protocolApplied.seriesDoses[x] : 0..1 Recommended number of doses for immunity. One of these 2
      fhir:Immunization.protocolApplied.seriesDosesPositiveInt [ positiveInt ]
      fhir:Immunization.protocolApplied.seriesDosesString [ string ]

  ], ...;
]

Changes since DSTU2 R3

Immunization
Immunization.status
  • Change value set from http://hl7.org/fhir/ValueSet/medication-admin-status to http://hl7.org/fhir/ValueSet/immunization-status to http://hl7.org/fhir/ValueSet/immunization-status|4.0.1
Immunization.notGiven Immunization.statusReason
  • Renamed from wasNotGiven to notGiven to statusReason
  • Min Cardinality changed from 1 to 0
  • Type changed from boolean to CodeableConcept
  • No longer marked as Modifier
Immunization.occurrence[x]
  • Renamed from date to occurrence[x]
  • Min Cardinality changed from 0 to 1
  • Add Type string
Immunization.recorded
  • Added Element
Immunization.primarySource
  • Min Cardinality changed from 1 to 0
Immunization.performer
  • Renamed from practitioner to performer
Immunization.performer.function
  • Moved from Immunization.practitioner.role to function
  • Change value set from http://hl7.org/fhir/ValueSet/immunization-role to http://hl7.org/fhir/ValueSet/immunization-function
Immunization.performer.actor
  • Moved from Immunization.practitioner to Immunization.performer
  • Type Reference: Added Target Types PractitionerRole, Organization
Immunization.reasonCode
  • Moved from Immunization.explanation.reason to reasonCode
Immunization.reasonReference
  • Added Element
Immunization.reportOrigin Immunization.isSubpotent
  • Added Element
Immunization.practitioner Immunization.subpotentReason
  • Added Element
Immunization.practitioner.role Immunization.education
  • Added Element
Immunization.practitioner.actor Immunization.education.documentType
  • Added Element
Immunization.vaccinationProtocol.doseSequence Immunization.education.reference
  • Added Element
Immunization.education.publicationDate
  • Added Element
Immunization.education.presentationDate
  • Added Element
Immunization.programEligibility
  • Added Element
Immunization.fundingSource
  • Added Element
Immunization.protocolApplied
  • Renamed from vaccinationProtocol to protocolApplied
Immunization.protocolApplied.series
  • Moved from Immunization.vaccinationProtocol to Immunization.protocolApplied
Immunization.protocolApplied.authority
  • Moved from Immunization.vaccinationProtocol to Immunization.protocolApplied
Immunization.protocolApplied.targetDisease
  • Moved from Immunization.vaccinationProtocol to Immunization.protocolApplied
  • Min Cardinality changed from 1 to 0
Immunization.protocolApplied.doseNumber[x]
  • Moved from Immunization.vaccinationProtocol.doseSequence to doseNumber[x]
  • Min Cardinality changed from 0 to 1
  • Add Type string
Immunization.protocolApplied.seriesDoses[x]
  • Moved from Immunization.vaccinationProtocol.seriesDoses to seriesDoses[x]
  • Add Type string
Immunization.reported Immunization.explanation
  • deleted
Immunization.performer Immunization.vaccinationProtocol.description
  • deleted
Immunization.requester Immunization.vaccinationProtocol.doseStatus
  • deleted
Immunization.vaccinationProtocol.doseStatusReason
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

See R2 <--> R3 <--> R4 Conversion Maps (status = 2 3 tests that all execute ok. 2 fail All tests pass round-trip testing and 2 3 r3 resources are invalid (2 (0 errors). ). )

