Immunization

The FHIR resource Immunization is for historic Immunization records

idΣ1..1string
id0..1string
extensionI0..*Extension
versionIdΣ0..1id
lastUpdatedΣ0..1instant
sourceΣ0..1uri
profileΣ1..1canonical(StructureDefinition)
securityΣ0..1CodingBinding
tagΣ0..1Coding
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..1Resource
antigenDoseI0..*Extension(Complex)
modifierExtension?! I0..*Extension
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
id0..0string
extensionI0..*Extension
codingΣ0..0Coding
textΣ1..1string
systemΣ1..1uri
valueΣ1..1string
periodΣ0..1Period
assignerΣ0..1Reference(Organization)
statusΣ ?!1..1codeBinding
statusReason0..1CodeableConcept
id0..0string
extensionI0..*Extension
id0..0string
extensionI0..*Extension
systemΣ0..1uri
versionΣ0..1string
codeΣ0..1code
displayΣ0..1string
userSelectedΣ0..1boolean
id0..0string
extensionI0..*Extension
systemΣ1..1uri
versionΣ0..0string
codeΣ1..1code
displayΣ1..1string
userSelectedΣ0..0boolean
id0..0string
extensionI0..*Extension
systemΣ1..1uri
versionΣ0..0string
codeΣ1..1code
displayΣ1..1string
userSelectedΣ0..0boolean
id0..0string
extensionI0..*Extension
systemΣ1..1uri
versionΣ0..0string
codeΣ1..1code
displayΣ0..1string
userSelectedΣ0..0boolean
textΣ0..1string
id0..0string
extensionI0..*Extension
referenceΣ I1..1string
typeΣ0..0uriBinding
identifierΣ0..0Identifier
displayΣ0..0string
encounter0..1Reference(Encounter)
id0..1string
id0..0string
extensionI0..*Extension
url1..1uriFixed Value
valueBooleanboolean
value0..1System.DateTime
recorded0..1dateTime
primarySourceΣ0..1boolean
reportOrigin0..1CodeableConcept
id0..0string
extensionI0..*Extension
referenceΣ I1..1string
typeΣ0..0uriBinding
identifierΣ0..0Identifier
displayΣ0..0string
manufacturer0..1Reference(Organization)
lotNumber0..1string
expirationDate0..1date
id0..0string
extensionI0..*Extension
id0..0string
extensionI0..*Extension
systemΣ0..1uri
versionΣ0..0string
codeΣ0..1code
displayΣ0..1string
userSelectedΣ0..0boolean
textΣ0..0string
id0..0string
extensionI0..*Extension
id0..0string
extensionI0..*Extension
systemΣ0..1uri
versionΣ0..0string
codeΣ0..1code
displayΣ0..1string
userSelectedΣ0..0boolean
textΣ0..0string
id0..0string
extensionI0..*Extension
valueΣ0..1decimal
comparatorΣ ?!0..0codeBinding
unitΣ0..1string
systemΣ I0..0uri
codeΣ0..0code
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
functionΣ0..1CodeableConceptBinding
id0..1string
extensionI0..*Extension
referenceΣ I0..1string
typeΣ0..1uriBinding
identifierΣ0..1Identifier
displayΣ0..1string
noteΣ0..*Annotation
reasonCode0..1CodeableConcept
reasonReference0..1Reference(Condition | Observation | DiagnosticReport)
isSubpotentΣ ?!0..1boolean
id0..1string
extensionI0..*Extension
id0..0string
extensionI0..*Extension
systemΣ1..1uri
versionΣ0..1string
codeΣ1..1code
displayΣ1..1string
userSelectedΣ0..1boolean
id0..1string
extensionI0..*Extension
systemΣ1..1uri
versionΣ0..1string
codeΣ1..1code
displayΣ1..1string
userSelectedΣ0..1boolean
textΣ0..1string
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
documentType0..1string
reference0..1uri
publicationDate0..1dateTime
presentationDate0..1dateTime
programEligibility0..1CodeableConcept
fundingSource0..1CodeableConcept
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
date0..1dateTime
detail0..1Reference(Observation)
reported0..1boolean
id0..0string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
series0..0string
authority0..0Reference(Organization)
targetDisease0..0CodeableConcept
id0..1string
_doseNumberI0..1Extension(Complex)
value0..1System.String
Immunization
DefinitionFHIR resource applies for PIR Immunization History
Cardinality0...*
Invariants
  • 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()
Mappings
  • rim: Entity. Role, or Act
  • workflow: Event
  • v2: VXU_V04
  • rim: SubstanceAdministration
Immunization.id
DefinitionPIR Internal Immunization ID
Cardinality1...1
Typestring
SummaryTrue
Comments

See Mappings

Mappings
  • source-PIR: PIR Imms ID
  • source-PHSL: immunizationId
Immunization.meta
DefinitionThe 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.
Cardinality1...1
TypeMeta
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Immunization.meta.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Immunization.meta.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
Immunization.meta.versionId
DefinitionThe version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.
Cardinality0...1
Typeid
SummaryTrue
Comments

Apply "2025.01.1". This indicates the FHIR Specs as of year 2025 Jan.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Immunization.meta.lastUpdated
DefinitionWhen the resource last changed - e.g. when the version changed.
Cardinality0...1
Typeinstant
SummaryTrue
Comments

Updated: Relax the previously crossed-out elements.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Immunization.meta.source
DefinitionA uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.
Cardinality0...1
Typeuri
SummaryTrue
Comments

In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Immunization.meta.profile
DefinitionA list of profiles (references to [StructureDefinition](structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](structuredefinition-definitions.html#StructureDefinition.url).
Cardinality1...1
Typecanonical(StructureDefinition)
SummaryTrue
Comments

Use 'http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/Immunization'

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Immunization.meta.security
DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
Cardinality0...1
TypeCoding
Binding

Security Labels from the Healthcare Privacy and Security Classification System.

All Security Labels (extensible)
SummaryTrue
Comments

The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Immunization.meta.tag
DefinitionTags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
Cardinality0...1
TypeCoding
Binding

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

CommonTags (example)
SummaryTrue
Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Immunization.implicitRules
DefinitionA 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.
Cardinality0...1
Typeuri
ModifierTrue
SummaryTrue
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Immunization.language
DefinitionThe base language in which the resource is written.
Cardinality0...1
Typecode
Binding

A human language.

CommonLanguages (preferred)
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).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Immunization.text
DefinitionA 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.
Cardinality0...1
TypeNarrative
Aliasnarrative, html, xhtml, display
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: Act.text?
Immunization.contained
DefinitionThese 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.
Cardinality0...1
TypeResource
Aliasinline resources, anonymous resources, contained 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.

Mappings
  • rim: N/A
Immunization.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: N/A
Immunization.extension:antigenDose
DefinitionAntgien(s) + Antigen Dose Number + Antigen Dose Status associated with the Agent administered
Cardinality0...*
TypeExtension(Complex)
Aliasextensions, user content
Comments

To apply for antigens information

Invariants
  • 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()
Mappings
  • rim: N/A
  • rim: n/a
Immunization.modifierExtension
DefinitionMay 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).
Cardinality0...*
TypeExtension
ModifierTrue
Aliasextensions, user content
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.

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.

Invariants
  • 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()
Mappings
  • rim: N/A
Immunization.identifier
DefinitionPIR Immunization Identifier(s) which include Panorama Internal Immunization ID, External Immunization ID from different source systems).
Cardinality1...*
TypeIdentifier
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.identifier
  • w5: FiveWs.identifier
  • rim: .id
  • cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/id
Immunization.identifier.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Immunization.identifier.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
Immunization.identifier.use
DefinitionThe purpose of this identifier.
Cardinality0...1
Typecode
Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)
ModifierTrue
SummaryTrue
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: N/A
  • rim: Role.code or implied by context
Immunization.identifier.type
DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Cardinality1...1
TypeCodeableConcept
Binding

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

Identifier Type Codes (extensible)
SummaryTrue
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: CX.5
  • rim: Role.code or implied by context
Immunization.identifier.type.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...0
Typestring
Mappings
  • rim: n/a
Immunization.identifier.type.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
Immunization.identifier.type.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality0...0
TypeCoding
SummaryTrue
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Immunization.identifier.type.text
DefinitionA 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.
Cardinality1...1
Typestring
SummaryTrue
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

See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  • source-PIR: PANORAMAIMMZID'
  • source-NHA: NHACEDARIMMS
  • source-VCH: VCHPARISIMMS
  • source-FHA: FHAPARISIMMS
  • source-PNet: PHARMANETIMMS
  • source-CznSub: CZNSUBIMMSID
  • source-immsBC: HEALTHCONNECT
  • source-eForms: EFORMIMMSID
Immunization.identifier.system
DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique.
Cardinality1...1
Typeuri
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.

Comments

See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General

http://www.acme.com/identifiers/patient


Mappings
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
  • source-PIR: https://health.gov.bc.ca/fhir/NamingSystem/ca-bc-panorama-immunization-id
  • source-NHA: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-nha
  • source-FHA: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-fha
  • source-VCH: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-vcha
  • source-PNet: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-pharmanet-document-number
  • source-CznSub: https://ehealthbc.ca/NamingSystem/ca-bc-citizen-submission
  • source-eForms: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-eForm
  • source-immsBC: https://ehealthbc.ca/NamingSystem/ca-bc-health-connect
Immunization.identifier.value
DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system.
Cardinality1...1
Typestring
SummaryTrue
Comments

See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General

123456


Mappings
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
  • source-PIR: PIR Immunization ID
  • source-FHA: FHA PARIS Immunization ID
  • source-NHA: NHA CeDaR Immunization ID
  • source-VCH: VCH PARIS Immunization ID
  • source-PNet: PharmaNet Immunization ID
  • source-PHSL: immunizationId
Immunization.identifier.period
DefinitionTime period during which identifier is/was valid for use.
Cardinality0...1
TypePeriod
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
Immunization.identifier.assigner
DefinitionOrganization that issued/manages the identifier.
Cardinality0...1
TypeReference(Organization)
SummaryTrue
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
Immunization.status
DefinitionIndicates the current status of the immunization record.
Cardinality1...1
Typecode
Binding

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

ImmunizationStatusCodes (required)
ModifierTrue
SummaryTrue
Comments

IDS sends "completed" or "entered-in-error" immunization records only.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.status
  • w5: FiveWs.status
  • rim: statusCode
Immunization.statusReason
DefinitionIndicates the reason the immunization event was not performed.
Cardinality0...1
TypeCodeableConcept
Binding

The reason why a vaccine was not administered.

ImmunizationStatusReasonCodes (example)
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.statusReason
  • rim: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
Immunization.vaccineCode
DefinitionVaccine that was administered.
Cardinality1...1
TypeCodeableConcept
Binding

The code for vaccine product administered.

VaccineAdministeredValueSet (example)
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.code
  • w5: FiveWs.what[x]
  • v2: RXA-5
  • rim: .code
  • cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/realmCode/code
Immunization.vaccineCode.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...0
Typestring
Mappings
  • rim: n/a
Immunization.vaccineCode.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
Immunization.vaccineCode.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality0...*
TypeCoding
SummaryTrue
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.

