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Immunization

Describes the event of a patient being administered a vaccine or a record of an immunization as reported by a patient, a clinician or another party.

Properties

NameRequiredTypeDescription
identifierIdentifier[]

Business identifier

Details

A unique identifier assigned to this immunization record.

statuscode

completed | entered-in-error | not-done

Details

Indicates the current status of the immunization event.

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

statusReasonCodeableConcept

Reason not done

Details

Indicates the reason the immunization event was not performed.

This is generally only used for the status of "not-done". The reason for performing the immunization event is captured in reasonCode, not here.

vaccineCodeCodeableConcept

Vaccine product administered

Details

Vaccine that was administered or was to be administered.

patientReference<Patient>

Who was immunized

Details

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

encounterReference<Encounter>

Encounter immunization was part of

Details

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

occurrence[x]dateTime, string

Vaccine administration date

Details

Date vaccine administered or was to be administered.

When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given. An exact date is always preferable, but the use of the String data type is acceptable when an exact date is not known. A small number of vaccines (e.g. live oral typhoid vaccine) are given as a series of patient self-administered dose over a span of time. In cases like this, often, only the first dose (typically a provider supervised dose) is recorded with the occurrence indicating the date/time of the first dose.

recordeddateTime

When the immunization was first captured in the subject's record

Details

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

primarySourceboolean

Indicates context the data was recorded in

Details

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.

Reflects the “reliability” of the content.

reportOriginCodeableConcept

Indicates the source of a secondarily reported record

Details

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

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

locationReference<Location>

Where immunization occurred

Details

The service delivery location where the vaccine administration occurred.

manufacturerReference<Organization>

Vaccine manufacturer

Details

Name of vaccine manufacturer.

lotNumberstring

Vaccine lot number

Details

Lot number of the vaccine product.

expirationDatedate

Vaccine expiration date

Details

Date vaccine batch expires.

siteCodeableConcept

Body site vaccine was administered

Details

Body site where vaccine was administered.

routeCodeableConcept

How vaccine entered body

Details

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

doseQuantityQuantity

Amount of vaccine administered

Details

The quantity of vaccine product that was administered.

performerImmunizationPerformer[]

Who performed event

Details

Indicates who performed the immunization event.

idstring

Unique id for inter-element referencing

Details

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

extensionExtension[]

Additional content defined by implementations

Details

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

modifierExtensionExtension[]

Extensions that cannot be ignored even if unrecognized

Details

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

functionCodeableConcept

What type of performance was done

Details

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

actorReference< Practitioner | PractitionerRole | Organization >

Individual or organization who was performing

Details

The practitioner or organization who performed the action.

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

noteAnnotation[]

Additional immunization notes

Details

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

reasonCodeCodeableConcept[]

Why immunization occurred

Details

Reasons why the vaccine was administered.

reasonReferenceReference< Condition | Observation | DiagnosticReport >[]

Why immunization occurred

Details

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

isSubpotentboolean

Dose potency

Details

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

Typically, the recognition of the dose being sub-potent is retrospective, after the administration (ex. notification of a manufacturer recall after administration). However, in the case of a partial administration (the patient moves unexpectedly and only some of the dose is actually administered), subpotency may be recognized immediately, but it is still important to record the event.

subpotentReasonCodeableConcept[]

Reason for being subpotent

Details

Reason why a dose is considered to be subpotent.

educationImmunizationEducation[]

Educational material presented to patient

Details

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

idstring

Unique id for inter-element referencing

Details

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

extensionExtension[]

Additional content defined by implementations

Details

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

modifierExtensionExtension[]

Extensions that cannot be ignored even if unrecognized

Details

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

documentTypestring

Educational material document identifier

Details

Identifier of the material presented to the patient.

referenceuri

Educational material reference pointer

Details

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

publicationDatedateTime

Educational material publication date

Details

Date the educational material was published.

presentationDatedateTime

Educational material presentation date

Details

Date the educational material was given to the patient.

programEligibilityCodeableConcept[]

Patient eligibility for a vaccination program

Details

Indicates a patient's eligibility for a funding program.

fundingSourceCodeableConcept

Funding source for the vaccine

Details

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).

reactionImmunizationReaction[]

Details of a reaction that follows immunization

Details

Categorical data indicating that an adverse event is associated in time to an immunization.

A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case, it should be recorded as a new AllergyIntolerance resource instance as most systems will not query against past Immunization.reaction elements.

idstring

Unique id for inter-element referencing

Details

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

extensionExtension[]

Additional content defined by implementations

Details

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

modifierExtensionExtension[]

Extensions that cannot be ignored even if unrecognized

Details

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

datedateTime

When reaction started

Details

Date of reaction to the immunization.

detailReference<Observation>

Additional information on reaction

Details

Details of the reaction.

reportedboolean

Indicates self-reported reaction

Details

Self-reported indicator.

protocolAppliedImmunizationProtocolApplied[]

Protocol followed by the provider

Details

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

idstring

Unique id for inter-element referencing

Details

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

extensionExtension[]

Additional content defined by implementations

Details

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

modifierExtensionExtension[]

Extensions that cannot be ignored even if unrecognized

Details

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

seriesstring

Name of vaccine series

Details

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

authorityReference<Organization>

Who is responsible for publishing the recommendations

Details

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

targetDiseaseCodeableConcept[]

Vaccine preventatable disease being targetted

Details

The vaccine preventable disease the dose is being administered against.

doseNumber[x]positiveInt, string

Dose number within series

Details

Nominal position in a series.

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

seriesDoses[x]positiveInt, string

Recommended number of doses for immunity

Details

The recommended number of doses to achieve immunity.

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

Search Parameters

NameTypeDescriptionExpression
datedate Vaccination (non)-Administration Date Immunization.occurrence
identifiertoken Business identifier Immunization.identifier
patientreference The patient for the vaccination record Immunization.patient
locationreferenceThe service delivery location or facility in which the vaccine was / was to be administeredImmunization.location
lot-numberstringVaccine Lot NumberImmunization.lotNumber
manufacturerreferenceVaccine ManufacturerImmunization.manufacturer
performerreferenceThe practitioner or organization who played a role in the vaccinationImmunization.performer.actor
reactionreferenceAdditional information on reactionImmunization.reaction.detail
reaction-datedateWhen reaction startedImmunization.reaction.date
reason-codetokenReason why the vaccine was administeredImmunization.reasonCode
reason-referencereferenceWhy immunization occurredImmunization.reasonReference
seriesstringThe series being followed by the providerImmunization.protocolApplied.series
statustokenImmunization event statusImmunization.status
status-reasontokenReason why the vaccine was not administeredImmunization.statusReason
target-diseasetokenThe target disease the dose is being administered againstImmunization.protocolApplied.targetDisease
vaccine-codetokenVaccine Product AdministeredImmunization.vaccineCode

Inherited Properties

NameRequiredTypeDescription
idstring

Logical id of this artifact

Details

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

metaMeta

Metadata about the resource

Details

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

implicitRulesuri

A set of rules under which this content was created

Details

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

languagecode

Language of the resource content

Details

The base language in which the resource is written.

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

textNarrative

Text summary of the resource, for human interpretation

Details

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

containedResource[]

Contained, inline Resources

Details

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

extensionExtension[]

Additional content defined by implementations

Details

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

modifierExtensionExtension[]

Extensions that cannot be ignored

Details

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.