Structure

?! Σ 1..1 Flag for whether immunization was given Vaccination Why immunization occurred What protocol was Details of vaccine protocol string Name of vaccine CodeableConcept Disease immunized against CodeableConcept Vaccination Protocol Dose Status codes ( Example
Name Flags Card. Type Description & Constraints doco
. . Immunization I TU DomainResource Immunization event information
+ If immunization was administered (notGiven=false) then explanation.reasonNotGiven SHALL be absent. + If immunization was not administered (notGiven=true) then there SHALL be no reaction nor explanation.reason present Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier 0..* Identifier Business identifier
. . . status ?! Σ 1..1 code completed | entered-in-error | not-done
Immunization Status Codes ( Required )
. . notGiven . statusReason 0..1 boolean CodeableConcept Reason not done
Immunization Status Reason Codes ( Example )
. . . vaccineCode Σ 1..1 CodeableConcept Vaccine product administered
Vaccine Administered Value Set ( Example )
. . . patient Σ 1..1 Reference ( Patient ) Who was immunized
. . . encounter 0..1 Reference ( Encounter ) Encounter administered as immunization was part of
. . . occurrence[x] Σ 1..1 Vaccine administration date
.... occurrenceDateTime dateTime
.... occurrenceString string
. . . date recorded 0..1 dateTime Vaccination administration date When the immunization was first captured in the subject's record
. . . primarySource Σ 1..1 0..1 boolean Indicates context the data was recorded in
. . . reportOrigin 0..1 CodeableConcept Indicates the source of a secondarily reported record
Immunization Origin Codes ( Example )
. . . location 0..1 Reference ( Location ) Where vaccination immunization occurred
. . . manufacturer 0..1 Reference ( Organization ) Vaccine manufacturer
. . . lotNumber 0..1 string Vaccine lot number
. . . expirationDate 0..1 date Vaccine expiration date
. . . site 0..1 CodeableConcept Body site vaccine was administered
Codes for Immunization Site of Administration ( Example )
. . . route 0..1 CodeableConcept How vaccine entered body
Immunization Route Codes ( Example )
. . . doseQuantity 0..1 SimpleQuantity Amount of vaccine administered
. . . practitioner performer Σ 0..* BackboneElement Who performed event
. . . role . function Σ 0..1 CodeableConcept What type of performance was done
Immunization Role Function Codes ( Extensible )
. . . . actor Σ 1..1 Reference ( Practitioner | PractitionerRole | Organization ) Individual or organization who was performing
. . . note Σ 0..* Annotation Additional immunization notes
. . . reasonCode 0..* CodeableConcept Why immunization occurred
Immunization Reason Codes ( Example )
... reasonReference 0..* Reference ( Condition | Observation | DiagnosticReport ) Why immunization occurred
... isSubpotent ?! Σ 0..1 boolean Dose potency
... subpotentReason 0..* CodeableConcept Reason for being subpotent
Immunization Subpotent Reason ( Example )
. . . explanation education I 0..1 0..* BackboneElement Administration/non-administration reasons Educational material presented to patient
+ Rule: One of documentType or reference SHALL be present
.... documentType 0..1 string Educational material document identifier
. . . reason . reference 0..* 0..1 uri Educational material reference pointer
.... publicationDate 0..1 dateTime Educational material publication date
.... presentationDate 0..1 dateTime Educational material presentation date
... programEligibility 0..* CodeableConcept Patient eligibility for a vaccination program
Immunization Reason Codes Program Eligibility ( Example )
. . . reasonNotGiven fundingSource 0..* 0..1 CodeableConcept Why immunization did not occur Funding source for the vaccine
Immunization Reasons for Not Immunizing Codes Funding Source ( Example )
. . . reaction 0..* BackboneElement Details of a reaction that follows immunization
. . . . date 0..1 dateTime When reaction started
. . . . detail 0..1 Reference ( Observation ) Additional information on reaction
. . . . reported 0..1 boolean Indicates self-reported reaction
. . vaccinationProtocol . protocolApplied 0..* BackboneElement Protocol followed by the provider
. . . . doseSequence series 0..1 positiveInt string Dose number within Name of vaccine series
. . . description . authority 0..1 string Reference ( Organization ) Who is responsible for publishing the recommendations
. . . authority . targetDisease 0..1 0..* Reference CodeableConcept Vaccine preventatable disease being targetted
Immunization Target Disease Codes ( Organization Example )
Who is responsible for protocol
. . . series . doseNumber[x] 0..1 1..1 Dose number within series
. . . . . seriesDoses doseNumberPositiveInt 0..1 positiveInt Recommended number of doses for immunity
. . . targetDisease . . doseNumberString 1..* Vaccination Protocol Dose Target Codes ( Example string )
. . . doseStatus . seriesDoses[x] 1..1 0..1 Indicates if dose counts towards Recommended number of doses for immunity
. . . . . seriesDosesPositiveInt positiveInt )
. . . doseStatusReason . . seriesDosesString 0..1 CodeableConcept string Why dose does (not) count Vaccination Protocol Dose Status Reason codes ( Example )

doco Documentation for this format

UML Diagram ( Legend )

