HL7 Belgium Vaccination (Patient Dossier)
1.0.1 - STU

This page is part of the HL7 Belgium FHIR Implementation Guide - Vaccination profiles (v1.0.1: Trial Use) based on FHIR R4. The current version which supercedes this version is 1.0.2. For a full list of available versions, see the Directory of published versions

Resource Profile: BeVaccination - Detailed Descriptions

Active as of 2022-10-19 Maturity Level: 1

Definitions for the be-vaccination resource profile.

1. Immunization
InvariantsDefined on this element
be-rule-vaccination-1: If vaccineCode.code is other, then vaccinecode text must exist (: vaccineCode.coding.code = 'other' implies vaccineCode.text.exists() )
be-rule-vaccination-2: The product code SHALL be cnk, cti extended or atc (: extension('https://www.ehealth.fgov.be/standards/fhir/vaccination/StructureDefinition/be-ext-administeredProduct').valueCodeableConcept.exists().not() or extension('https://www.ehealth.fgov.be/standards/fhir/vaccination/StructureDefinition/be-ext-administeredProduct').extension('coded').valueCodeableConcept.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/medication/NamingSystem/be-ns-cnk-codes').exists() or extension('https://www.ehealth.fgov.be/standards/fhir/vaccination/StructureDefinition/be-ext-administeredProduct').extension('coded').valueCodeableConcept.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/medication/NamingSystem/be-ns-cti-extended-code').exists() or extension('https://www.ehealth.fgov.be/standards/fhir/vaccination/StructureDefinition/be-ext-administeredProduct').extension('coded').valueCodeableConcept.coding.where(system = 'http://whocc.no/atc').exists())
be-rule-vaccination-3: The reaction detail code SHALL come from be-vs-reaction-manifestation (: reaction.detail.empty() or reaction.detail.resolve().code.memberOf('https://www.ehealth.fgov.be/standards/fhir/core-clinical/ValueSet/be-vs-reaction-manifestation-code').anyTrue())
2. Immunization.extension
Control10..*
SlicingThis element introduces a set of slices on Immunization.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
3. Immunization.extension:vaccination-originalorder
SliceNamevaccination-originalorder
Control0..1
TypeExtension(BeVaccinationOriginalOrder) (Extension Type: Reference)
4. Immunization.extension:administeredProduct
SliceNameadministeredProduct
Control0..1
TypeExtension(BeAdministeredProduct) (Complex Extension)
5. Immunization.extension:vaccination-confirmationStatus
SliceNamevaccination-confirmationStatus
Control0..1
TypeExtension(BeVaccinationConfirmationStatus) (Extension Type: code)
6. Immunization.extension:recorder
SliceNamerecorder
Control1..1
TypeExtension(BeExtRecorder) (Extension Type: Reference)
7. Immunization.extension:note
SliceNamenote
Control0..1
TypeExtension(BeExtSimpleNote) (Extension Type: Annotation)
8. Immunization.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Must Supporttrue
9. Immunization.identifier.system
Control1..?
Must Supporttrue
10. Immunization.identifier.value
Control1..?
Must Supporttrue
11. Immunization.status
Must Supporttrue
12. Immunization.statusReason
BindingThe codes SHALL be taken from BeVSVaccinationStatusReasonFor example codes, see ImmunizationStatusReasonCodes
Must Supporttrue
13. Immunization.vaccineCode
BindingThe codes SHALL be taken from BeVSVaccineCodeFor example codes, see VaccineAdministeredValueSet
Must Supporttrue
14. Immunization.patient
TypeReference(BePatient|Patient))
Must Supporttrue
15. Immunization.encounter
Must Supporttrue
16. Immunization.occurrenceDateTime
Control0..1
TypedateTime
Must Supporttrue
17. Immunization.occurrenceString
Control0..1
Typestring
Must Supporttrue
18. Immunization.recorded
Control10..1
Must Supporttrue
19. Immunization.location
Control0..01
20. Immunization.lotNumber
Control0..01
21. Immunization.expirationDate
Control0..01
22. Immunization.site
BindingThe codes SHALL be taken from BeVSVaccinationBodySiteFor example codes, see CodesForImmunizationSiteOfAdministration
Must Supporttrue
23. Immunization.site.extension:bodyLaterality
SliceNamebodyLaterality
Control0..1
TypeExtension(BeExtLaterality) (Extension Type: Coding)
24. Immunization.route
BindingThe codes SHALL be taken from BeVSVaccineAdministrationRouteFor example codes, see ImmunizationRouteCodes
Must Supporttrue
25. Immunization.doseQuantity
Must Supporttrue
26. Immunization.performer
Must Supporttrue
27. Immunization.performer.actor
TypeReference(BePractitioner|BeOrganization|BePractitionerRole|Practitioner|PractitionerRole|Organization))
28. Immunization.reasonCode
BindingThe codes SHOULD be taken from BeVSVaccinationReasonCodeFor example codes, see ImmunizationReasonCodes
Must Supporttrue
29. Immunization.reasonReference
Must Supporttrue
30. Immunization.reaction
Must Supporttrue
31. Immunization.reaction.date
Control10..1
32. Immunization.protocolApplied
Control0..0*
Must Supporttrue
1. Immunization
Definition

