HL7 Belgium Vaccination (Patient Dossier)
1.1.1 - STU Belgium flag

This page is part of the HL7 Belgium FHIR Implementation Guide - Vaccination profiles (v1.1.1: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Resource Profile: BeVaccination - Detailed Descriptions

Active as of 2025-03-24 Maturity Level: 1

Definitions for the be-vaccination resource profile.

Guidance on how to interpret the contents of this table can be found here

0. 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.

ShortImmunization event information
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-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())
be-rule-vaccination-1: If vaccineCode.code is other, then vaccinecode text must exist ((vaccineCode.coding.where(code = 'other').exists() or vaccineCode.coding.where(code = '787859002' and system = 'http://snomed.info/sct').exists() ) 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').extension('coded').select($this.value as CodeableConcept)).exists().not() or (extension('https://www.ehealth.fgov.be/standards/fhir/vaccination/StructureDefinition/be-ext-administeredProduct').extension('coded').select($this.value as CodeableConcept)).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').select($this.value as CodeableConcept)).coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/medication/NamingSystem/be-ns-cti-extended-code').exists() or (extension('https://www.ehealth.fgov.be/standards/fhir/vaccination/StructureDefinition/be-ext-administeredProduct').extension('coded').select($this.value as CodeableConcept)).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())
be-rule-vaccination-4: If the encounter has a location, and it has a type, its type should be from be-vs-care-location (encounter.empty() or encounter.resolve().location.empty() or encounter.resolve().location.location.resolve().type.empty() or encounter.resolve().location.location.resolve().type.coding.memberOf('https://www.ehealth.fgov.be/standards/fhir/vaccination/ValueSet/be-vs-care-location').anyTrue())
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.

ShortA set of rules under which this content was created
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.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. 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.

ShortExtensionAdditional content defined by implementations
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.

Control10..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-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 areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. Immunization.extension:vaccination-originalorder
    Slice Namevaccination-originalorder
    Definition

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

    ShortBeVaccinationOriginalOrder
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(BeVaccinationOriginalOrder) (Extension Type: Reference(ImmunizationRecommendation, MedicationRequest, CarePlan))
    Is Modifierfalse
    Invariantsele-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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. Immunization.extension:administeredProduct
    Slice NameadministeredProduct
    Definition

    The product administered

    ShortBeAdministeredProduct
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(BeAdministeredProduct) (Complex Extension)
    Is Modifierfalse
    Invariantsele-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:vaccination-confirmationStatus
    Slice Namevaccination-confirmationStatus
    Definition

    How certain/reliable is the vaccination information

    ShortBeVaccinationConfirmationStatus
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(BeVaccinationConfirmationStatus) (Extension Type: code)
    Is Modifierfalse
    Invariantsele-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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    12. Immunization.extension:recorder
    Slice Namerecorder
    Definition

    The recorder of the information - note that this may not always be the same as the asserter - when a patient reports to a nurse and the nurse enters the data, the asserter is the patient, but the recorder is the nurse

    ShortBeExtRecorder
    Control1..1
    This element is affected by the following invariants: ele-1
    TypeExtension(BeExtRecorder) (Extension Type: Choice of: CodeableConcept, Reference)
    Is Modifierfalse
    Invariantsele-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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    14. Immunization.extension:note
    Slice Namenote
    Definition

    Simple note extension if the element doesn't have a note. To be replaced by https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-ext-simple-note

    ShortBeExtSimpleNote
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(BeExtSimpleNote) (Extension Type: Annotation)
    Is Modifierfalse
    Invariantsele-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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    16. Immunization.extension:vaccination-stock-location
    Slice Namevaccination-stock-location
    Definition

    The coded inventory location or type of inventory where the vaccine product was dispensed from.

    ShortBeVaccinationStockOrigin
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(BeVaccinationStockOrigin) (Extension Type: Reference(Location))
    Is Modifierfalse
    Invariantsele-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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    18. Immunization.extension:vaccination-stock-funding-organization
    Slice Namevaccination-stock-funding-organization
    Definition

    The funding source for the vaccine product.