Immunization ( DomainResource ) A unique identifier assigned to this immunization record identifier : Identifier [0..*] Indicates the current status of the vaccination 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 Immunization. (Strength=Required) Immunization Status ImmunizationStatusCodes ! » Indicates if the vaccination was or reason the immunization event was not given (this element modifies the meaning of other elements) performed notGiven statusReason : boolean CodeableConcept [1..1] [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 administered. (Strength=Example) Vaccine Administered Value Set VaccineAdministeredValueSet ?? » 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 » Date vaccine administered or was to be administered occurrence[x] : Type [1..1] « dateTime | string » The date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event recorded : dateTime [0..1] 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 primarySource : boolean [1..1] [0..1] The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine reportOrigin : CodeableConcept [0..1] « The source of the data for a record which is not from a primary source. (Strength=Example) Immunization Origin ImmunizationOriginCodes ?? » The service delivery location where the vaccine administration occurred location : Reference [0..1] « Location » Name of vaccine manufacturer manufacturer : Reference [0..1] « Organization » 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 administered. (Strength=Example) Codes for Immunization Site o... 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 administered. (Strength=Example) Immunization Route 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..*] Reasons why the vaccine was administered reasonCode : CodeableConcept [0..*] « Practitioner The reason why a vaccine was administered. (Strength=Example) ImmunizationReasonCodes ?? » Condition, Observation or DiagnosticReport that supports why the immunization was administered reasonReference : Reference [0..*] « Condition | Observation | DiagnosticReport » 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..*] « The reason why a dose is considered to be subpotent. (Strength=Example) ImmunizationSubpotentReason ?? » Indicates a patient's eligibility for a funding program programEligibility : CodeableConcept [0..*] « The patient's eligibility for a vaccation program. (Strength=Example) ImmunizationProgramEligibility ?? » 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) fundingSource : CodeableConcept [0..1] « The source of funding used to purchase the vaccine administered. (Strength=Example) ImmunizationFundingSource ?? » Performer Describes the type of performance (e.g. ordering provider, administering provider, etc.) role function : CodeableConcept [0..1] « The role a practitioner or organization plays in the immunization event event. (Strength=Extensible) Immunization Role ImmunizationFunctionCodes + » The device, practitioner, etc. practitioner or organization who performed the action actor : Reference [1..1] « Practitioner | PractitionerRole | Organization » Explanation Education Reasons why a vaccine was administered Identifier of the material presented to the patient reason documentType : CodeableConcept string [0..*] [0..1] The reason why a vaccine Reference pointer to the educational material given to the patient if the information was administered (Strength=Example) on line Immunization Reason reference ?? : uri [0..1] Reason why a vaccine Date the educational material was not administered published reasonNotGiven publicationDate : CodeableConcept dateTime [0..*] [0..1] The reason why a vaccine Date the educational material was not administered (Strength=Example) given to the patient Immunization Reasons for presentationDate Not ... : dateTime ?? [0..1] Reaction Date of reaction to the immunization date : dateTime [0..1] Details of the reaction detail : Reference [0..1] « Observation » Self-reported indicator reported : boolean [0..1] VaccinationProtocol Nominal position in a series 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. E.g. ACIP authority : Reference [0..1] Organization ProtocolApplied 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 Indicates the authority who published the protocol (e.g. ACIP) that is being followed seriesDoses authority : positiveInt Reference [0..1] « Organization » The targeted vaccine preventable disease the dose is being administered against targetDisease : CodeableConcept [1..*] [0..*] « The vaccine preventable disease target of the vaccination protocol dose is being administered for. (Strength=Example) Vaccination Protocol Dose Tar... ImmunizationTargetDiseaseCodes ?? » Indicates if the immunization event should "count" against the protocol Nominal position in a series doseStatus doseNumber[x] : CodeableConcept Type [1..1] The status of the vaccination protocol (i.e. should this count) (Strength=Example) Vaccination Protocol Dose « positiveInt Sta... | string ?? » Provides an explanation as The recommended number of doses to why an immunization event should or should not count against the protocol achieve immunity doseStatusReason seriesDoses[x] : CodeableConcept Type [0..1] The reason for the determining if a vaccination should count or why vaccination should not count. (Strength=Example) Vaccination Protocol « positiveInt Dose Sta... | string ?? » Indicates who or what performed the immunization event practitioner performer [0..*] Reasons why a Educational material presented to the patient (or guardian) at the time of vaccine was or was not administered administration explanation education [0..1] [0..*] 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 protocol (set of recommendations) being followed by the vaccine was provider who administered the dose vaccinationProtocol 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>
 <
 <