SlicingUnordered, Open, by code(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Immunization.vaccineCode.coding.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...0
Typestring
Mappings
  • rim: n/a
Immunization.vaccineCode.coding.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
Immunization.vaccineCode.coding.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality0...1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Immunization.vaccineCode.coding.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...1
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Immunization.vaccineCode.coding.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality0...1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Immunization.vaccineCode.coding.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
Immunization.vaccineCode.coding.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Immunization.vaccineCode.coding:AgentNVC
DefinitionAgent code and name in NVC
Cardinality1...1
TypeCoding
SummaryTrue
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Immunization.vaccineCode.coding:AgentNVC.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...0
Typestring
Mappings
  • rim: n/a
Immunization.vaccineCode.coding:AgentNVC.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
Immunization.vaccineCode.coding:AgentNVC.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality1...1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  • code-NVC: https://nvc-cnv.canada.ca
  • code-SNOMED: http://snomed.info/sct
Immunization.vaccineCode.coding:AgentNVC.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...0
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Immunization.vaccineCode.coding:AgentNVC.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality1...1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  • source-PIR: BCYREPORTING.RBCY_FN_GET_CONCEPT_CODE(H33_VACCINATION_MASTER_ASIIS_VACC_CODE)
  • source-PHSL: immunizationAgentCode
Immunization.vaccineCode.coding:AgentNVC.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality1...1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  • source-PIR: REPORTING.GET_ITERM_DESC(H33_VACCINATION_MASTER_ASIIS_VACC_CODE)
  • source-PHSL: immunizationAgentDescription
Immunization.vaccineCode.coding:AgentNVC.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...0
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Immunization.vaccineCode.coding:AgentPIR
DefinitionA reference to a code defined by a terminology system.
Cardinality0...1
TypeCoding
SummaryTrue
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Immunization.vaccineCode.coding:AgentPIR.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...0
Typestring
Mappings
  • rim: n/a
Immunization.vaccineCode.coding:AgentPIR.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
Immunization.vaccineCode.coding:AgentPIR.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality1...1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  • code-PIR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-code
Immunization.vaccineCode.coding:AgentPIR.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...0
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Immunization.vaccineCode.coding:AgentPIR.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality1...1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Immunization.vaccineCode.coding:AgentPIR.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality1...1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
Immunization.vaccineCode.coding:AgentPIR.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...0
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Immunization.vaccineCode.coding:Tradename
DefinitionTradename of agent administered
Cardinality0...1
TypeCoding
SummaryTrue
Requirements

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

Comments

Tradename of agent administered

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Immunization.vaccineCode.coding:Tradename.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...0
Typestring
Mappings
  • rim: n/a
Immunization.vaccineCode.coding:Tradename.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
Immunization.vaccineCode.coding:Tradename.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality1...1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  • code-CVC: https://cvc.canimmunize.ca
  • code-SNOMED: http://snomed.info/sct
Immunization.vaccineCode.coding:Tradename.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...0
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Immunization.vaccineCode.coding:Tradename.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality1...1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  • source-PIR: BCYREPORTNG.RBCY_FN_GET_CONCEPT_CODE (H33_VACCINATION_MASTER.ASIIS_VACC_CODE)
  • source-PHSL: tradeName
Immunization.vaccineCode.coding:Tradename.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  • source-PIR: REPORTNG.GET_ITERM_DESC(H33_VACCINATION_MASTER.ASIIS_VACC_CODE)
Immunization.vaccineCode.coding:Tradename.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...0
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Immunization.vaccineCode.text
DefinitionA 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.
Cardinality0...1
Typestring
SummaryTrue
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

See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  • source-PIR: immunizationAgentCombineDescription
  • source-PHSL: immunizationAgentCombineDescription
Immunization.patient
DefinitionThe patient who either received or did not receive the immunization.
Cardinality1...1
TypeReference(Patient)
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.subject
  • w5: FiveWs.subject[x]
  • v2: PID-3
  • rim: .partipication[ttypeCode=].role
  • w5: FiveWs.subject
Immunization.patient.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...0
Typestring
Mappings
  • rim: n/a
Immunization.patient.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
Immunization.patient.reference
DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Cardinality1...1
Typestring
SummaryTrue
Comments

See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
  • source-PIR: fullURL of Panorama + "Patient'+PIR Client ID
Immunization.patient.type
DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Cardinality0...0
Typeuri
Binding

Aa resource (or, for logical models, the URI of the logical model).

ResourceType (extensible)
SummaryTrue
Comments

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
Immunization.patient.identifier
DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Cardinality0...0
TypeIdentifier
SummaryTrue
Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .identifier
Immunization.patient.display
DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
Cardinality0...0
Typestring
SummaryTrue
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
Immunization.encounter
DefinitionThe visit or admission or other contact between patient and health care provider the immunization was performed as part of.
Cardinality0...1
TypeReference(Encounter)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.context
  • w5: FiveWs.context
  • v2: PV1-19
  • rim: component->EncounterEvent
Immunization.occurrence[x]
DefinitionDate vaccine administered
Cardinality1...1
TypedateTime
SummaryTrue
Comments

See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.occurrence[x]
  • w5: FiveWs.done[x]
  • v2: RXA-3
  • rim: .effectiveTime
  • cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value
  • source-PIR: imms.h33_vaccination_master.vacc_date
  • source-PHSL: vaccDate
Immunization.occurrence[x].id
Definitionunique id for the element within a resource (for internal references)
Cardinality0...1
Typestring
Immunization.occurrence[x].extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Immunization.occurrence[x].extension:_occurrenceDateTime
DefinitionEstimated Flag for Vaccination Date
Cardinality0...*
TypeExtension(boolean)
Aliasextensions, user content
Comments

See Mappings

Invariants
  • 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()
Mappings
  • rim: n/a
  • rim: N/A
  • source-PHSL: VM.VACC_DATE_ESTIMATED_IND = 'Y
  • source-PHSL: note="E"
Immunization.occurrence[x].extension:_occurrenceDateTime.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...0
Typestring
Mappings
  • rim: n/a
Immunization.occurrence[x].extension:_occurrenceDateTime.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
Immunization.occurrence[x].extension:_occurrenceDateTime.url
DefinitionSource of the definition for the extension code - a logical name or a URL.
Cardinality1...1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value

https://ehealthontario.ca/API/FHIR/StructureDefinition/ca-on-extension-estimated-date

Mappings
  • rim: N/A
Immunization.occurrence[x].extension:_occurrenceDateTime.value[x]
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality0...1
Typeboolean
Comments

Apply PIR: H33_VACCINATION_MASTER.VACC_DATE

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
Immunization.occurrence[x].value
DefinitionThe actual value
Cardinality0...1
TypeSystem.DateTime
Immunization.recorded
DefinitionThe date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event.
Cardinality0...1
TypedateTime
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.recorded
  • rim: .participation[typeCode=AUT].time
Immunization.primarySource
DefinitionAn 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.
Cardinality0...1
Typeboolean
SummaryTrue
Comments

Reflects the “reliability” of the content.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.source
  • v2: RXA-9
  • rim: immunization.uncertaintycode (if primary source=false, uncertainty=U)
Immunization.reportOrigin
DefinitionThe source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.
Cardinality0...1
TypeCodeableConcept
Binding

The source of the data for a record which is not from a primary source.

ImmunizationOriginCodes (example)
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.source
  • v2: RXA-9
  • rim: .participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported) .participation[typeCode=INF].role[classCode=LIC] (this syntax for health care professional) .participation[typeCode=INF].role[classCode=PRS] (this syntax for family member)
Immunization.location
DefinitionImmunization Service Delivery Location (SDL)
Cardinality0...1
TypeReference(Location)
Comments

See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.location
  • w5: FiveWs.where[x]
  • v2: RXA-27 (or RXA-11, deprecated as of v2.7)
  • rim: .participation[typeCode=LOC].COCT_MT240000UV
  • source-PHSL: serviceDeliveryLocationName
  • source-PIR: H33_VACCINATION_MASTER.location_id
Immunization.location.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...0
Typestring
Mappings
  • rim: n/a
Immunization.location.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
Immunization.location.reference
DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Cardinality1...1
Typestring
SummaryTrue
Comments

fullURL of Panorama + 'Location' + PIR Loc ID + 'org' + PIR Imms Org ID

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
Immunization.location.type
DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Cardinality0...0
Typeuri
Binding

Aa resource (or, for logical models, the URI of the logical model).

ResourceType (extensible)
SummaryTrue
Comments

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
Immunization.location.identifier
DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Cardinality0...0
TypeIdentifier
SummaryTrue
Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .identifier
Immunization.location.display
DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
Cardinality0...0
Typestring
SummaryTrue
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
Immunization.manufacturer
DefinitionName of vaccine manufacturer.
Cardinality0...1
TypeReference(Organization)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: RXA-17
  • rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=ORG]
  • cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacuturerOrganization/name
Immunization.lotNumber
DefinitionLot number of the vaccine product.
Cardinality0...1
Typestring
Comments

See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: RXA-15
  • rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].id
  • cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/lotNumberText
  • source-PIR: INV_PRODUCT_LOT_INFO.LOT_NUMBER
  • source-PHSL: lotNumber
Immunization.expirationDate
DefinitionDate vaccine batch expires.
Cardinality0...1
Typedate
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: RXA-16
  • rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime
Immunization.site
DefinitionBody site where vaccine was administered.
Cardinality0...1
TypeCodeableConcept
Binding

The site at which the vaccine was administered.

CodesForImmunizationSiteOfAdministration (example)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: RXR-2
  • rim: observation.targetSiteCode
  • cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/approachSiteCode/code
Immunization.site.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...0
Typestring
Mappings
  • rim: n/a
Immunization.site.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
Immunization.site.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality0...*
TypeCoding
SummaryTrue
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Immunization.site.coding.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...0
Typestring
Mappings
  • rim: n/a
Immunization.site.coding.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
Immunization.site.coding.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality0...1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Use 'http://snomed.info/sct''

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Immunization.site.coding.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...0
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Immunization.site.coding.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality0...1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Apply SNOMED code

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Immunization.site.coding.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
Immunization.site.coding.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...0
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Immunization.site.text
DefinitionA 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.
Cardinality0...0
Typestring
SummaryTrue
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Immunization.route
DefinitionThe path by which the vaccine product is taken into the body.
Cardinality0...1
TypeCodeableConcept
Binding

The route by which the vaccine was administered.

ImmunizationRouteCodes (example)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: RXR-1
  • rim: .routeCode
  • cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/routeCode/code
Immunization.route.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...0
Typestring
Mappings
  • rim: n/a
Immunization.route.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
Immunization.route.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality0...*
TypeCoding
SummaryTrue
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Immunization.route.coding.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...0
Typestring
Mappings
  • rim: n/a
Immunization.route.coding.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
Immunization.route.coding.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality0...1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Use 'http://snomed.info/sct'

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Immunization.route.coding.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...0
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Immunization.route.coding.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality0...1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Apply SNOMED code

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Immunization.route.coding.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
Immunization.route.coding.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...0
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Immunization.route.text
DefinitionA 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.
Cardinality0...0
Typestring
SummaryTrue
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Immunization.doseQuantity
DefinitionThe quantity of vaccine product that was administered.
Cardinality0...1
TypeSimpleQuantity
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: RXA-6 / RXA-7
  • rim: .doseQuantity
Immunization.doseQuantity.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...0
Typestring
Mappings
  • rim: n/a
Immunization.doseQuantity.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
Immunization.doseQuantity.value
DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value.
Cardinality0...1
Typedecimal
SummaryTrue
Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.2 / CQ - N/A
  • rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
  • source-PIR: H33_VACCINATION_MASTER.CC_VOLUME
  • source-PHSL: dosage
Immunization.doseQuantity.comparator
DefinitionNot allowed to be used in this context
Cardinality0...0
Typecode
Binding

How the Quantity should be understood and represented.