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.

Control0..*
InvariantsDefined on this element
be-rule-vaccination-1: If vaccineCode.code is other, then vaccinecode text must exist (: vaccineCode.coding.code = 'other' implies vaccineCode.text.exists() )
be-rule-vaccination-2: The product code SHALL be cnk, cti extended or atc (: extension('https://www.ehealth.fgov.be/standards/fhir/vaccination/StructureDefinition/be-ext-administeredProduct').valueCodeableConcept.exists().not() or extension('https://www.ehealth.fgov.be/standards/fhir/vaccination/StructureDefinition/be-ext-administeredProduct').extension('coded').valueCodeableConcept.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/medication/NamingSystem/be-ns-cnk-codes').exists() or extension('https://www.ehealth.fgov.be/standards/fhir/vaccination/StructureDefinition/be-ext-administeredProduct').extension('coded').valueCodeableConcept.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/medication/NamingSystem/be-ns-cti-extended-code').exists() or extension('https://www.ehealth.fgov.be/standards/fhir/vaccination/StructureDefinition/be-ext-administeredProduct').extension('coded').valueCodeableConcept.coding.where(system = 'http://whocc.no/atc').exists())
be-rule-vaccination-3: The reaction detail code SHALL come from be-vs-reaction-manifestation (: reaction.detail.empty() or reaction.detail.resolve().code.memberOf('https://www.ehealth.fgov.be/standards/fhir/core-clinical/ValueSet/be-vs-reaction-manifestation-code').anyTrue())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (: contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (: text.`div`.exists())
2. Immunization.implicitRules
Definition

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.

Control0..1
Typeuri
Is Modifiertrue
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
3. Immunization.extension
Definition

An Extension

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.

Control10..*
TypeExtension
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Immunization.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
4. Immunization.extension:vaccination-originalorder
SliceNamevaccination-originalorder
Definition

A plan, proposal or order that is fulfilled in whole or in part by an event.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(BeVaccinationOriginalOrder) (Extension Type: Reference)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
5. Immunization.extension:administeredProduct
SliceNameadministeredProduct
Definition

The product administered

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.

Control0..1* This element is affected by the following invariants: ele-1
TypeExtension(BeAdministeredProduct) (Complex Extension)
InvariantsDefined on this element
ele-1: (: )
ext-1: (: )
6. Immunization.extension:vaccination-confirmationStatus
SliceNamevaccination-confirmationStatus
Definition

How certain/reliable is the vaccination information

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(BeVaccinationConfirmationStatus) (Extension Type: code)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
7. Immunization.extension:recorder
SliceNamerecorder
Definition

An Extension

Control1..1 This element is affected by the following invariants: ele-1
TypeExtension(BeExtRecorder) (Extension Type: Reference)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
8. Immunization.extension:note
SliceNamenote
Definition

Simple note extension if the element doesn't have a note

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(BeExtSimpleNote) (Extension Type: Annotation)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
9. Immunization.modifierExtension
Definition

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).