 <status value="[code]"/><!-- 1..1 completed | entered-in-error | not-done -->
 <statusReason><!-- 0..1 CodeableConcept Reason not done --></statusReason>

 <vaccineCode><!-- 1..1 CodeableConcept Vaccine product administered --></vaccineCode>
 <patient><!-- 1..1 Reference(Patient) Who was immunized --></patient>
 <</encounter>
 <
 <

 <encounter><!-- 0..1 Reference(Encounter) Encounter immunization was part of --></encounter>
 <occurrence[x]><!-- 1..1 dateTime|string Vaccine administration date --></occurrence[x]>
 <recorded value="[dateTime]"/><!-- 0..1 When the immunization was first captured in the subject's record -->
 <primarySource value="[boolean]"/><!-- 0..1 Indicates context the data was recorded in -->

 <reportOrigin><!-- 0..1 CodeableConcept Indicates the source of a secondarily reported record --></reportOrigin>
 <</location>

 <location><!-- 0..1 Reference(Location) Where immunization occurred --></location>

 <manufacturer><!-- 0..1 Reference(Organization) Vaccine manufacturer --></manufacturer>
 <
 <

 <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(SimpleQuantity) Amount of vaccine administered --></doseQuantity>
 <
  <</role>
  <</actor>
 </practitioner>
 <</note>
 <
  <</reason>
  <</reasonNotGiven>
 </explanation>

 <performer>  <!-- 0..* Who performed event -->
  <function><!-- 0..1 CodeableConcept What type of performance was done --></function>
  <actor><!-- 1..1 Reference(Practitioner|PractitionerRole|Organization) Individual or organization who was performing --></actor>
 </performer>
 <note><!-- 0..* Annotation Additional immunization notes --></note>
 <reasonCode><!-- 0..* CodeableConcept Why immunization occurred --></reasonCode>
 <reasonReference><!-- 0..* Reference(Condition|Observation|DiagnosticReport) Why immunization occurred --></reasonReference>
 <isSubpotent value="[boolean]"/><!-- 0..1 Dose potency -->
 <subpotentReason><!-- 0..* CodeableConcept Reason for being subpotent --></subpotentReason>
 <education>  <!-- 0..* Educational material presented to patient -->
  <documentType value="[string]"/><!-- 0..1 Educational material document identifier -->
  <reference value="[uri]"/><!-- 0..1 Educational material reference pointer -->
  <publicationDate value="[dateTime]"/><!-- 0..1 Educational material publication date -->
  <presentationDate value="[dateTime]"/><!-- 0..1 Educational material presentation date -->
 </education>
 <programEligibility><!-- 0..* CodeableConcept Patient eligibility for a vaccination program --></programEligibility>
 <fundingSource><!-- 0..1 CodeableConcept Funding source for the vaccine --></fundingSource>

 <reaction>  <!-- 0..* Details of a reaction that follows immunization -->
  <

  <date value="[dateTime]"/><!-- 0..1 When reaction started -->

  <detail><!-- 0..1 Reference(Observation) Additional information on reaction --></detail>
  <