QuantityComparator (required)
ModifierTrue
SummaryTrue
Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.1 / CQ.1
  • rim: IVL properties
Immunization.doseQuantity.unit
DefinitionA human-readable form of the unit.
Cardinality0...1
Typestring
SummaryTrue
Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Comments

See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.unit
  • source-PIR: H33_VACCINATION_MASTER.DOSAGE_UOM_CNCPT_ID
  • source-PHSL: dosageUOMDescription
Immunization.doseQuantity.system
DefinitionThe identification of the system that provides the coded form of the unit.
Cardinality0...0
Typeuri
SummaryTrue
Requirements

Need to know the system that defines the coded form of the unit.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: CO.codeSystem, PQ.translation.codeSystem
Immunization.doseQuantity.code
DefinitionA computer processable form of the unit in some unit representation system.
Cardinality0...0
Typecode
SummaryTrue
Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.code, MO.currency, PQ.translation.code
Immunization.performer
DefinitionIndicates who performed the immunization event.
Cardinality0...*
TypeBackboneElement
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.performer
  • v2: ORC-12 / RXA-10
  • rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
Immunization.performer.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Immunization.performer.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

Invariants
  • 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()
Mappings
  • rim: n/a
Immunization.performer.modifierExtension
DefinitionMay 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).
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
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.

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.

Invariants
  • 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()
Mappings
  • rim: N/A
Immunization.performer.function
DefinitionDescribes the type of performance (e.g. ordering provider, administering provider, etc.).
Cardinality0...1
TypeCodeableConcept
Binding

The role a practitioner or organization plays in the immunization event.

ImmunizationFunctionCodes (extensible)
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.performer.function
  • rim: .participation.functionCode
Immunization.performer.actor
DefinitionProvider who administered the vaccine
Cardinality1...1
TypeReference(Practitioner | PractitionerRole | Organization)
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.performer.actor
  • w5: FiveWs.actor
  • rim: .player
Immunization.performer.actor.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Immunization.performer.actor.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
Immunization.performer.actor.reference
DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Cardinality0...1
Typestring
SummaryTrue
Comments

fullURL of Panorama + 'Practitioner' + PIR Provider ID

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
Immunization.performer.actor.type
DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Cardinality0...1
Typeuri
Binding

Aa resource (or, for logical models, the URI of the logical model).

ResourceType (extensible)
SummaryTrue
Comments

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
Immunization.performer.actor.identifier
DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Cardinality0...1
TypeIdentifier
SummaryTrue
Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .identifier
Immunization.performer.actor.display
DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
Cardinality0...1
Typestring
SummaryTrue
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
Immunization.note
DefinitionExtra information about the immunization that is not conveyed by the other attributes.
Cardinality0...*
TypeAnnotation
SummaryTrue
Comments

See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.note
  • v2: OBX-5 : OBX-3 = 48767-8
  • rim: note
  • source-PIR: IMMUNIZATION_COMMENT.COMMENT_TEXT
  • source-PHSL: commentText
Immunization.reasonCode
DefinitionReasons why the vaccine was administered.
Cardinality0...1
TypeCodeableConcept
Binding

The reason why a vaccine was administered.

ImmunizationReasonCodes (example)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.reasonCode
  • rim: [actionNegationInd=false].reasonCode
Immunization.reasonReference
DefinitionCondition, Observation or DiagnosticReport that supports why the immunization was administered.
Cardinality0...1
TypeReference(Condition | Observation | DiagnosticReport)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.reasonReference
  • rim: N/A
Immunization.isSubpotent
DefinitionIndication if a dose is considered to be subpotent. By default, a dose should be considered to be potent. If dose potency has been overriden, set to "true".
Cardinality0...1
Typeboolean
ModifierTrue
SummaryTrue
Comments

See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: RXA-20 = PA (partial administration)
  • rim: N/A
  • source-PIR: PIR imms.vaccine_status.status
  • source-PHSL: note="O"
Immunization.subpotentReason
DefinitionReason why a dose is considered to be subpotent and Status.
Cardinality0...*
TypeCodeableConcept
Binding

The reason why a dose is considered to be subpotent.

ImmunizationSubpotentReason (example)
Comments

See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
  • source-PIR: imms.vaccine_status.status_reason
Immunization.subpotentReason.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Immunization.subpotentReason.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
Immunization.subpotentReason.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality1...1
TypeCoding
SummaryTrue
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.

SlicingUnordered, Open, by code(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Immunization.subpotentReason.coding:doseStatusReason
DefinitionDose Status Overriden Reason
Cardinality0...1
TypeCoding
SummaryTrue
Requirements

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

Comments

To be applied when vaccine status = "OI", "OV".

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Immunization.subpotentReason.coding:doseStatusReason.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...0
Typestring
Mappings
  • rim: n/a
Immunization.subpotentReason.coding:doseStatusReason.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
Immunization.subpotentReason.coding:doseStatusReason.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality1...1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  • source-PIR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-code
Immunization.subpotentReason.coding:doseStatusReason.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...1
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Immunization.subpotentReason.coding:doseStatusReason.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality1...1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Immunization.subpotentReason.coding:doseStatusReason.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality1...1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  • source-PIR-doseStatusReason: "Reason - " + BCYREPORTNG.RBCY_FN_GET_AGENT_STATUS(H33_VACCINATION_MASTER.IMMUNIZATION_ID)
Immunization.subpotentReason.coding:doseStatusReason.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Immunization.subpotentReason.coding:doseStatus
DefinitionDose Status if overriden (from Valid to Invalid) or (from Invalid to Valid)
Cardinality1...1
TypeCoding
SummaryTrue
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Immunization.subpotentReason.coding:doseStatus.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Immunization.subpotentReason.coding:doseStatus.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
Immunization.subpotentReason.coding:doseStatus.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality1...1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Use 'https://ehealth.bc.ca/fhir/CodeSystem/ca-bc-dose-status'

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Immunization.subpotentReason.coding:doseStatus.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...1
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Immunization.subpotentReason.coding:doseStatus.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality1...1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  • source-PIR: BCYREPORTNG.RBCY_FN_GET_AGENT_STATUS
  • source-PHSL: agentOverrideStatus
Immunization.subpotentReason.coding:doseStatus.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality1...1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  • source-PIR-status: "Status - " + BCYREPORTNG.RBCY_FN_GET_AGENT_STATUS (VM.IMMUNIZATION_ID) = 'Valid (override)'
Immunization.subpotentReason.coding:doseStatus.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Immunization.subpotentReason.text
DefinitionA 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.
Cardinality0...1
Typestring
SummaryTrue
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

To be applied when vaccine status = "FI" Forecaster Invalid. PIR Forecaster invalidated the imms record for the following possible reasons:

  1. Non-WHO approved tradename
  2. Administered prior to eligibility – interval or age
  3. Additional dose resulting from use of multi-antigen agent
  4. Client administered with same agent on same day
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Immunization.education
DefinitionEducational material presented to the patient (or guardian) at the time of vaccine administration.
Cardinality0...1
TypeBackboneElement
Invariants
  • 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()
Mappings
  • rim: N/A
Immunization.education.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Immunization.education.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

Invariants
  • 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()
Mappings
  • rim: n/a
Immunization.education.modifierExtension
DefinitionMay 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).
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
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.

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.

Invariants
  • 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()
Mappings
  • rim: N/A
Immunization.education.documentType
DefinitionIdentifier of the material presented to the patient.
Cardinality0...1
Typestring
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: OBX-5 : OBX-3 = 69764-9
  • rim: N/A
Immunization.education.reference
DefinitionReference pointer to the educational material given to the patient if the information was on line.
Cardinality0...1
Typeuri
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
Immunization.education.publicationDate
DefinitionDate the educational material was published.
Cardinality0...1
TypedateTime
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: OBX-5 : OBX-3 = 29768-9
  • rim: N/A
Immunization.education.presentationDate
DefinitionDate the educational material was given to the patient.
Cardinality0...1
TypedateTime
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: OBX-5 : OBX-3 = 29769-7
  • rim: N/A
Immunization.programEligibility
DefinitionIndicates a patient's eligibility for a funding program.
Cardinality0...1
TypeCodeableConcept
Binding

The patient's eligibility for a vaccation program.

ImmunizationProgramEligibility (example)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: OBX-5 : OBX-3 = 64994-7
  • rim: N/A
Immunization.fundingSource
DefinitionIndicates 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).
Cardinality0...1
TypeCodeableConcept
Binding

The source of funding used to purchase the vaccine administered.

ImmunizationFundingSource (example)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
Immunization.reaction
DefinitionCategorical data indicating that an adverse event is associated in time to an immunization.
Cardinality0...1
TypeBackboneElement
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: OBX-3
  • rim: Observation[classCode=obs].code
Immunization.reaction.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Immunization.reaction.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

Invariants
  • 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()
Mappings
  • rim: n/a
Immunization.reaction.modifierExtension
DefinitionMay 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).
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
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.

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.

Invariants
  • 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()
Mappings
  • rim: N/A
Immunization.reaction.date
DefinitionDate of reaction to the immunization.
Cardinality0...1
TypedateTime
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: OBX-14 (ideally this would be reported in an IAM segment, but IAM is not part of the HL7 v2 VXU message - most likely would appear in OBX segments if at all)
  • rim: .effectiveTime
Immunization.reaction.detail
DefinitionDetails of the reaction.
Cardinality0...1
TypeReference(Observation)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: OBX-5
  • rim: .value
Immunization.reaction.reported
DefinitionSelf-reported indicator.
Cardinality0...1
Typeboolean
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (HL7 v2 doesn't seem to provide for this)
  • rim: .participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported=true)
Immunization.protocolApplied
DefinitionDose Number or Revised Dose Number
Cardinality0...*
TypeBackboneElement
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
Immunization.protocolApplied.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...0
Typestring
Mappings
  • rim: n/a
Immunization.protocolApplied.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

Invariants
  • 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()
Mappings
  • rim: n/a
Immunization.protocolApplied.modifierExtension
DefinitionMay 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).
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
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.

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.

Invariants
  • 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()
Mappings
  • rim: N/A
Immunization.protocolApplied.series
DefinitionOne possible path to achieve presumed immunity against a disease - within the context of an authority.
Cardinality0...0
Typestring
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
Immunization.protocolApplied.authority
DefinitionIndicates the authority who published the protocol (e.g. ACIP) that is being followed.
Cardinality0...0
TypeReference(Organization)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
Immunization.protocolApplied.targetDisease
DefinitionThe vaccine preventable disease the dose is being administered against.
Cardinality0...0
TypeCodeableConcept
Binding

The vaccine preventable disease the dose is being administered for.

ImmunizationTargetDiseaseCodes (example)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
Immunization.protocolApplied.doseNumber[x]
DefinitionNominal position in a series based on Antigen.
Cardinality1...1
Typestring
Comments

Dose Number based on Antigen Level. See Mappings

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
  • source-PIR: BCYREPORTNG.RBCY_FN_GET_AGENT_DOSE_NUM(VM.IMMUNIZATION_ID)
  • source-PHSL: agentDoseNumber
Immunization.protocolApplied.doseNumber[x].id
Definitionunique id for the element within a resource (for internal references)
Cardinality0...1
Typestring
Immunization.protocolApplied.doseNumber[x].extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Immunization.protocolApplied.doseNumber[x].extension:_doseNumber
DefinitionRevised Dose Number + Reason + comments
Cardinality0...1
TypeExtension(Complex)
Aliasextensions, user content
Comments

To apply when there is revised dose number in PIR.