    ShortBeVaccinationStockFundingOrganization
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(BeVaccinationStockFundingOrganization) (Extension Type: Reference(Organization))
    Is Modifierfalse
    Invariantsele-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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    20. 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).

    ShortExtensions that cannot be ignored
    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.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Summaryfalse
    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
    Invariantsele-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())
    22. Immunization.identifier
    Definition

    A unique identifier assigned to this immunization record.

    ShortA unique business identifier for a vaccination entryBusiness identifier
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    TypeIdentifier
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. Immunization.identifier.use
    Definition

    The purpose of this identifier.

    Shortusual | official | temp | secondary | old (If known)
    Comments

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

    Control0..1
    BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
    (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

    Identifies the purpose for this identifier, if known .

    Typecode
    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

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

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. Immunization.identifier.system
    Definition

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

    ShortThe namespace for the identifier value
    Comments

    Identifier.system is always case sensitive.

    Control10..1
    Typeuri
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    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.

    Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. Immunization.identifier.value
    Definition

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

    ShortThe value that is unique
    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.

    Control10..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Example<br/><b>General</b>:123456
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. Immunization.status
    Definition

    Indicates the current status of the immunization event.

    ShortThe status of this vaccination record entrycompleted | entered-in-error | not-done
    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.

    Control1..1
    BindingThe codes SHALL be taken from ImmunizationStatusCodeshttp://hl7.org/fhir/ValueSet/immunization-status|4.0.1
    (required to http://hl7.org/fhir/ValueSet/immunization-status|4.0.1)

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

    Typecode
    Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains statuses entered-in-error and not-done which means that the resource should not be treated as valid
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    32. Immunization.statusReason
    Definition

    Indicates the reason the immunization event was not performed.

    ShortReason not done
    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.

    Control0..1
    BindingThe codes SHALL be taken from For example codes, see BeVSVaccinationStatusReasonhttp://hl7.org/fhir/ValueSet/immunization-status-reason
    (required to https://www.ehealth.fgov.be/standards/fhir/vaccination/ValueSet/be-vs-vaccination-status-reason)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    34. Immunization.vaccineCode
    Definition

    Vaccine that was administered or was to be administered.

    ShortThe vaccine code - a type of vaccine, typically identified by the diseas(s) it covers. For example MMR, HPV, Tetanus, DTPaVaccine product administered
    Control1..1
    BindingThe codes SHALL be taken from For example codes, see BeVSVaccineCodehttp://hl7.org/fhir/ValueSet/vaccine-code
    (required to https://www.ehealth.fgov.be/standards/fhir/vaccination/ValueSet/be-vs-vaccine-code)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    36. Immunization.patient
    Definition

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

    ShortThe patient that this received vaccination entry refers toWho was immunized
    Control1..1
    TypeReference(BePatient, Patient)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    38. Immunization.encounter
    Definition

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

    ShortEncounter immunization was part of
    Control0..1
    TypeReference(Encounter)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    40. Immunization.occurrence[x]
    Definition

    Date vaccine administered or was to be administered.

    ShortVaccine administration date
    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.

    Control1..1
    TypeChoice of: dateTime, string
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-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 areUnordered and Closed, and can be differentiated using the following discriminators:
    • type @ $this
    • 42. Immunization.occurrence[x]:occurrenceDateTime
      Slice NameoccurrenceDateTime
      Definition

      Date vaccine administered or was to be administered.

      ShortVaccine administration date
      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.

      Control01..1
      TypedateTime, string
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      44. Immunization.occurrence[x]:occurrenceString
      Slice NameoccurrenceString
      Definition

      Date vaccine administered or was to be administered.

      ShortVaccine administration date
      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.