  <reported value="[boolean]"/><!-- 0..1 Indicates self-reported reaction -->

 </reaction>
 <
  <
  <
  <</authority>
  <
  <
  <</targetDisease>
  <</doseStatus>
  <</doseStatusReason>
 </vaccinationProtocol>

 <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><!-- 0..* CodeableConcept Vaccine preventatable disease being targetted --></targetDisease>
  <doseNumber[x]><!-- 1..1 positiveInt|string Dose number within series --></doseNumber[x]>
  <seriesDoses[x]><!-- 0..1 positiveInt|string Recommended number of doses for immunity --></seriesDoses[x]>
 </protocolApplied>

</Immunization>

JSON Template 

{doco
  "resourceType" : "",

  "resourceType" : "Immunization",

  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "
    "
    "

  "identifier" : [{ Identifier }], // Business identifier
  "status" : "<code>", // R!  completed | entered-in-error | not-done
  "statusReason" : { CodeableConcept }, // Reason not done
  "vaccineCode" : { CodeableConcept }, // R!  Vaccine product administered
  "patient" : { Reference(Patient) }, // R!  Who was immunized
  "encounter" : { Reference(Encounter) }, // Encounter immunization was part of
  // occurrence[x]: Vaccine administration date. One of these 2:

  "occurrenceDateTime" : "<dateTime>",
  "occurrenceString" : "<string>",
  "recorded" : "<dateTime>", // When the immunization was first captured in the subject's record
  "primarySource" : <boolean>, // Indicates context the data was recorded in
  "reportOrigin" : { CodeableConcept }, // Indicates the source of a secondarily reported record
  "location" : { Reference(Location) }, // Where immunization occurred
  "manufacturer" : { Reference(Organization) }, // Vaccine manufacturer
  "lotNumber" : "<string>", // Vaccine lot number
  "expirationDate" : "<date>", // Vaccine expiration date
  "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 }, // What type of performance was done
    "actor" : { Reference(Practitioner|PractitionerRole|Organization) } // R!  Individual or organization who was performing

  }],
  "
  "
    "
    "
  },
  "
    "
    "
    "

  "note" : [{ Annotation }], // Additional immunization notes
  "reasonCode" : [{ CodeableConcept }], // Why immunization occurred
  "reasonReference" : [{ Reference(Condition|Observation|DiagnosticReport) }], // Why immunization occurred
  "isSubpotent" : <boolean>, // Dose potency
  "subpotentReason" : [{ CodeableConcept }], // Reason for being subpotent
  "education" : [{ // Educational material presented to patient
    "documentType" : "<string>", // Educational material document identifier
    "reference" : "<uri>", // Educational material reference pointer
    "publicationDate" : "<dateTime>", // Educational material publication date
    "presentationDate" : "<dateTime>" // Educational material presentation date

  }],
  "
    "
    "
    "
    "
    "
    "
    "
    "

  "programEligibility" : [{ CodeableConcept }], // Patient eligibility for a vaccination program
  "fundingSource" : { CodeableConcept }, // Funding source for the vaccine
  "reaction" : [{ // Details of a reaction that follows immunization
    "date" : "<dateTime>", // When reaction started
    "detail" : { Reference(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 preventatable disease being targetted
    // doseNumber[x]: Dose number within series. One of these 2:

    "doseNumberPositiveInt" : "<positiveInt>",
    "doseNumberString" : "<string>",
    // seriesDoses[x]: Recommended number of doses for immunity. One of these 2:

    "seriesDosesPositiveInt" : "<positiveInt>"
    "seriesDosesString" : "<string>"

  }]
}

Turtle Template 

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


[ a fhir:;

[ a fhir:Immunization;