Control0..*
TypeExtension
Is Modifiertrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
10. Immunization.identifier
Definition

A unique identifier assigned to this immunization record.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
11. Immunization.identifier.use
Definition

The purpose of this identifier.

Control0..1
BindingThe codes SHALL be taken from IdentifierUse

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
12. Immunization.identifier.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Control10..1
Typeuri
Must Supporttrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Example
General:http://www.acme.com/identifiers/patient
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
13. Immunization.identifier.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Control10..1
Typestring
Must Supporttrue
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Example
General:123456
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
14. Immunization.status
Definition

Indicates the current status of the immunization event.

Control1..1
BindingThe codes SHALL be taken from ImmunizationStatusCodes

A set of codes indicating the current status of an Immunization.

Typecode
Is Modifiertrue
Must Supporttrue
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
15. Immunization.statusReason
Definition

Indicates the reason the immunization event was not performed.

Control0..1
BindingThe codes SHALL be taken from BeVSVaccinationStatusReasonFor example codes, see ImmunizationStatusReasonCodes
TypeCodeableConcept
Must Supporttrue
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
16. Immunization.vaccineCode
Definition

Vaccine that was administered or was to be administered.

Control1..1
BindingThe codes SHALL be taken from BeVSVaccineCodeFor example codes, see VaccineAdministeredValueSet
TypeCodeableConcept
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
17. Immunization.patient
Definition

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

Control1..1
TypeReference(BePatient|Patient))
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
18. Immunization.encounter
Definition

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

Control0..1
TypeReference(Encounter))
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
19. Immunization.occurrence[x]
Definition

Date vaccine administered or was to be administered.

Control1..1
TypeChoice of: dateTime, string
[x] NoteSee Choice of Data Types for further information about how to use [x]
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Immunization.occurrence[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
20. Immunization.occurrence[x]:occurrenceDateTime
SliceNameoccurrenceDateTime
Definition

Date vaccine administered or was to be administered.

Control01..1
TypeChoice of: dateTime, string
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
21. Immunization.occurrence[x]:occurrenceString
SliceNameoccurrenceString
Definition

Date vaccine administered or was to be administered.

Control01..1
TypeChoice of: string, dateTime
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
22. Immunization.recorded
Definition

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

Control10..1
TypedateTime
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
23. Immunization.location
Definition

The service delivery location where the vaccine administration occurred.

Control0..01
TypeReference(Location))
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
24. Immunization.lotNumber
Definition

Lot number of the vaccine product.

Control0..01
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
25. Immunization.expirationDate
Definition

Date vaccine batch expires.

Control0..01
Typedate
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
26. Immunization.site
Definition

Body site where vaccine was administered.

Control0..1
BindingThe codes SHALL be taken from BeVSVaccinationBodySiteFor example codes, see CodesForImmunizationSiteOfAdministration
TypeCodeableConcept
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
27. Immunization.site.extension:bodyLaterality
SliceNamebodyLaterality
Definition

An explicit statement of laterality of a lesion, or a treatment, etc.

Control0..1
TypeExtension(BeExtLaterality) (Extension Type: Coding)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
28. Immunization.route
Definition

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

Control0..1
BindingThe codes SHALL be taken from BeVSVaccineAdministrationRouteFor example codes, see ImmunizationRouteCodes
TypeCodeableConcept
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
29. Immunization.doseQuantity
Definition

The quantity of vaccine product that was administered.

Control0..1
TypeQuantity(SimpleQuantity)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
30. Immunization.performer
Definition

Indicates who performed the immunization event.