      Control01..1
      Typestring, dateTime
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      46. Immunization.recorded
      Definition

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

      ShortThe date/time when the vaccination event has been recordedWhen the immunization was first captured in the subject's record
      Control10..1
      TypedateTime
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      48. Immunization.location
      Definition

      The service delivery location where the vaccine administration occurred.

      ShortWhere immunization occurred
      Control0..01
      TypeReference(Location)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      50. Immunization.lotNumber
      Definition

      Lot number of the vaccine product.

      ShortVaccine lot number
      Control0..01
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      52. Immunization.expirationDate
      Definition

      Date vaccine batch expires.

      ShortVaccine expiration date
      Control0..01
      Typedate
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      54. Immunization.site
      Definition

      Body site where vaccine was administered.

      ShortBody site vaccine was administered
      Control0..1
      BindingThe codes SHALL be taken from For example codes, see BeVSVaccinationBodySitehttp://hl7.org/fhir/ValueSet/immunization-site
      (required to https://www.ehealth.fgov.be/standards/fhir/vaccination/ValueSet/be-vs-vaccination-bodysite)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      56. Immunization.site.extension:bodyLaterality
      Slice NamebodyLaterality
      Definition

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

      ShortBeExtLaterality
      Control0..1
      TypeExtension(BeExtLaterality) (Extension Type: Coding)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-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())
      58. Immunization.route
      Definition

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

      ShortHow vaccine entered body
      Control0..1
      BindingThe codes SHALL be taken from For example codes, see BeVSVaccineAdministrationRoutehttp://hl7.org/fhir/ValueSet/immunization-route
      (required to https://www.ehealth.fgov.be/standards/fhir/vaccination/ValueSet/be-vs-vaccination-administration-route)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      60. Immunization.doseQuantity
      Definition

      The quantity of vaccine product that was administered.

      ShortAmount of vaccine administered
      Control0..1
      TypeQuantity(SimpleQuantity)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      62. Immunization.performer
      Definition

      Indicates who performed the immunization event.

      ShortWho performed event
      Control0..1*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      64. 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).

      ShortExtensions that cannot be ignored even if unrecognized
      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.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      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
      Invariantsele-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())
      66. Immunization.performer.actor
      Definition

      The practitioner or organization who performed the action.

      ShortIndividual or organization who was performing
      Comments

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

      Control1..1
      TypeReference(BePractitioner, BeOrganization, BePractitionerRole, Practitioner, PractitionerRole, Organization)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      68. Immunization.reasonCode
      Definition

      Reasons why the vaccine was administered.

      ShortCan be used to indicate whether vaccination/prophylaxis took place pre- or post-expositionWhy immunization occurred
      Control0..*
      BindingThe codes SHOULD be taken from For example codes, see BeVSVaccinationReasonCodehttp://hl7.org/fhir/ValueSet/immunization-reason
      (preferred to https://www.ehealth.fgov.be/standards/fhir/vaccination/ValueSet/be-vs-vaccination-reason-code)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      70. Immunization.reasonReference
      Definition

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

      ShortWhy vaccination has occurred or not (reference to a finding)Why immunization occurred
      Control0..*
      TypeReference(Condition, Observation, DiagnosticReport)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      72. Immunization.isSubpotent
      Definition

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

      ShortDose potency
      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.

      Control0..1
      Typeboolean
      Is Modifiertrue because This element is labeled as a modifier because an immunization event with a subpotent vaccine doesn't protect the patient the same way as a potent dose.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Meaning if MissingBy default, a dose should be considered to be potent.
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      74. Immunization.reaction
      Definition

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

      ShortReaction immediately after vaccination (15-30 minutes)Details of a reaction that follows immunization
      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.

      Control0..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      76. 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).

      ShortExtensions that cannot be ignored even if unrecognized
      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.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      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
      Invariantsele-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())
      78. Immunization.reaction.date
      Definition

      Date of reaction to the immunization.

      ShortWhen reaction started
      Control10..1
      TypedateTime
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      80. Immunization.protocolApplied
      Definition

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

      ShortProtocol followed by the provider
      Control0..0*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))