  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:Immunization.identifier [ Identifier ], ... ; # 0..* Business identifier
  fhir:
  fhir:

  fhir:Immunization.status [ code ]; # 1..1 completed | entered-in-error | not-done
  fhir:Immunization.statusReason [ CodeableConcept ]; # 0..1 Reason not done

  fhir:Immunization.vaccineCode [ CodeableConcept ]; # 1..1 Vaccine product administered
  fhir:Immunization.patient [ Reference(Patient) ]; # 1..1 Who was immunized
  fhir:
  fhir:
  fhir:

  fhir:Immunization.encounter [ Reference(Encounter) ]; # 0..1 Encounter immunization was part of
  # Immunization.occurrence[x] : 1..1 Vaccine administration date. One of these 2
    fhir:Immunization.occurrenceDateTime [ dateTime ]
    fhir:Immunization.occurrenceString [ string ]
  fhir:Immunization.recorded [ dateTime ]; # 0..1 When the immunization was first captured in the subject's record
  fhir:Immunization.primarySource [ boolean ]; # 0..1 Indicates context the data was recorded in

  fhir:Immunization.reportOrigin [ CodeableConcept ]; # 0..1 Indicates the source of a secondarily reported record
  fhir:

  fhir:Immunization.location [ Reference(Location) ]; # 0..1 Where immunization occurred

  fhir:Immunization.manufacturer [ Reference(Organization) ]; # 0..1 Vaccine manufacturer
  fhir:Immunization.lotNumber [ string ]; # 0..1 Vaccine lot number
  fhir:Immunization.expirationDate [ date ]; # 0..1 Vaccine expiration date
  fhir:Immunization.site [ CodeableConcept ]; # 0..1 Body site vaccine  was administered
  fhir:Immunization.route [ CodeableConcept ]; # 0..1 How vaccine entered body
  fhir:Immunization.doseQuantity [ Quantity(SimpleQuantity) ]; # 0..1 Amount of vaccine administered
  fhir:
    fhir:
    fhir:

  fhir:Immunization.performer [ # 0..* Who performed event
    fhir:Immunization.performer.function [ CodeableConcept ]; # 0..1 What type of performance was done
    fhir:Immunization.performer.actor [ Reference(Practitioner|PractitionerRole|Organization) ]; # 1..1 Individual or organization who was performing

  ], ...;
  fhir:
  fhir:
    fhir:
    fhir:
  ];

  fhir:Immunization.note [ Annotation ], ... ; # 0..* Additional immunization notes
  fhir:Immunization.reasonCode [ CodeableConcept ], ... ; # 0..* Why immunization occurred
  fhir:Immunization.reasonReference [ Reference(Condition|Observation|DiagnosticReport) ], ... ; # 0..* Why immunization occurred
  fhir:Immunization.isSubpotent [ boolean ]; # 0..1 Dose potency
  fhir:Immunization.subpotentReason [ CodeableConcept ], ... ; # 0..* Reason for being subpotent
  fhir:Immunization.education [ # 0..* Educational material presented to patient
    fhir:Immunization.education.documentType [ string ]; # 0..1 Educational material document identifier
    fhir:Immunization.education.reference [ uri ]; # 0..1 Educational material reference pointer
    fhir:Immunization.education.publicationDate [ dateTime ]; # 0..1 Educational material publication date
    fhir:Immunization.education.presentationDate [ dateTime ]; # 0..1 Educational material presentation date
  ], ...;
  fhir:Immunization.programEligibility [ CodeableConcept ], ... ; # 0..* Patient eligibility for a vaccination program
  fhir:Immunization.fundingSource [ CodeableConcept ]; # 0..1 Funding source for the vaccine

  fhir:Immunization.reaction [ # 0..* Details of a reaction that follows immunization
    fhir:Immunization.reaction.date [ dateTime ]; # 0..1 When reaction started
    fhir:Immunization.reaction.detail [ Reference(Observation) ]; # 0..1 Additional information on reaction
    fhir:Immunization.reaction.reported [ boolean ]; # 0..1 Indicates self-reported reaction
  ], ...;
  fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:

  fhir:Immunization.protocolApplied [ # 0..* Protocol followed by the provider
    fhir:Immunization.protocolApplied.series [ string ]; # 0..1 Name of vaccine series
    fhir:Immunization.protocolApplied.authority [ Reference(Organization) ]; # 0..1 Who is responsible for publishing the recommendations
    fhir:Immunization.protocolApplied.targetDisease [ CodeableConcept ], ... ; # 0..* Vaccine preventatable disease being targetted
    # Immunization.protocolApplied.doseNumber[x] : 1..1 Dose number within series. One of these 2
      fhir:Immunization.protocolApplied.doseNumberPositiveInt [ positiveInt ]
      fhir:Immunization.protocolApplied.doseNumberString [ string ]
    # Immunization.protocolApplied.seriesDoses[x] : 0..1 Recommended number of doses for immunity. One of these 2
      fhir:Immunization.protocolApplied.seriesDosesPositiveInt [ positiveInt ]
      fhir:Immunization.protocolApplied.seriesDosesString [ string ]

  ], ...;
]

Changes since DSTU2 Release 3

Immunization
Immunization.status
  • Change value set from http://hl7.org/fhir/ValueSet/medication-admin-status to http://hl7.org/fhir/ValueSet/immunization-status to http://hl7.org/fhir/ValueSet/immunization-status|4.0.1
Immunization.notGiven Immunization.statusReason
  • Renamed from wasNotGiven to notGiven to statusReason
  • Min Cardinality changed from 1 to 0
  • Type changed from boolean to CodeableConcept
  • No longer marked as Modifier
Immunization.occurrence[x]
  • Renamed from date to occurrence[x]
  • Min Cardinality changed from 0 to 1
  • Add Type string
Immunization.recorded
  • Added Element
Immunization.primarySource
  • Min Cardinality changed from 1 to 0
Immunization.performer
  • Renamed from practitioner to performer
Immunization.performer.function
  • Moved from Immunization.practitioner.role to function
  • Change value set from http://hl7.org/fhir/ValueSet/immunization-role to http://hl7.org/fhir/ValueSet/immunization-function
Immunization.performer.actor
  • Moved from Immunization.practitioner to Immunization.performer
  • Type Reference: Added Target Types PractitionerRole, Organization
Immunization.reasonCode
  • Moved from Immunization.explanation.reason to reasonCode
Immunization.reasonReference
  • Added Element
Immunization.reportOrigin Immunization.isSubpotent
  • Added Element
Immunization.practitioner Immunization.subpotentReason
  • Added Element
Immunization.practitioner.role Immunization.education
  • Added Element
Immunization.practitioner.actor Immunization.education.documentType
  • Added Element
Immunization.vaccinationProtocol.doseSequence Immunization.education.reference
  • Added Element
Immunization.education.publicationDate
  • Added Element
Immunization.education.presentationDate
  • Added Element
Immunization.programEligibility
  • Added Element
Immunization.fundingSource
  • Added Element
Immunization.protocolApplied
  • Renamed from vaccinationProtocol to protocolApplied
Immunization.protocolApplied.series
  • Moved from Immunization.vaccinationProtocol to Immunization.protocolApplied
Immunization.protocolApplied.authority
  • Moved from Immunization.vaccinationProtocol to Immunization.protocolApplied
Immunization.protocolApplied.targetDisease
  • Moved from Immunization.vaccinationProtocol to Immunization.protocolApplied
  • Min Cardinality changed from 1 to 0
Immunization.protocolApplied.doseNumber[x]
  • Moved from Immunization.vaccinationProtocol.doseSequence to doseNumber[x]
  • Min Cardinality changed from 0 to 1
  • Add Type string
Immunization.protocolApplied.seriesDoses[x]
  • Moved from Immunization.vaccinationProtocol.seriesDoses to seriesDoses[x]
  • Add Type string
Immunization.reported Immunization.explanation
  • deleted
Immunization.performer Immunization.vaccinationProtocol.description
  • deleted
Immunization.requester Immunization.vaccinationProtocol.doseStatus
  • deleted
Immunization.vaccinationProtocol.doseStatusReason
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

See R2 <--> R3 <--> R4 Conversion Maps (status = 2 3 tests that all execute ok. 2 fail All tests pass round-trip testing and 2 3 r3 resources are invalid (2 (0 errors). ). )