Control0..*
TypeBackboneElement
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
31. Immunization.performer.modifierExtension
Definition

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).

Control0..*
TypeExtension
Is Modifiertrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
32. Immunization.performer.actor
Definition

The practitioner or organization who performed the action.

Control1..1
TypeReference(BePractitioner|BeOrganization|BePractitionerRole|Practitioner|PractitionerRole|Organization))
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
33. Immunization.reasonCode
Definition

Reasons why the vaccine was administered.

Control0..*
BindingThe codes SHOULD be taken from BeVSVaccinationReasonCodeFor example codes, see ImmunizationReasonCodes
TypeCodeableConcept
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
34. Immunization.reasonReference
Definition

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

Control0..*
TypeReference(Condition|Observation|DiagnosticReport))
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
35. Immunization.isSubpotent
Definition

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

Control0..1
Typeboolean
Is Modifiertrue
Comments

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.

Meaning if MissingBy default, a dose should be considered to be potent.
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
36. Immunization.reaction
Definition

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

Control0..*
TypeBackboneElement
Must Supporttrue
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
37. Immunization.reaction.modifierExtension
Definition

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).

Control0..*
TypeExtension
Is Modifiertrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
38. Immunization.reaction.date
Definition

Date of reaction to the immunization.

Control10..1
TypedateTime
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
39. Immunization.protocolApplied
Definition

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

Control0..0*
TypeBackboneElement
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
1. Immunization
Definition

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.

Control0..*
2. Immunization.id
Definition

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

Control0..1
Typeid
Comments

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

3. Immunization.meta
Definition

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.

Control0..1
TypeMeta
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
4. Immunization.implicitRules
Definition

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.

Control0..1
Typeuri
Is Modifiertrue
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
5. Immunization.language
Definition

The base language in which the resource is written.

Control0..1
BindingThe codes SHOULD be taken from CommonLanguages A human language
Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
Comments

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).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
6. Immunization.text
Definition

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.

Control0..1
TypeNarrative
Alternate Namesnarrativehtmlxhtmldisplay
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
7. Immunization.contained
Definition

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.

Control0..*
TypeResource
Alternate Namesinline resourcesanonymous resourcescontained resources
Comments

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.

8. Immunization.extension
Definition

An Extension

Control1..*
TypeExtension
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Immunization.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
9. Immunization.extension:vaccination-originalorder
SliceNamevaccination-originalorder
Definition

A plan, proposal or order that is fulfilled in whole or in part by an event.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(BeVaccinationOriginalOrder) (Extension Type: Reference)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
10. Immunization.extension:administeredProduct
SliceNameadministeredProduct
Definition

The product administered

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(BeAdministeredProduct) (Complex Extension)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
11. Immunization.extension:vaccination-confirmationStatus
SliceNamevaccination-confirmationStatus
Definition

How certain/reliable is the vaccination information

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(BeVaccinationConfirmationStatus) (Extension Type: code)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
12. Immunization.extension:recorder
SliceNamerecorder
Definition

An Extension

Control1..1 This element is affected by the following invariants: ele-1
TypeExtension(BeExtRecorder) (Extension Type: Reference)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
13. Immunization.extension:note
SliceNamenote
Definition

Simple note extension if the element doesn't have a note

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(BeExtSimpleNote) (Extension Type: Annotation)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
14. Immunization.modifierExtension
Definition

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).

Control0..*
TypeExtension
Is Modifiertrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensionsuser content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
15. Immunization.identifier
Definition

A unique identifier assigned to this immunization record.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
16. Immunization.identifier.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
17. Immunization.identifier.extension
Definition

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.

Control0..*
TypeExtension
Alternate Namesextensionsuser content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Immunization.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
18. Immunization.identifier.use
Definition

The purpose of this identifier.

