Release 4B 5

This page is part of the FHIR Specification (v4.3.0: R4B (v5.0.0: R5 - STU ). The This is the current published version which supercedes in it's permanent home (it will always be available at this version is 5.0.0 . URL). For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R5 R4B R4

Immunization-example-protocol.json

Example Immunization/protocol (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 where the provider indicates the protocol being followed

{
  "resourceType": "Immunization",
  "id": "protocol",
  "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;protocol&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>: Twinrix (HepA/HepB) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v2-0292.html\">PH_VaccinesAdministeredCVX_CDC_NIP</a>#104)</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>: 2018-06-18</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>: PT123F</p><p><b>expirationDate</b>: 2018-12-15</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>isSubpotent</b>: false</p><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><blockquote><p><b>protocolApplied</b></p><p><b>series</b>: 2-dose</p><p><b>targetDisease</b>: Viral hepatitis, type A <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#40468003)</span></p><p><b>doseNumber</b>: 1</p></blockquote><blockquote><p><b>protocolApplied</b></p><p><b>series</b>: 3-dose</p><p><b>targetDisease</b>: Type B viral hepatitis <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#66071002)</span></p><p><b>doseNumber</b>: 2</p></blockquote></div>"

  "resourceType" : "Immunization",
  "id" : "protocol",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Immunization</b><a name=\"protocol\"> </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;protocol&quot; </p></div><p><b>identifier</b>: id:\u00a0urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234</p><p><b>status</b>: completed</p><p><b>vaccineCode</b>: Twinrix (HepA/HepB) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.1.0/CodeSystem-CVX.html\">Vaccine Administered Code Set (CVX)</a>#104)</span></p><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>: PT123F</p><p><b>expirationDate</b>: 2018-12-15</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>: 2018-06-18</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/5.1.0/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/5.1.0/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/5.1.0/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/5.1.0/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>isSubpotent</b>: false</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>Not Eligible <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.1.0/CodeSystem-immunization-program-eligibility.html\">Immunization Program Eligibility</a>#ineligible)</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/5.1.0/CodeSystem-immunization-funding-source.html\">Immunization Funding Source</a>#private)</span></p><blockquote><p><b>protocolApplied</b></p><p><b>series</b>: 2-dose</p><p><b>targetDisease</b>: Viral hepatitis, type A <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#40468003)</span></p><p><b>doseNumber</b>: 1</p></blockquote><blockquote><p><b>protocolApplied</b></p><p><b>series</b>: 3-dose</p><p><b>targetDisease</b>: Type B viral hepatitis <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#66071002)</span></p><p><b>doseNumber</b>: 2</p><p><b>seriesDoses</b>: 3</p></blockquote></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": "http://hl7.org/fhir/sid/cvx",
        "code": "104"
      }
    ],
    "text": "Twinrix (HepA/HepB)"

  "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" : "http://hl7.org/fhir/sid/cvx",
      "code" : "104"
    }],
    "text" : "Twinrix (HepA/HepB)"

  },
  "patient": {
    "reference": "Patient/example"

  "manufacturer" : {
    "reference" : {
      "reference" : "Organization/hl7"
    }

  },
  "encounter": {
    "reference": "Encounter/example"

  "lotNumber" : "PT123F",
  "expirationDate" : "2018-12-15",
  "patient" : {
    "reference" : "Patient/example"

  },
  "occurrenceDateTime": "2018-06-18",
  "primarySource": true,
  "location": {
    "reference": "Location/1"

  "encounter" : {
    "reference" : "Encounter/example"

  },
  "manufacturer": {
    "reference": "Organization/hl7"

  "occurrenceDateTime" : "2018-06-18",
  "primarySource" : true,
  "location" : {
    "reference" : "Location/1"

  },
  "lotNumber": "PT123F",
  "expirationDate": "2018-12-15",
  "site": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActSite",
        "code": "LA",
        "display": "left arm"
      }
    ]

  "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"
      }
    ]

  "route" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/v3-RouteOfAdministration",
      "code" : "IM",
      "display" : "Injection, intramuscular"
    }]

  },
  "doseQuantity": {
    "value": 5,
    "system": "http://unitsofmeasure.org",
    "code": "mg"

  "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"
      }

  "performer" : [{
    "function" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/v2-0443",
        "code" : "OP"
      }]

    },
    {
      "function": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0443",
            "code": "AP"
          }
        ]
      },
      "actor": {
        "reference": "Practitioner/example"
      }
    }
  ],
  "isSubpotent": false,
  "programEligibility": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/immunization-program-eligibility",
          "code": "ineligible"
        }
      ]

    "actor" : {
      "reference" : "Practitioner/example"

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

  },
  "protocolApplied": [
    {
      "series": "2-dose",
      "targetDisease": [
        {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "40468003"
            }
          ]
        }
      ],
      "doseNumberPositiveInt": 1

  {
    "function" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/v2-0443",
        "code" : "AP"
      }]

    },
    {
      "series": "3-dose",
      "targetDisease": [
        {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "66071002"
            }
          ]
        }
      ],
      "doseNumberPositiveInt": 2

    "actor" : {
      "reference" : "Practitioner/example"

    }
  ]

  }],
  "isSubpotent" : false,
  "programEligibility" : [{
    "program" : {
      "text" : "VFC"
    },
    "programStatus" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/immunization-program-eligibility",
        "code" : "ineligible"
      }]
    }
  }],
  "fundingSource" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/immunization-funding-source",
      "code" : "private"
    }]
  },
  "protocolApplied" : [{
    "series" : "2-dose",
    "targetDisease" : [{
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "40468003"
      }]
    }],
    "doseNumber" : "1"
  },
  {
    "series" : "3-dose",
    "targetDisease" : [{
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "66071002"
      }]
    }],
    "doseNumber" : "2",
    "seriesDoses" : "3"
  }]

}

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.