 

Alternate See the Profiles & Extensions and the alternate definitions: Master Definition ( XML , + JSON ), , XML Schema / Schematron (for ) + JSON Schema , ShEx (for Turtle ) + see the extensions & the dependency analysis

11.6.3.1 11.7.3.1 Terminology Bindings

Immunization.practitioner.role Immunization.explanation.reasonNotGiven Immunization.vaccinationProtocol.targetDisease Immunization.vaccinationProtocol.doseStatus Immunization.vaccinationProtocol.doseStatusReason
Path Definition Type Reference
Immunization.status A set of codes indicating the current status of an Immunization Immunization. Required Immunization Status Codes ImmunizationStatusCodes
Immunization.statusReason The reason why a vaccine was not administered. Example ImmunizationStatusReasonCodes
Immunization.vaccineCode The code for vaccine product administered administered. Example Vaccine Administered Value Set VaccineAdministeredValueSet
Immunization.reportOrigin The source of the data for a record which is not from a primary source. Example Immunization Origin Codes ImmunizationOriginCodes
Immunization.site The site at which the vaccine was administered administered. Example Codes for Immunization Site of Administration CodesForImmunizationSiteOfAdministration
Immunization.route The route by which the vaccine was administered administered. Example Immunization Route Codes ImmunizationRouteCodes
Immunization.performer.function The role a practitioner or organization plays in the immunization event event. Extensible Immunization Role Codes ImmunizationFunctionCodes
Immunization.explanation.reason Immunization.reasonCode The reason why a vaccine was administered administered. Example Immunization Reason Codes ImmunizationReasonCodes
Immunization.subpotentReason The reason why a vaccine was not administered dose is considered to be subpotent. Example Immunization Reasons for Not Immunizing Codes ImmunizationSubpotentReason
Immunization.programEligibility The disease target of the vaccination protocol patient's eligibility for a vaccation program. Example Vaccination Protocol Dose Target Codes ImmunizationProgramEligibility
Immunization.fundingSource The status source of funding used to purchase the vaccination protocol (i.e. should this count) vaccine administered. Example Vaccination Protocol Dose Status codes ImmunizationFundingSource
Immunization.protocolApplied.targetDisease The reason for vaccine preventable disease the determining if a vaccination should count or why vaccination should not count. dose is being administered for. Example Vaccination Protocol Dose Status Reason codes ImmunizationTargetDiseaseCodes

11.6.3.2 11.7.3.2 Constraints

id Level Location Description Expression
imm-1 : If immunization was not administered (notGiven=true) then there SHALL be no reaction nor explanation.reason present ( expression : (notGiven = true).not() or (reaction.empty() and explanation.reason.empty()) ) imm-2 : If immunization was administered (notGiven=false) then explanation.reasonNotGiven Rule Immunization.education One of documentType or reference SHALL be absent. ( expression present : (notGiven = true) documentType.exists() or explanation.reasonNotGiven.empty() reference.exists() )

11.6.4 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.

token Administrations which were not given Immunization.notGiven
Name Type Description Expression In Common
date date Vaccination (non)-Administration Date Immunization.date Immunization.occurrence 18 17 Resources
dose-sequence number Dose number within series Immunization.vaccinationProtocol.doseSequence identifier token Business identifier Immunization.identifier 26 30 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
( Organization ) 		notgiven
patient reference The patient for the vaccination record Immunization.patient
( Patient ) 		31 33 Resources
practitioner performer reference The practitioner or organization who played a role in the vaccination Immunization.practitioner.actor Immunization.performer.actor
( Practitioner , Organization , PractitionerRole )
reaction reference Additional information on reaction Immunization.reaction.detail
( Observation )
reaction-date date When reaction started Immunization.reaction.date
reason reason-code token Reason why the vaccine was administered Immunization.reasonCode
reason-reference reference Why immunization occurred Immunization.explanation.reason Immunization.reasonReference
( Condition , Observation , DiagnosticReport )
reason-not-given series token string Explanation of reason vaccination was not administered The series being followed by the provider Immunization.explanation.reasonNotGiven 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