Control0..1
BindingThe codes SHALL be taken from IdentifierUse Identifies the purpose for this identifier, if known
Typecode
Is Modifiertrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
19. Immunization.identifier.type
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Control0..1
BindingThe codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable A coded type for an identifier that can be used to determine which identifier to use for a specific purpose
TypeCodeableConcept
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
20. Immunization.identifier.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Control1..1
Typeuri
Must Supporttrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Example
General:http://www.acme.com/identifiers/patient
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
21. Immunization.identifier.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Control1..1
Typestring
Must Supporttrue
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Example
General:123456
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
22. Immunization.identifier.period
Definition

Time period during which identifier is/was valid for use.

Control0..1
TypePeriod
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
23. Immunization.identifier.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(Organization))
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
24. Immunization.status
Definition

Indicates the current status of the immunization event.

Control1..1
BindingThe codes SHALL be taken from ImmunizationStatusCodes A set of codes indicating the current status of an Immunization
Typecode
Is Modifiertrue
Must Supporttrue
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
25. Immunization.statusReason
Definition

Indicates the reason the immunization event was not performed.

Control0..1
BindingThe codes SHALL be taken from BeVSVaccinationStatusReason
TypeCodeableConcept
Must Supporttrue
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
26. Immunization.vaccineCode
Definition

Vaccine that was administered or was to be administered.

Control1..1
BindingThe codes SHALL be taken from BeVSVaccineCode
TypeCodeableConcept
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
27. Immunization.patient
Definition

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

Control1..1
TypeReference(BePatient))
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
28. Immunization.encounter
Definition

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

Control0..1
TypeReference(Encounter))
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
29. Immunization.occurrence[x]
Definition

Date vaccine administered or was to be administered.

Control1..1
TypeChoice of: dateTime, string
[x] NoteSee Choice of Data Types for further information about how to use [x]
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Immunization.occurrence[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
30. Immunization.occurrence[x]:occurrenceDateTime
SliceNameoccurrenceDateTime
Definition

Date vaccine administered or was to be administered.

Control0..1
TypedateTime
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
31. Immunization.occurrence[x]:occurrenceString
SliceNameoccurrenceString
Definition

Date vaccine administered or was to be administered.

Control0..1
Typestring
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
32. Immunization.recorded
Definition

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

Control1..1
TypedateTime
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
33. Immunization.primarySource
Definition

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.

Control0..1
Typeboolean
Comments

Reflects the “reliability” of the content.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
34. Immunization.reportOrigin
Definition

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

Control0..1
BindingFor example codes, see ImmunizationOriginCodes The source of the data for a record which is not from a primary source
TypeCodeableConcept
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
35. Immunization.location
Definition

The service delivery location where the vaccine administration occurred.

Control0..0
TypeReference(Location))
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
36. Immunization.manufacturer
Definition

Name of vaccine manufacturer.

Control0..1
TypeReference(Organization))
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
37. Immunization.lotNumber
Definition

Lot number of the vaccine product.

Control0..0
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
38. Immunization.expirationDate
Definition

Date vaccine batch expires.

Control0..0
Typedate
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
39. Immunization.site
Definition

Body site where vaccine was administered.

Control0..1
BindingThe codes SHALL be taken from BeVSVaccinationBodySite
TypeCodeableConcept
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
40. Immunization.site.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
41. Immunization.site.extension
Definition

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.

Control0..*
TypeExtension
Alternate Namesextensionsuser content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Immunization.site.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
42. Immunization.site.extension:bodyLaterality
SliceNamebodyLaterality
Definition

An explicit statement of laterality of a lesion, or a treatment, etc.

Control0..1
TypeExtension(BeExtLaterality) (Extension Type: Coding)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
43. Immunization.site.coding
Definition

A reference to a code defined by a terminology system.

Control0..*
TypeCoding
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
44. Immunization.site.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control0..1
Typestring
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
45. Immunization.route
Definition

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

Control0..1
BindingThe codes SHALL be taken from BeVSVaccineAdministrationRoute
TypeCodeableConcept
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
46. Immunization.doseQuantity
Definition

The quantity of vaccine product that was administered.