Invariants
  • 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()
Mappings
  • rim: n/a
  • rim: N/A
Immunization.protocolApplied.doseNumber[x].value
DefinitionThe actual value
Cardinality0...1
TypeSystem.String
Immunization.protocolApplied.seriesDoses[x]
DefinitionThe recommended number of doses to achieve immunity.
Cardinality0...0
TypepositiveInt
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="02bfa3ad-4130-4ac6-a64e-a4f34fffb6a3" />
    <meta>
        <versionId value="26" />
        <lastUpdated value="2025-01-24T22:53:20.4967554+00:00" />
    </meta>
    <url value="http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/Immunization" />
    <name value="Immunization" />
    <status value="draft" />
    <date value="2022-02-04T19:50:20.0867005+00:00" />
    <fhirVersion value="4.0.1" />
    <mapping>
        <identity value="workflow" />
        <uri value="http://hl7.org/fhir/workflow" />
        <name value="Workflow Pattern" />
    </mapping>
    <mapping>
        <identity value="v2" />
        <uri value="http://hl7.org/v2" />
        <name value="HL7 v2 Mapping" />
    </mapping>
    <mapping>
        <identity value="rim" />
        <uri value="http://hl7.org/v3" />
        <name value="RIM Mapping" />
    </mapping>
    <mapping>
        <identity value="w5" />
        <uri value="http://hl7.org/fhir/fivews" />
        <name value="FiveWs Pattern Mapping" />
    </mapping>
    <mapping>
        <identity value="cda" />
        <uri value="http://hl7.org/v3/cda" />
        <name value="CDA (R2)" />
    </mapping>
    <kind value="resource" />
    <abstract value="false" />
    <type value="Immunization" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Immunization" />
    <derivation value="constraint" />
    <differential>
        <element id="Immunization">
            <path value="Immunization" />
            <short value="FHIR resource applies for PIR Immunization History" />
            <definition value="FHIR resource applies for PIR Immunization History" />
        </element>
        <element id="Immunization.id">
            <path value="Immunization.id" />
            <short value="PIR Internal Immunization ID" />
            <definition value="PIR Internal Immunization ID" />
            <comment value="See Mappings" />
            <min value="1" />
            <mapping>
                <identity value="source-PIR" />
                <map value="PIR Imms ID" />
            </mapping>
            <mapping>
                <identity value="source-PHSL" />
                <map value="immunizationId" />
            </mapping>
        </element>
        <element id="Immunization.meta">
            <path value="Immunization.meta" />
            <min value="1" />
        </element>
        <element id="Immunization.meta.versionId">
            <path value="Immunization.meta.versionId" />
            <comment value="Apply &quot;2025.01.1&quot;.  This indicates the FHIR Specs as of year 2025 Jan." />
        </element>
        <element id="Immunization.meta.lastUpdated">
            <path value="Immunization.meta.lastUpdated" />
            <comment value="Updated: Relax the previously crossed-out elements." />
        </element>
        <element id="Immunization.meta.profile">
            <path value="Immunization.meta.profile" />
            <comment value="Use &#39;http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/Immunization&#39;" />
            <min value="1" />
            <max value="1" />
        </element>
        <element id="Immunization.meta.security">
            <path value="Immunization.meta.security" />
            <max value="1" />
        </element>
        <element id="Immunization.meta.tag">
            <path value="Immunization.meta.tag" />
            <max value="1" />
        </element>
        <element id="Immunization.contained">
            <path value="Immunization.contained" />
            <max value="1" />
        </element>
        <element id="Immunization.extension:antigenDose">
            <path value="Immunization.extension" />
            <sliceName value="antigenDose" />
            <short value="Antgien(s) + Antigen Dose Number + Antigen Dose Status associated with the Agent administered" />
            <definition value="Antgien(s) + Antigen Dose Number + Antigen Dose Status associated with the Agent administered" />
            <type>
                <code value="Extension" />
                <profile value="http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/immz-antigen" />
            </type>
        </element>
        <element id="Immunization.identifier">
            <path value="Immunization.identifier" />
            <short value="PIR internal Immunization Identifier + External Immunization ID from source system(s)" />
            <definition value="PIR Immunization Identifier(s) which include Panorama Internal Immunization ID, External Immunization ID from different source systems)." />
            <min value="1" />
        </element>
        <element id="Immunization.identifier.type">
            <path value="Immunization.identifier.type" />
            <min value="1" />
        </element>
        <element id="Immunization.identifier.type.id">
            <path value="Immunization.identifier.type.id" />
            <max value="0" />
        </element>
        <element id="Immunization.identifier.type.coding">
            <path value="Immunization.identifier.type.coding" />
            <max value="0" />
        </element>
        <element id="Immunization.identifier.type.text">
            <path value="Immunization.identifier.type.text" />
            <comment value="See Mappings" />
            <min value="1" />
            <mapping>
                <identity value="source-PIR" />
                <map value="PANORAMAIMMZID&#39;" />
            </mapping>
            <mapping>
                <identity value="source-NHA" />
                <map value="NHACEDARIMMS" />
            </mapping>
            <mapping>
                <identity value="source-VCH" />
                <map value="VCHPARISIMMS" />
            </mapping>
            <mapping>
                <identity value="source-FHA" />
                <map value="FHAPARISIMMS" />
            </mapping>
            <mapping>
                <identity value="source-PNet" />
                <map value="PHARMANETIMMS" />
            </mapping>
            <mapping>
                <identity value="source-CznSub" />
                <map value="CZNSUBIMMSID" />
            </mapping>
            <mapping>
                <identity value="source-immsBC" />
                <map value="HEALTHCONNECT" />
            </mapping>
            <mapping>
                <identity value="source-eForms" />
                <map value="EFORMIMMSID" />
            </mapping>
        </element>
        <element id="Immunization.identifier.system">
            <path value="Immunization.identifier.system" />
            <comment value="See Mappings" />
            <min value="1" />
            <mapping>
                <identity value="source-PIR" />
                <map value="https://health.gov.bc.ca/fhir/NamingSystem/ca-bc-panorama-immunization-id" />
            </mapping>
            <mapping>
                <identity value="source-NHA" />
                <map value="https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-nha" />
            </mapping>
            <mapping>
                <identity value="source-FHA" />
                <map value="https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-fha" />
            </mapping>
            <mapping>
                <identity value="source-VCH" />
                <map value="https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-vcha" />
            </mapping>
            <mapping>
                <identity value="source-PNet" />
                <map value="https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-pharmanet-document-number" />
            </mapping>
            <mapping>
                <identity value="source-CznSub" />
                <map value="https://ehealthbc.ca/NamingSystem/ca-bc-citizen-submission" />
            </mapping>
            <mapping>
                <identity value="source-eForms" />
                <map value="https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-eForm" />
            </mapping>
            <mapping>
                <identity value="source-immsBC" />
                <map value="https://ehealthbc.ca/NamingSystem/ca-bc-health-connect" />
            </mapping>
        </element>
        <element id="Immunization.identifier.value">
            <path value="Immunization.identifier.value" />
            <comment value="See Mappings" />
            <min value="1" />
            <mapping>
                <identity value="source-PIR" />
                <map value="PIR Immunization ID" />
            </mapping>
            <mapping>
                <identity value="source-FHA" />
                <map value="FHA PARIS Immunization ID" />
            </mapping>
            <mapping>
                <identity value="source-NHA" />
                <map value="NHA CeDaR Immunization ID" />
            </mapping>
            <mapping>
                <identity value="source-VCH" />
                <map value="VCH PARIS Immunization ID" />
            </mapping>
            <mapping>
                <identity value="source-PNet" />
                <map value="PharmaNet Immunization ID" />
            </mapping>
            <mapping>
                <identity value="source-PHSL" />
                <map value="immunizationId" />
            </mapping>
        </element>
        <element id="Immunization.status">
            <path value="Immunization.status" />
            <short value="completed | entered-in-error |" />
            <definition value="Indicates the current status of the immunization record." />
            <comment value="IDS sends &quot;completed&quot; or &quot;entered-in-error&quot; immunization records only." />
        </element>
        <element id="Immunization.vaccineCode">
            <path value="Immunization.vaccineCode" />
            <definition value="Vaccine that was administered." />
        </element>
        <element id="Immunization.vaccineCode.id">
            <path value="Immunization.vaccineCode.id" />
            <max value="0" />
        </element>
        <element id="Immunization.vaccineCode.coding">
            <path value="Immunization.vaccineCode.coding" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="code" />
                </discriminator>
                <rules value="open" />
            </slicing>
        </element>
        <element id="Immunization.vaccineCode.coding.id">
            <path value="Immunization.vaccineCode.coding.id" />
            <max value="0" />
        </element>
        <element id="Immunization.vaccineCode.coding:AgentNVC">
            <path value="Immunization.vaccineCode.coding" />
            <sliceName value="AgentNVC" />
            <short value="Agent administered" />
            <definition value="Agent code and name  in NVC" />
            <min value="1" />
            <max value="1" />
        </element>
        <element id="Immunization.vaccineCode.coding:AgentNVC.id">
            <path value="Immunization.vaccineCode.coding.id" />
            <max value="0" />
        </element>
        <element id="Immunization.vaccineCode.coding:AgentNVC.system">
            <path value="Immunization.vaccineCode.coding.system" />
            <comment value="See Mappings" />
            <min value="1" />
            <mapping>
                <identity value="code-NVC" />
                <map value="https://nvc-cnv.canada.ca" />
            </mapping>
            <mapping>
                <identity value="code-SNOMED" />
                <map value="http://snomed.info/sct" />
            </mapping>
        </element>
        <element id="Immunization.vaccineCode.coding:AgentNVC.version">
            <path value="Immunization.vaccineCode.coding.version" />
            <max value="0" />
        </element>
        <element id="Immunization.vaccineCode.coding:AgentNVC.code">
            <path value="Immunization.vaccineCode.coding.code" />
            <comment value="See Mappings" />
            <min value="1" />
            <mapping>
                <identity value="source-PIR" />
                <map value="BCYREPORTING.RBCY_FN_GET_CONCEPT_CODE(H33_VACCINATION_MASTER_ASIIS_VACC_CODE)" />
            </mapping>
            <mapping>
                <identity value="source-PHSL" />
                <map value="immunizationAgentCode" />
            </mapping>
        </element>
        <element id="Immunization.vaccineCode.coding:AgentNVC.display">
            <path value="Immunization.vaccineCode.coding.display" />
            <comment value="See Mappings" />
            <min value="1" />
            <mapping>
                <identity value="source-PIR" />
                <map value="REPORTING.GET_ITERM_DESC(H33_VACCINATION_MASTER_ASIIS_VACC_CODE)" />
            </mapping>
            <mapping>
                <identity value="source-PHSL" />
                <map value="immunizationAgentDescription" />
            </mapping>
        </element>
        <element id="Immunization.vaccineCode.coding:AgentNVC.userSelected">
            <path value="Immunization.vaccineCode.coding.userSelected" />
            <max value="0" />
        </element>
        <element id="Immunization.vaccineCode.coding:AgentPIR">
            <path value="Immunization.vaccineCode.coding" />
            <sliceName value="AgentPIR" />
            <max value="1" />
        </element>
        <element id="Immunization.vaccineCode.coding:AgentPIR.id">
            <path value="Immunization.vaccineCode.coding.id" />
            <max value="0" />
        </element>
        <element id="Immunization.vaccineCode.coding:AgentPIR.system">
            <path value="Immunization.vaccineCode.coding.system" />
            <comment value="See Mappings" />
            <min value="1" />
            <mapping>
                <identity value="code-PIR" />
                <map value="https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-code" />
            </mapping>
        </element>
        <element id="Immunization.vaccineCode.coding:AgentPIR.version">
            <path value="Immunization.vaccineCode.coding.version" />
            <max value="0" />
        </element>
        <element id="Immunization.vaccineCode.coding:AgentPIR.code">
            <path value="Immunization.vaccineCode.coding.code" />
            <min value="1" />
        </element>
        <element id="Immunization.vaccineCode.coding:AgentPIR.display">