Control0..1
TypeQuantity(SimpleQuantity)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
47. Immunization.performer
Definition

Indicates who performed the immunization event.

Control0..*
TypeBackboneElement
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
48. Immunization.performer.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
49. Immunization.performer.extension
Definition

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.

Control0..*
TypeExtension
Alternate Namesextensionsuser content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
50. Immunization.performer.modifierExtension
Definition

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).

Control0..*
TypeExtension
Is Modifiertrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensionsuser contentmodifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
51. Immunization.performer.function
Definition

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

Control0..1
BindingThe codes SHALL be taken from ImmunizationFunctionCodes; other codes may be used where these codes are not suitable The role a practitioner or organization plays in the immunization event
TypeCodeableConcept
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
52. Immunization.performer.actor
Definition

The practitioner or organization who performed the action.

Control1..1
TypeReference(BePractitionerBeOrganizationBePractitionerRole))
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
53. Immunization.note
Definition

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

Control0..*
TypeAnnotation
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
54. Immunization.reasonCode
Definition

Reasons why the vaccine was administered.

Control0..*
BindingThe codes SHOULD be taken from BeVSVaccinationReasonCode
TypeCodeableConcept
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
55. Immunization.reasonReference
Definition

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

Control0..*
TypeReference(ConditionObservationDiagnosticReport))
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
56. Immunization.isSubpotent
Definition

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

Control0..1
Typeboolean
Is Modifiertrue
Comments

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.

Meaning if MissingBy default, a dose should be considered to be potent.
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
57. Immunization.subpotentReason
Definition

Reason why a dose is considered to be subpotent.

Control0..*
BindingFor example codes, see ImmunizationSubpotentReason The reason why a dose is considered to be subpotent
TypeCodeableConcept
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
58. Immunization.education
Definition

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

Control0..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
imm-1: One of documentType or reference SHALL be present (: documentType.exists() or reference.exists())
59. Immunization.education.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
60. Immunization.education.extension
Definition

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.

Control0..*
TypeExtension
Alternate Namesextensionsuser content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
61. Immunization.education.modifierExtension
Definition

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).

Control0..*
TypeExtension
Is Modifiertrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensionsuser contentmodifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
62. Immunization.education.documentType
Definition

Identifier of the material presented to the patient.

Control0..1
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
63. Immunization.education.reference
Definition

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

Control0..1
Typeuri
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
64. Immunization.education.publicationDate
Definition

Date the educational material was published.

Control0..1
TypedateTime
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
65. Immunization.education.presentationDate
Definition

Date the educational material was given to the patient.

Control0..1
TypedateTime
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
66. Immunization.programEligibility
Definition

Indicates a patient's eligibility for a funding program.

Control0..*
BindingFor example codes, see ImmunizationProgramEligibility The patient's eligibility for a vaccation program
TypeCodeableConcept
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
67. Immunization.fundingSource
Definition

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).

Control0..1
BindingFor example codes, see ImmunizationFundingSource The source of funding used to purchase the vaccine administered
TypeCodeableConcept
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
68. Immunization.reaction
Definition

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

Control0..*
TypeBackboneElement
Must Supporttrue
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
69. Immunization.reaction.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
70. Immunization.reaction.extension
Definition

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.

Control0..*
TypeExtension
Alternate Namesextensionsuser content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
71. Immunization.reaction.modifierExtension
Definition

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).

Control0..*
TypeExtension
Is Modifiertrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensionsuser contentmodifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
72. Immunization.reaction.date
Definition

Date of reaction to the immunization.

Control1..1
TypedateTime
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
73. Immunization.reaction.detail
Definition

Details of the reaction.

Control0..1
TypeReference(Observation))
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
74. Immunization.reaction.reported
Definition

Self-reported indicator.

Control0..1
Typeboolean
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
75. Immunization.protocolApplied
Definition

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

Control0..0
TypeBackboneElement
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))