            <path value="Immunization.vaccineCode.coding.display" />
            <min value="1" />
        </element>
        <element id="Immunization.vaccineCode.coding:AgentPIR.userSelected">
            <path value="Immunization.vaccineCode.coding.userSelected" />
            <max value="0" />
        </element>
        <element id="Immunization.vaccineCode.coding:Tradename">
            <path value="Immunization.vaccineCode.coding" />
            <sliceName value="Tradename" />
            <short value="Tradename administered" />
            <definition value="Tradename of agent administered" />
            <comment value="Tradename of agent administered" />
            <max value="1" />
        </element>
        <element id="Immunization.vaccineCode.coding:Tradename.id">
            <path value="Immunization.vaccineCode.coding.id" />
            <max value="0" />
        </element>
        <element id="Immunization.vaccineCode.coding:Tradename.system">
            <path value="Immunization.vaccineCode.coding.system" />
            <comment value="See Mappings" />
            <min value="1" />
            <mapping>
                <identity value="code-CVC" />
                <map value="https://cvc.canimmunize.ca" />
            </mapping>
            <mapping>
                <identity value="code-SNOMED" />
                <map value="http://snomed.info/sct" />
            </mapping>
        </element>
        <element id="Immunization.vaccineCode.coding:Tradename.version">
            <path value="Immunization.vaccineCode.coding.version" />
            <max value="0" />
        </element>
        <element id="Immunization.vaccineCode.coding:Tradename.code">
            <path value="Immunization.vaccineCode.coding.code" />
            <comment value="See Mappings" />
            <min value="1" />
            <mapping>
                <identity value="source-PIR" />
                <map value="BCYREPORTNG.RBCY_FN_GET_CONCEPT_CODE (H33_VACCINATION_MASTER.ASIIS_VACC_CODE)" />
            </mapping>
            <mapping>
                <identity value="source-PHSL" />
                <map value="tradeName" />
            </mapping>
        </element>
        <element id="Immunization.vaccineCode.coding:Tradename.display">
            <path value="Immunization.vaccineCode.coding.display" />
            <comment value="See Mappings" />
            <mapping>
                <identity value="source-PIR" />
                <map value="REPORTNG.GET_ITERM_DESC(H33_VACCINATION_MASTER.ASIIS_VACC_CODE)" />
            </mapping>
        </element>
        <element id="Immunization.vaccineCode.coding:Tradename.userSelected">
            <path value="Immunization.vaccineCode.coding.userSelected" />
            <max value="0" />
        </element>
        <element id="Immunization.vaccineCode.text">
            <path value="Immunization.vaccineCode.text" />
            <comment value="See Mappings" />
            <mapping>
                <identity value="source-PIR" />
                <map value="immunizationAgentCombineDescription" />
            </mapping>
            <mapping>
                <identity value="source-PHSL" />
                <map value="immunizationAgentCombineDescription" />
            </mapping>
        </element>
        <element id="Immunization.patient.id">
            <path value="Immunization.patient.id" />
            <max value="0" />
        </element>
        <element id="Immunization.patient.reference">
            <path value="Immunization.patient.reference" />
            <comment value="See Mappings" />
            <min value="1" />
            <mapping>
                <identity value="source-PIR" />
                <map value="fullURL of Panorama + &quot;Patient&#39;+PIR Client ID" />
            </mapping>
        </element>
        <element id="Immunization.patient.type">
            <path value="Immunization.patient.type" />
            <max value="0" />
        </element>
        <element id="Immunization.patient.identifier">
            <path value="Immunization.patient.identifier" />
            <max value="0" />
        </element>
        <element id="Immunization.patient.display">
            <path value="Immunization.patient.display" />
            <max value="0" />
        </element>
        <element id="Immunization.occurrence[x]">
            <path value="Immunization.occurrence[x]" />
            <definition value="Date vaccine administered" />
            <comment value="See Mappings" />
            <type>
                <code value="dateTime" />
            </type>
            <mapping>
                <identity value="source-PIR" />
                <map value="imms.h33_vaccination_master.vacc_date" />
            </mapping>
            <mapping>
                <identity value="source-PHSL" />
                <map value="vaccDate" />
            </mapping>
        </element>
        <element id="Immunization.occurrence[x].extension:_occurrenceDateTime">
            <path value="Immunization.occurrence[x].extension" />
            <sliceName value="_occurrenceDateTime" />
            <short value="Estimated Flag for Vaccination Date" />
            <definition value="Estimated Flag for Vaccination Date" />
            <comment value="See Mappings" />
            <type>
                <code value="Extension" />
                <profile value="https://ehealthontario.ca/API/FHIR/StructureDefinition/ca-on-extension-estimated-date" />
            </type>
            <mapping>
                <identity value="source-PHSL" />
                <map value="VM.VACC_DATE_ESTIMATED_IND = &#39;Y" />
            </mapping>
            <mapping>
                <identity value="source-PHSL" />
                <map value="note=&quot;E&quot;" />
            </mapping>
        </element>
        <element id="Immunization.occurrence[x].extension:_occurrenceDateTime.value[x]">
            <path value="Immunization.occurrence[x].extension.value[x]" />
            <comment value="Apply PIR: H33_VACCINATION_MASTER.VACC_DATE" />
        </element>
        <element id="Immunization.location">
            <path value="Immunization.location" />
            <short value="Immunization Service Delivery Location (SDL)" />
            <definition value="Immunization Service Delivery Location (SDL)" />
            <comment value="See Mappings" />
            <mapping>
                <identity value="source-PHSL" />
                <map value="serviceDeliveryLocationName" />
            </mapping>
            <mapping>
                <identity value="source-PIR" />
                <map value="H33_VACCINATION_MASTER.location_id" />
            </mapping>
        </element>
        <element id="Immunization.location.id">
            <path value="Immunization.location.id" />
            <max value="0" />
        </element>
        <element id="Immunization.location.reference">
            <path value="Immunization.location.reference" />
            <comment value="fullURL of Panorama + &#39;Location&#39; + PIR Loc ID + &#39;org&#39; + PIR Imms Org ID" />
            <min value="1" />
        </element>
        <element id="Immunization.location.type">
            <path value="Immunization.location.type" />
            <max value="0" />
        </element>
        <element id="Immunization.location.identifier">
            <path value="Immunization.location.identifier" />
            <max value="0" />
        </element>
        <element id="Immunization.location.display">
            <path value="Immunization.location.display" />
            <max value="0" />
        </element>
        <element id="Immunization.lotNumber">
            <path value="Immunization.lotNumber" />
            <comment value="See Mappings" />
            <mapping>
                <identity value="source-PIR" />
                <map value="INV_PRODUCT_LOT_INFO.LOT_NUMBER" />
            </mapping>
            <mapping>
                <identity value="source-PHSL" />
                <map value="lotNumber" />
            </mapping>
        </element>
        <element id="Immunization.site.id">
            <path value="Immunization.site.id" />
            <max value="0" />
        </element>
        <element id="Immunization.site.coding.id">
            <path value="Immunization.site.coding.id" />
            <max value="0" />
        </element>
        <element id="Immunization.site.coding.system">
            <path value="Immunization.site.coding.system" />
            <comment value="Use &#39;http://snomed.info/sct&#39;&#39;" />
        </element>
        <element id="Immunization.site.coding.version">
            <path value="Immunization.site.coding.version" />
            <max value="0" />
        </element>
        <element id="Immunization.site.coding.code">
            <path value="Immunization.site.coding.code" />
            <comment value="Apply SNOMED code" />
        </element>
        <element id="Immunization.site.coding.userSelected">
            <path value="Immunization.site.coding.userSelected" />
            <max value="0" />
        </element>
        <element id="Immunization.site.text">
            <path value="Immunization.site.text" />
            <max value="0" />
        </element>
        <element id="Immunization.route.id">
            <path value="Immunization.route.id" />
            <max value="0" />
        </element>
        <element id="Immunization.route.coding.id">
            <path value="Immunization.route.coding.id" />
            <max value="0" />
        </element>
        <element id="Immunization.route.coding.system">
            <path value="Immunization.route.coding.system" />
            <comment value="Use &#39;http://snomed.info/sct&#39;" />
        </element>
        <element id="Immunization.route.coding.version">
            <path value="Immunization.route.coding.version" />
            <max value="0" />
        </element>
        <element id="Immunization.route.coding.code">
            <path value="Immunization.route.coding.code" />
            <comment value="Apply SNOMED code" />
        </element>
        <element id="Immunization.route.coding.userSelected">
            <path value="Immunization.route.coding.userSelected" />
            <max value="0" />
        </element>
        <element id="Immunization.route.text">
            <path value="Immunization.route.text" />
            <max value="0" />
        </element>
        <element id="Immunization.doseQuantity.id">
            <path value="Immunization.doseQuantity.id" />
            <max value="0" />
        </element>
        <element id="Immunization.doseQuantity.value">
            <path value="Immunization.doseQuantity.value" />
            <comment value="See Mappings" />
            <mapping>
                <identity value="source-PIR" />
                <map value="H33_VACCINATION_MASTER.CC_VOLUME" />
            </mapping>
            <mapping>
                <identity value="source-PHSL" />
                <map value="dosage" />
            </mapping>
        </element>
        <element id="Immunization.doseQuantity.unit">
            <path value="Immunization.doseQuantity.unit" />
            <comment value="See Mappings" />
            <mapping>
                <identity value="source-PIR" />
                <map value="H33_VACCINATION_MASTER.DOSAGE_UOM_CNCPT_ID" />
            </mapping>
            <mapping>
                <identity value="source-PHSL" />
                <map value="dosageUOMDescription" />
            </mapping>
        </element>
        <element id="Immunization.doseQuantity.system">
            <path value="Immunization.doseQuantity.system" />
            <max value="0" />
        </element>
        <element id="Immunization.doseQuantity.code">
            <path value="Immunization.doseQuantity.code" />
            <max value="0" />
        </element>
        <element id="Immunization.performer.actor">
            <path value="Immunization.performer.actor" />
            <short value="Provider who administered the vaccine" />
            <definition value="Provider who administered the vaccine" />
        </element>
        <element id="Immunization.performer.actor.reference">
            <path value="Immunization.performer.actor.reference" />
            <comment value="fullURL of Panorama + &#39;Practitioner&#39; + PIR Provider ID" />
        </element>
        <element id="Immunization.note">
            <path value="Immunization.note" />
            <comment value="See Mappings" />
            <mapping>
                <identity value="source-PIR" />
                <map value="IMMUNIZATION_COMMENT.COMMENT_TEXT" />
            </mapping>
            <mapping>
                <identity value="source-PHSL" />
                <map value="commentText" />
            </mapping>
        </element>
        <element id="Immunization.reasonCode">
            <path value="Immunization.reasonCode" />
            <max value="1" />
        </element>
        <element id="Immunization.reasonReference">
            <path value="Immunization.reasonReference" />
            <max value="1" />
        </element>
        <element id="Immunization.isSubpotent">
            <path value="Immunization.isSubpotent" />
            <definition value="Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent.  If dose potency has been overriden, set to &quot;true&quot;." />
            <comment value="See Mappings" />
            <mapping>
                <identity value="source-PIR" />
                <map value="PIR imms.vaccine_status.status" />
                <comment value="If invalid, &quot;1350752&quot;" />
            </mapping>
            <mapping>
                <identity value="source-PHSL" />
                <map value="note=&quot;O&quot;" />
            </mapping>
        </element>
        <element id="Immunization.subpotentReason">
            <path value="Immunization.subpotentReason" />
            <short value="Reason + Status for being subpotent" />
            <definition value="Reason why a dose is considered to be subpotent and Status." />
            <comment value="See Mappings" />
            <mapping>
                <identity value="source-PIR" />
                <map value="imms.vaccine_status.status_reason" />
            </mapping>
        </element>
        <element id="Immunization.subpotentReason.coding">
            <path value="Immunization.subpotentReason.coding" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="code" />
                </discriminator>
                <rules value="open" />
            </slicing>
            <min value="1" />
            <max value="1" />
        </element>
        <element id="Immunization.subpotentReason.coding:doseStatusReason">
            <path value="Immunization.subpotentReason.coding" />
            <sliceName value="doseStatusReason" />
            <short value="Slice 1: Dose Status Overriden Reason" />
            <definition value="Dose Status Overriden Reason" />
            <comment value="To be applied when vaccine status = &quot;OI&quot;, &quot;OV&quot;." />
            <max value="1" />
        </element>
        <element id="Immunization.subpotentReason.coding:doseStatusReason.id">
            <path value="Immunization.subpotentReason.coding.id" />
            <max value="0" />
        </element>
        <element id="Immunization.subpotentReason.coding:doseStatusReason.system">
            <path value="Immunization.subpotentReason.coding.system" />
            <comment value="See Mappings" />
            <min value="1" />
            <mapping>
                <identity value="source-PIR" />
                <map value="https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-code" />
            </mapping>
        </element>
        <element id="Immunization.subpotentReason.coding:doseStatusReason.code">
            <path value="Immunization.subpotentReason.coding.code" />
            <min value="1" />
        </element>
        <element id="Immunization.subpotentReason.coding:doseStatusReason.display">
            <path value="Immunization.subpotentReason.coding.display" />
            <comment value="See Mappings" />
            <min value="1" />
            <mapping>
                <identity value="source-PIR-doseStatusReason" />
                <map value="&quot;Reason - &quot; + BCYREPORTNG.RBCY_FN_GET_AGENT_STATUS(H33_VACCINATION_MASTER.IMMUNIZATION_ID)" />
            </mapping>
        </element>
        <element id="Immunization.subpotentReason.coding:doseStatus">
            <path value="Immunization.subpotentReason.coding" />
            <sliceName value="doseStatus" />
            <short value="Dose Status if overriden" />
            <definition value="Dose Status if overriden (from Valid to Invalid) or (from Invalid to Valid)" />
            <min value="1" />
            <max value="1" />
        </element>
        <element id="Immunization.subpotentReason.coding:doseStatus.system">
            <path value="Immunization.subpotentReason.coding.system" />
            <comment value="Use &#39;https://ehealth.bc.ca/fhir/CodeSystem/ca-bc-dose-status&#39;" />
            <min value="1" />
        </element>
        <element id="Immunization.subpotentReason.coding:doseStatus.code">
            <path value="Immunization.subpotentReason.coding.code" />
            <comment value="See Mappings" />
            <min value="1" />
            <mapping>
                <identity value="source-PIR" />
                <map value="BCYREPORTNG.RBCY_FN_GET_AGENT_STATUS" />
            </mapping>
            <mapping>
                <identity value="source-PHSL" />
                <map value="agentOverrideStatus" />
            </mapping>
        </element>
        <element id="Immunization.subpotentReason.coding:doseStatus.display">
            <path value="Immunization.subpotentReason.coding.display" />
            <comment value="See Mappings" />
            <min value="1" />
            <mapping>
                <identity value="source-PIR-status" />
                <map value="&quot;Status - &quot; + BCYREPORTNG.RBCY_FN_GET_AGENT_STATUS (VM.IMMUNIZATION_ID) = &#39;Valid (override)&#39;" />
            </mapping>
        </element>
        <element id="Immunization.subpotentReason.text">
            <path value="Immunization.subpotentReason.text" />
            <comment value="To be applied when vaccine status = &quot;FI&quot; Forecaster Invalid.\nPIR Forecaster invalidated the imms record for the following possible reasons:\n1. Non-WHO approved tradename\n2. Administered prior to eligibility – interval or age \n3. Additional dose resulting from use of multi-antigen agent\n4. Client administered with same agent on same day" />
        </element>
        <element id="Immunization.education">
            <path value="Immunization.education" />
            <max value="1" />
        </element>
        <element id="Immunization.programEligibility">
            <path value="Immunization.programEligibility" />
            <max value="1" />
        </element>
        <element id="Immunization.reaction">
            <path value="Immunization.reaction" />
            <max value="1" />
        </element>
        <element id="Immunization.protocolApplied">
            <path value="Immunization.protocolApplied" />
            <short value="Dose Number or Revised Dose Number" />
            <definition value="Dose Number or Revised Dose Number" />
        </element>
        <element id="Immunization.protocolApplied.id">
            <path value="Immunization.protocolApplied.id" />
            <max value="0" />
        </element>
        <element id="Immunization.protocolApplied.series">
            <path value="Immunization.protocolApplied.series" />
            <max value="0" />
        </element>
        <element id="Immunization.protocolApplied.authority">
            <path value="Immunization.protocolApplied.authority" />
            <max value="0" />
        </element>
        <element id="Immunization.protocolApplied.targetDisease">
            <path value="Immunization.protocolApplied.targetDisease" />
            <max value="0" />
        </element>
        <element id="Immunization.protocolApplied.doseNumber[x]">
            <path value="Immunization.protocolApplied.doseNumber[x]" />
            <definition value="Nominal position in a series based on Antigen." />
            <comment value="Dose Number based on Antigen Level.  See Mappings" />
            <type>
                <code value="string" />
            </type>
            <mapping>
                <identity value="source-PIR" />
                <map value="BCYREPORTNG.RBCY_FN_GET_AGENT_DOSE_NUM(VM.IMMUNIZATION_ID)" />
            </mapping>
            <mapping>
                <identity value="source-PHSL" />
                <map value="agentDoseNumber" />
            </mapping>
        </element>
        <element id="Immunization.protocolApplied.doseNumber[x].extension:_doseNumber">
            <path value="Immunization.protocolApplied.doseNumber[x].extension" />
            <sliceName value="_doseNumber" />
            <short value="Revised Dose Number + Reason + comments" />
            <definition value="Revised Dose Number + Reason + comments" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/immz-revise-dose" />
            </type>
            <isModifier value="false" />
        </element>
        <element id="Immunization.protocolApplied.seriesDoses[x]">
            <path value="Immunization.protocolApplied.seriesDoses[x]" />
            <max value="0" />
        </element>
    </differential>
</StructureDefinition>
{
    "resourceType": "StructureDefinition",
    "id": "02bfa3ad-4130-4ac6-a64e-a4f34fffb6a3",
    "meta": {
        "versionId": "26",
        "lastUpdated": "01/24/2025 22:53:20"
    },
    "url": "http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/Immunization",
    "name": "Immunization",
    "status": "draft",
    "date": "02/04/2022 19:50:20",
    "fhirVersion": "4.0.1",
    "mapping":  [
        {
            "identity": "workflow",
            "uri": "http://hl7.org/fhir/workflow",
            "name": "Workflow Pattern"
        },
        {
            "identity": "v2",
            "uri": "http://hl7.org/v2",
            "name": "HL7 v2 Mapping"
        },
        {
            "identity": "rim",
            "uri": "http://hl7.org/v3",
            "name": "RIM Mapping"
        },
        {
            "identity": "w5",
            "uri": "http://hl7.org/fhir/fivews",
            "name": "FiveWs Pattern Mapping"
        },
        {
            "identity": "cda",
            "uri": "http://hl7.org/v3/cda",
            "name": "CDA (R2)"
        }
    ],
    "kind": "resource",
    "abstract": false,
    "type": "Immunization",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Immunization",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Immunization",
                "path": "Immunization",
                "short": "FHIR resource applies for PIR Immunization History",
                "definition": "FHIR resource applies for PIR Immunization History"
            },
            {
                "id": "Immunization.id",
                "path": "Immunization.id",
                "short": "PIR Internal Immunization ID",
                "definition": "PIR Internal Immunization ID",
                "comment": "See Mappings",
                "min": 1,
                "mapping":  [
                    {
                        "identity": "source-PIR",
                        "map": "PIR Imms ID"
                    },
                    {
                        "identity": "source-PHSL",
                        "map": "immunizationId"
                    }
                ]
            },
            {
                "id": "Immunization.meta",
                "path": "Immunization.meta",
                "min": 1
            },
            {
                "id": "Immunization.meta.versionId",
                "path": "Immunization.meta.versionId",
                "comment": "Apply \"2025.01.1\".  This indicates the FHIR Specs as of year 2025 Jan."
            },
            {
                "id": "Immunization.meta.lastUpdated",
                "path": "Immunization.meta.lastUpdated",
                "comment": "Updated: Relax the previously crossed-out elements."
            },
            {
                "id": "Immunization.meta.profile",
                "path": "Immunization.meta.profile",
                "comment": "Use 'http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/Immunization'",
                "min": 1,
                "max": "1"
            },
            {
                "id": "Immunization.meta.security",
                "path": "Immunization.meta.security",
                "max": "1"
            },
            {
                "id": "Immunization.meta.tag",
                "path": "Immunization.meta.tag",
                "max": "1"
            },
            {
                "id": "Immunization.contained",
                "path": "Immunization.contained",
                "max": "1"
            },
            {
                "id": "Immunization.extension:antigenDose",
                "path": "Immunization.extension",
                "sliceName": "antigenDose",
                "short": "Antgien(s) + Antigen Dose Number + Antigen Dose Status associated with the Agent administered",
                "definition": "Antgien(s) + Antigen Dose Number + Antigen Dose Status associated with the Agent administered",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/immz-antigen"
                        ]
                    }
                ]
            },
            {
                "id": "Immunization.identifier",
                "path": "Immunization.identifier",
                "short": "PIR internal Immunization Identifier + External Immunization ID from source system(s)",
                "definition": "PIR Immunization Identifier(s) which include Panorama Internal Immunization ID, External Immunization ID from different source systems).",
                "min": 1
            },
            {
                "id": "Immunization.identifier.type",
                "path": "Immunization.identifier.type",
                "min": 1
            },
            {
                "id": "Immunization.identifier.type.id",
                "path": "Immunization.identifier.type.id",
                "max": "0"
            },
            {
                "id": "Immunization.identifier.type.coding",
                "path": "Immunization.identifier.type.coding",
                "max": "0"
            },
            {
                "id": "Immunization.identifier.type.text",
                "path": "Immunization.identifier.type.text",
                "comment": "See Mappings",
                "min": 1,
                "mapping":  [
                    {
                        "identity": "source-PIR",
                        "map": "PANORAMAIMMZID'"
                    },
                    {
                        "identity": "source-NHA",
                        "map": "NHACEDARIMMS"
                    },
                    {
                        "identity": "source-VCH",
                        "map": "VCHPARISIMMS"
                    },
                    {
                        "identity": "source-FHA",
                        "map": "FHAPARISIMMS"
                    },
                    {
                        "identity": "source-PNet",
                        "map": "PHARMANETIMMS"
                    },
                    {
                        "identity": "source-CznSub",
                        "map": "CZNSUBIMMSID"
                    },
                    {
                        "identity": "source-immsBC",
                        "map": "HEALTHCONNECT"
                    },
                    {
                        "identity": "source-eForms",
                        "map": "EFORMIMMSID"
                    }
                ]
            },
            {
                "id": "Immunization.identifier.system",
                "path": "Immunization.identifier.system",
                "comment": "See Mappings",
                "min": 1,
                "mapping":  [
                    {
                        "identity": "source-PIR",
                        "map": "https://health.gov.bc.ca/fhir/NamingSystem/ca-bc-panorama-immunization-id"
                    },
                    {
                        "identity": "source-NHA",
                        "map": "https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-nha"
                    },
                    {
                        "identity": "source-FHA",
                        "map": "https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-fha"
                    },
                    {
                        "identity": "source-VCH",
                        "map": "https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-vcha"
                    },
                    {
                        "identity": "source-PNet",
                        "map": "https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-pharmanet-document-number"
                    },
                    {
                        "identity": "source-CznSub",
                        "map": "https://ehealthbc.ca/NamingSystem/ca-bc-citizen-submission"
                    },
                    {
                        "identity": "source-eForms",
                        "map": "https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-eForm"
                    },
                    {
                        "identity": "source-immsBC",
                        "map": "https://ehealthbc.ca/NamingSystem/ca-bc-health-connect"
                    }
                ]
            },
            {
                "id": "Immunization.identifier.value",
                "path": "Immunization.identifier.value",
                "comment": "See Mappings",
                "min": 1,
                "mapping":  [
                    {
                        "identity": "source-PIR",
                        "map": "PIR Immunization ID"
                    },
                    {
                        "identity": "source-FHA",
                        "map": "FHA PARIS Immunization ID"
                    },
                    {
                        "identity": "source-NHA",
                        "map": "NHA CeDaR Immunization ID"
                    },
                    {
                        "identity": "source-VCH",
                        "map": "VCH PARIS Immunization ID"
                    },
                    {
                        "identity": "source-PNet",
                        "map": "PharmaNet Immunization ID"
                    },
                    {
                        "identity": "source-PHSL",
                        "map": "immunizationId"
                    }
                ]
            },
            {
                "id": "Immunization.status",
                "path": "Immunization.status",
                "short": "completed | entered-in-error |",
                "definition": "Indicates the current status of the immunization record.",
                "comment": "IDS sends \"completed\" or \"entered-in-error\" immunization records only."
            },
            {
                "id": "Immunization.vaccineCode",
                "path": "Immunization.vaccineCode",
                "definition": "Vaccine that was administered."
            },
            {
                "id": "Immunization.vaccineCode.id",
                "path": "Immunization.vaccineCode.id",
                "max": "0"
            },
            {
                "id": "Immunization.vaccineCode.coding",
                "path": "Immunization.vaccineCode.coding",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "code"
                        }
                    ],
                    "rules": "open"
                }
            },
            {
                "id": "Immunization.vaccineCode.coding.id",
                "path": "Immunization.vaccineCode.coding.id",
                "max": "0"
            },
            {
                "id": "Immunization.vaccineCode.coding:AgentNVC",
                "path": "Immunization.vaccineCode.coding",
                "sliceName": "AgentNVC",
                "short": "Agent administered",
                "definition": "Agent code and name  in NVC",
                "min": 1,
                "max": "1"
            },
            {
                "id": "Immunization.vaccineCode.coding:AgentNVC.id",
                "path": "Immunization.vaccineCode.coding.id",
                "max": "0"
            },
            {
                "id": "Immunization.vaccineCode.coding:AgentNVC.system",
                "path": "Immunization.vaccineCode.coding.system",
                "comment": "See Mappings",
                "min": 1,
                "mapping":  [
                    {
                        "identity": "code-NVC",
                        "map": "https://nvc-cnv.canada.ca"
                    },
                    {
                        "identity": "code-SNOMED",
                        "map": "http://snomed.info/sct"
                    }
                ]
            },
            {
                "id": "Immunization.vaccineCode.coding:AgentNVC.version",
                "path": "Immunization.vaccineCode.coding.version",
                "max": "0"
            },
            {
                "id": "Immunization.vaccineCode.coding:AgentNVC.code",
                "path": "Immunization.vaccineCode.coding.code",
                "comment": "See Mappings",
                "min": 1,
                "mapping":  [
                    {
                        "identity": "source-PIR",
                        "map": "BCYREPORTING.RBCY_FN_GET_CONCEPT_CODE(H33_VACCINATION_MASTER_ASIIS_VACC_CODE)"
                    },
                    {
                        "identity": "source-PHSL",
                        "map": "immunizationAgentCode"
                    }
                ]
            },
            {
                "id": "Immunization.vaccineCode.coding:AgentNVC.display",
                "path": "Immunization.vaccineCode.coding.display",
                "comment": "See Mappings",
                "min": 1,
                "mapping":  [
                    {
                        "identity": "source-PIR",
                        "map": "REPORTING.GET_ITERM_DESC(H33_VACCINATION_MASTER_ASIIS_VACC_CODE)"
                    },
                    {
                        "identity": "source-PHSL",
                        "map": "immunizationAgentDescription"
                    }
                ]
            },
            {
                "id": "Immunization.vaccineCode.coding:AgentNVC.userSelected",
                "path": "Immunization.vaccineCode.coding.userSelected",
                "max": "0"
            },
            {
                "id": "Immunization.vaccineCode.coding:AgentPIR",
                "path": "Immunization.vaccineCode.coding",
                "sliceName": "AgentPIR",
                "max": "1"
            },
            {
                "id": "Immunization.vaccineCode.coding:AgentPIR.id",
                "path": "Immunization.vaccineCode.coding.id",
                "max": "0"
            },
            {
                "id": "Immunization.vaccineCode.coding:AgentPIR.system",
                "path": "Immunization.vaccineCode.coding.system",
                "comment": "See Mappings",
                "min": 1,
                "mapping":  [
                    {
                        "identity": "code-PIR",
                        "map": "https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-code"
                    }
                ]
            },
            {
                "id": "Immunization.vaccineCode.coding:AgentPIR.version",
                "path": "Immunization.vaccineCode.coding.version",
                "max": "0"
            },
            {
                "id": "Immunization.vaccineCode.coding:AgentPIR.code",
                "path": "Immunization.vaccineCode.coding.code",
                "min": 1
            },
            {
                "id": "Immunization.vaccineCode.coding:AgentPIR.display",
                "path": "Immunization.vaccineCode.coding.display",
                "min": 1
            },
            {
                "id": "Immunization.vaccineCode.coding:AgentPIR.userSelected",
                "path": "Immunization.vaccineCode.coding.userSelected",
                "max": "0"
            },
            {
                "id": "Immunization.vaccineCode.coding:Tradename",
                "path": "Immunization.vaccineCode.coding",
                "sliceName": "Tradename",
                "short": "Tradename administered",
                "definition": "Tradename of agent administered",
                "comment": "Tradename of agent administered",
                "max": "1"
            },
            {
                "id": "Immunization.vaccineCode.coding:Tradename.id",
                "path": "Immunization.vaccineCode.coding.id",
                "max": "0"
            },
            {
                "id": "Immunization.vaccineCode.coding:Tradename.system",
                "path": "Immunization.vaccineCode.coding.system",
                "comment": "See Mappings",
                "min": 1,
                "mapping":  [
                    {
                        "identity": "code-CVC",
                        "map": "https://cvc.canimmunize.ca"
                    },
                    {
                        "identity": "code-SNOMED",
                        "map": "http://snomed.info/sct"
                    }
                ]
            },
            {
                "id": "Immunization.vaccineCode.coding:Tradename.version",
                "path": "Immunization.vaccineCode.coding.version",
                "max": "0"
            },
            {
                "id": "Immunization.vaccineCode.coding:Tradename.code",
                "path": "Immunization.vaccineCode.coding.code",
                "comment": "See Mappings",
                "min": 1,
                "mapping":  [
                    {
                        "identity": "source-PIR",
                        "map": "BCYREPORTNG.RBCY_FN_GET_CONCEPT_CODE (H33_VACCINATION_MASTER.ASIIS_VACC_CODE)"
                    },
                    {
                        "identity": "source-PHSL",
                        "map": "tradeName"
                    }
                ]
            },
            {
                "id": "Immunization.vaccineCode.coding:Tradename.display",
                "path": "Immunization.vaccineCode.coding.display",
                "comment": "See Mappings",
                "mapping":  [
                    {
                        "identity": "source-PIR",
                        "map": "REPORTNG.GET_ITERM_DESC(H33_VACCINATION_MASTER.ASIIS_VACC_CODE)"
                    }
                ]
            },
            {
                "id": "Immunization.vaccineCode.coding:Tradename.userSelected",
                "path": "Immunization.vaccineCode.coding.userSelected",
                "max": "0"
            },
            {
                "id": "Immunization.vaccineCode.text",
                "path": "Immunization.vaccineCode.text",
                "comment": "See Mappings",
                "mapping":  [
                    {
                        "identity": "source-PIR",
                        "map": "immunizationAgentCombineDescription"
                    },
                    {
                        "identity": "source-PHSL",
                        "map": "immunizationAgentCombineDescription"
                    }
                ]
            },
            {
                "id": "Immunization.patient.id",
                "path": "Immunization.patient.id",
                "max": "0"
            },
            {
                "id": "Immunization.patient.reference",
                "path": "Immunization.patient.reference",
                "comment": "See Mappings",
                "min": 1,
                "mapping":  [
                    {
                        "identity": "source-PIR",
                        "map": "fullURL of Panorama + \"Patient'+PIR Client ID"
                    }
                ]
            },
            {
                "id": "Immunization.patient.type",
                "path": "Immunization.patient.type",
                "max": "0"
            },
            {
                "id": "Immunization.patient.identifier",
                "path": "Immunization.patient.identifier",
                "max": "0"
            },
            {
                "id": "Immunization.patient.display",
                "path": "Immunization.patient.display",
                "max": "0"
            },
            {
                "id": "Immunization.occurrence[x]",
                "path": "Immunization.occurrence[x]",
                "definition": "Date vaccine administered",
                "comment": "See Mappings",
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "source-PIR",
                        "map": "imms.h33_vaccination_master.vacc_date"
                    },
                    {
                        "identity": "source-PHSL",
                        "map": "vaccDate"
                    }
                ]
            },
            {
                "id": "Immunization.occurrence[x].extension:_occurrenceDateTime",
                "path": "Immunization.occurrence[x].extension",
                "sliceName": "_occurrenceDateTime",
                "short": "Estimated Flag for Vaccination Date",
                "definition": "Estimated Flag for Vaccination Date",
                "comment": "See Mappings",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://ehealthontario.ca/API/FHIR/StructureDefinition/ca-on-extension-estimated-date"
                        ]
                    }
                ],
                "mapping":  [
                    {
                        "identity": "source-PHSL",
                        "map": "VM.VACC_DATE_ESTIMATED_IND = 'Y"
                    },
                    {
                        "identity": "source-PHSL",
                        "map": "note=\"E\""
                    }
                ]
            },
            {
                "id": "Immunization.occurrence[x].extension:_occurrenceDateTime.value[x]",
                "path": "Immunization.occurrence[x].extension.value[x]",
                "comment": "Apply PIR: H33_VACCINATION_MASTER.VACC_DATE"
            },
            {
                "id": "Immunization.location",
                "path": "Immunization.location",
                "short": "Immunization Service Delivery Location (SDL)",
                "definition": "Immunization Service Delivery Location (SDL)",
                "comment": "See Mappings",
                "mapping":  [
                    {
                        "identity": "source-PHSL",
                        "map": "serviceDeliveryLocationName"
                    },
                    {
                        "identity": "source-PIR",
                        "map": "H33_VACCINATION_MASTER.location_id"
                    }
                ]
            },
            {
                "id": "Immunization.location.id",
                "path": "Immunization.location.id",
                "max": "0"
            },
            {
                "id": "Immunization.location.reference",
                "path": "Immunization.location.reference",
                "comment": "fullURL of Panorama + 'Location' + PIR Loc ID + 'org' + PIR Imms Org ID",
                "min": 1
            },
            {
                "id": "Immunization.location.type",
                "path": "Immunization.location.type",
                "max": "0"
            },
            {
                "id": "Immunization.location.identifier",
                "path": "Immunization.location.identifier",
                "max": "0"
            },
            {
                "id": "Immunization.location.display",
                "path": "Immunization.location.display",
                "max": "0"
            },
            {
                "id": "Immunization.lotNumber",
                "path": "Immunization.lotNumber",
                "comment": "See Mappings",
                "mapping":  [
                    {
                        "identity": "source-PIR",
                        "map": "INV_PRODUCT_LOT_INFO.LOT_NUMBER"
                    },
                    {
                        "identity": "source-PHSL",
                        "map": "lotNumber"
                    }
                ]
            },
            {
                "id": "Immunization.site.id",
                "path": "Immunization.site.id",
                "max": "0"
            },
            {
                "id": "Immunization.site.coding.id",
                "path": "Immunization.site.coding.id",
                "max": "0"
            },
            {
                "id": "Immunization.site.coding.system",
                "path": "Immunization.site.coding.system",
                "comment": "Use 'http://snomed.info/sct''"
            },
            {
                "id": "Immunization.site.coding.version",
                "path": "Immunization.site.coding.version",
                "max": "0"
            },
            {
                "id": "Immunization.site.coding.code",
                "path": "Immunization.site.coding.code",
                "comment": "Apply SNOMED code"
            },
            {
                "id": "Immunization.site.coding.userSelected",
                "path": "Immunization.site.coding.userSelected",
                "max": "0"
            },
            {
                "id": "Immunization.site.text",
                "path": "Immunization.site.text",
                "max": "0"
            },
            {
                "id": "Immunization.route.id",
                "path": "Immunization.route.id",
                "max": "0"
            },
            {
                "id": "Immunization.route.coding.id",
                "path": "Immunization.route.coding.id",
                "max": "0"
            },
            {
                "id": "Immunization.route.coding.system",
                "path": "Immunization.route.coding.system",
                "comment": "Use 'http://snomed.info/sct'"
            },
            {
                "id": "Immunization.route.coding.version",
                "path": "Immunization.route.coding.version",
                "max": "0"
            },
            {
                "id": "Immunization.route.coding.code",
                "path": "Immunization.route.coding.code",
                "comment": "Apply SNOMED code"
            },
            {
                "id": "Immunization.route.coding.userSelected",
                "path": "Immunization.route.coding.userSelected",
                "max": "0"
            },
            {
                "id": "Immunization.route.text",
                "path": "Immunization.route.text",
                "max": "0"
            },
            {
                "id": "Immunization.doseQuantity.id",
                "path": "Immunization.doseQuantity.id",
                "max": "0"
            },
            {
                "id": "Immunization.doseQuantity.value",
                "path": "Immunization.doseQuantity.value",
                "comment": "See Mappings",
                "mapping":  [
                    {
                        "identity": "source-PIR",
                        "map": "H33_VACCINATION_MASTER.CC_VOLUME"
                    },
                    {
                        "identity": "source-PHSL",
                        "map": "dosage"
                    }
                ]
            },
            {
                "id": "Immunization.doseQuantity.unit",
                "path": "Immunization.doseQuantity.unit",
                "comment": "See Mappings",
                "mapping":  [
                    {
                        "identity": "source-PIR",
                        "map": "H33_VACCINATION_MASTER.DOSAGE_UOM_CNCPT_ID"
                    },
                    {
                        "identity": "source-PHSL",
                        "map": "dosageUOMDescription"
                    }
                ]
            },
            {
                "id": "Immunization.doseQuantity.system",
                "path": "Immunization.doseQuantity.system",
                "max": "0"
            },
            {
                "id": "Immunization.doseQuantity.code",
                "path": "Immunization.doseQuantity.code",
                "max": "0"
            },
            {
                "id": "Immunization.performer.actor",
                "path": "Immunization.performer.actor",
                "short": "Provider who administered the vaccine",
                "definition": "Provider who administered the vaccine"
            },
            {
                "id": "Immunization.performer.actor.reference",
                "path": "Immunization.performer.actor.reference",
                "comment": "fullURL of Panorama + 'Practitioner' + PIR Provider ID"
            },
            {
                "id": "Immunization.note",
                "path": "Immunization.note",
                "comment": "See Mappings",
                "mapping":  [
                    {
                        "identity": "source-PIR",
                        "map": "IMMUNIZATION_COMMENT.COMMENT_TEXT"
                    },
                    {
                        "identity": "source-PHSL",
                        "map": "commentText"
                    }
                ]
            },
            {
                "id": "Immunization.reasonCode",
                "path": "Immunization.reasonCode",
                "max": "1"
            },
            {
                "id": "Immunization.reasonReference",
                "path": "Immunization.reasonReference",
                "max": "1"
            },
            {
                "id": "Immunization.isSubpotent",
                "path": "Immunization.isSubpotent",
                "definition": "Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent.  If dose potency has been overriden, set to \"true\".",
                "comment": "See Mappings",
                "mapping":  [
                    {
                        "identity": "source-PIR",
                        "map": "PIR imms.vaccine_status.status",
                        "comment": "If invalid, \"1350752\""
                    },
                    {
                        "identity": "source-PHSL",
                        "map": "note=\"O\""
                    }
                ]
            },
            {
                "id": "Immunization.subpotentReason",
                "path": "Immunization.subpotentReason",
                "short": "Reason + Status for being subpotent",
                "definition": "Reason why a dose is considered to be subpotent and Status.",
                "comment": "See Mappings",
                "mapping":  [
                    {
                        "identity": "source-PIR",
                        "map": "imms.vaccine_status.status_reason"
                    }
                ]
            },
            {
                "id": "Immunization.subpotentReason.coding",
                "path": "Immunization.subpotentReason.coding",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "code"
                        }
                    ],
                    "rules": "open"
                },
                "min": 1,
                "max": "1"
            },
            {
                "id": "Immunization.subpotentReason.coding:doseStatusReason",
                "path": "Immunization.subpotentReason.coding",
                "sliceName": "doseStatusReason",
                "short": "Slice 1: Dose Status Overriden Reason",
                "definition": "Dose Status Overriden Reason",
                "comment": "To be applied when vaccine status = \"OI\", \"OV\".",
                "max": "1"
            },
            {
                "id": "Immunization.subpotentReason.coding:doseStatusReason.id",
                "path": "Immunization.subpotentReason.coding.id",
                "max": "0"
            },
            {
                "id": "Immunization.subpotentReason.coding:doseStatusReason.system",
                "path": "Immunization.subpotentReason.coding.system",
                "comment": "See Mappings",
                "min": 1,
                "mapping":  [
                    {
                        "identity": "source-PIR",
                        "map": "https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-code"
                    }
                ]
            },
            {
                "id": "Immunization.subpotentReason.coding:doseStatusReason.code",
                "path": "Immunization.subpotentReason.coding.code",
                "min": 1
            },
            {
                "id": "Immunization.subpotentReason.coding:doseStatusReason.display",
                "path": "Immunization.subpotentReason.coding.display",
                "comment": "See Mappings",
                "min": 1,
                "mapping":  [
                    {
                        "identity": "source-PIR-doseStatusReason",
                        "map": "\"Reason - \" + BCYREPORTNG.RBCY_FN_GET_AGENT_STATUS(H33_VACCINATION_MASTER.IMMUNIZATION_ID)"
                    }
                ]
            },
            {
                "id": "Immunization.subpotentReason.coding:doseStatus",
                "path": "Immunization.subpotentReason.coding",
                "sliceName": "doseStatus",
                "short": "Dose Status if overriden",
                "definition": "Dose Status if overriden (from Valid to Invalid) or (from Invalid to Valid)",
                "min": 1,
                "max": "1"
            },
            {
                "id": "Immunization.subpotentReason.coding:doseStatus.system",
                "path": "Immunization.subpotentReason.coding.system",
                "comment": "Use 'https://ehealth.bc.ca/fhir/CodeSystem/ca-bc-dose-status'",
                "min": 1
            },
            {
                "id": "Immunization.subpotentReason.coding:doseStatus.code",
                "path": "Immunization.subpotentReason.coding.code",
                "comment": "See Mappings",
                "min": 1,
                "mapping":  [
                    {
                        "identity": "source-PIR",
                        "map": "BCYREPORTNG.RBCY_FN_GET_AGENT_STATUS"
                    },
                    {
                        "identity": "source-PHSL",
                        "map": "agentOverrideStatus"
                    }
                ]
            },
            {
                "id": "Immunization.subpotentReason.coding:doseStatus.display",
                "path": "Immunization.subpotentReason.coding.display",
                "comment": "See Mappings",
                "min": 1,
                "mapping":  [
                    {
                        "identity": "source-PIR-status",
                        "map": "\"Status - \" + BCYREPORTNG.RBCY_FN_GET_AGENT_STATUS (VM.IMMUNIZATION_ID) = 'Valid (override)'"
                    }
                ]
            },
            {
                "id": "Immunization.subpotentReason.text",
                "path": "Immunization.subpotentReason.text",
                "comment": "To be applied when vaccine status = \"FI\" Forecaster Invalid.\nPIR Forecaster invalidated the imms record for the following possible reasons:\n1. Non-WHO approved tradename\n2. Administered prior to eligibility – interval or age \n3. Additional dose resulting from use of multi-antigen agent\n4. Client administered with same agent on same day"
            },
            {
                "id": "Immunization.education",
                "path": "Immunization.education",
                "max": "1"
            },
            {
                "id": "Immunization.programEligibility",
                "path": "Immunization.programEligibility",
                "max": "1"
            },
            {
                "id": "Immunization.reaction",
                "path": "Immunization.reaction",
                "max": "1"
            },
            {
                "id": "Immunization.protocolApplied",
                "path": "Immunization.protocolApplied",
                "short": "Dose Number or Revised Dose Number",
                "definition": "Dose Number or Revised Dose Number"
            },
            {
                "id": "Immunization.protocolApplied.id",
                "path": "Immunization.protocolApplied.id",
                "max": "0"
            },
            {
                "id": "Immunization.protocolApplied.series",
                "path": "Immunization.protocolApplied.series",
                "max": "0"
            },
            {
                "id": "Immunization.protocolApplied.authority",
                "path": "Immunization.protocolApplied.authority",
                "max": "0"
            },
            {
                "id": "Immunization.protocolApplied.targetDisease",
                "path": "Immunization.protocolApplied.targetDisease",
                "max": "0"
            },
            {
                "id": "Immunization.protocolApplied.doseNumber[x]",
                "path": "Immunization.protocolApplied.doseNumber[x]",
                "definition": "Nominal position in a series based on Antigen.",
                "comment": "Dose Number based on Antigen Level.  See Mappings",
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "source-PIR",
                        "map": "BCYREPORTNG.RBCY_FN_GET_AGENT_DOSE_NUM(VM.IMMUNIZATION_ID)"
                    },
                    {
                        "identity": "source-PHSL",
                        "map": "agentDoseNumber"
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied.doseNumber[x].extension:_doseNumber",
                "path": "Immunization.protocolApplied.doseNumber[x].extension",
                "sliceName": "_doseNumber",
                "short": "Revised Dose Number + Reason + comments",
                "definition": "Revised Dose Number + Reason + comments",
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/immz-revise-dose"
                        ]
                    }
                ],
                "isModifier": false
            },
            {
                "id": "Immunization.protocolApplied.seriesDoses[x]",
                "path": "Immunization.protocolApplied.seriesDoses[x]",
                "max": "0"
            }
        ]
    }
}