Profiles & Operations Index > Profile: Immunization
Profile: Immunization
Canonical URL:http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-immunization
Simplifier project page: Immunization (PS-ON)
Derived from: Immunization (R4)
Formal Views of Profile Content
Description of Profiles, Differentials, Snapshots and how the different presentations work
Differential View
ImmunizationPSON (Immunization) | I | Immunization | There are no (further) constraints on this element Element idImmunization Immunization event information DefinitionDescribes the event of a patient being administered a vaccine or a record of an immunization as reported by a patient, a clinician or another party.
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id | Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
meta | S Σ | 1..1 | Meta | There are no (further) constraints on this element Element idImmunization.meta Metadata about the resource 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.
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.meta.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.meta.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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versionId | Σ | 0..1 | id | There are no (further) constraints on this element Element idImmunization.meta.versionId Version specific identifier 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. The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
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lastUpdated | Σ | 0..1 | instant | There are no (further) constraints on this element Element idImmunization.meta.lastUpdated When the resource version last changed DefinitionWhen the resource last changed - e.g. when the version changed. This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.
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source | Σ | 0..1 | uri | There are no (further) constraints on this element Element idImmunization.meta.source Identifies where the resource comes from DefinitionA uri that identifies the source system of the resource. This provides a minimal amount of Provenance 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. 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.
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profile | S Σ | 1..* | canonical(StructureDefinition) | There are no (further) constraints on this element Element idImmunization.meta.profile Profiles this resource claims to conform to DefinitionA list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set. canonical(StructureDefinition) Constraints
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security | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element idImmunization.meta.security Security Labels applied to this resource DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. 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. Security Labels from the Healthcare Privacy and Security Classification System.
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tag | Σ | 0..* | Coding | There are no (further) constraints on this element Element idImmunization.meta.tag Tags applied to this resource 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. 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. Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idImmunization.implicitRules A set of rules under which this content was created 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. 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.
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language | 0..1 | codeBinding | There are no (further) constraints on this element Element idImmunization.language Language of the resource content DefinitionThe base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language.
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text | 0..1 | Narrative | There are no (further) constraints on this element Element idImmunization.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display 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. 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.
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contained | 0..* | Resource | There are no (further) constraints on this element Element idImmunization.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources 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. 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.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content 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). 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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identifier | 0..* | Identifier | There are no (further) constraints on this element Element idImmunization.identifier Business identifier DefinitionA unique identifier assigned to this immunization record.
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status | S Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element idImmunization.status completed | entered-in-error | not-done DefinitionIndicates the current status of the immunization event. Will generally be set to show that the immunization has been completed or not done. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. A set of codes indicating the current status of an Immunization.
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statusReason | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idImmunization.statusReason Reason not done DefinitionIndicates the reason the immunization event was not performed. This is generally only used for the status of "not-done". The reason for performing the immunization event is captured in reasonCode, not here. The reason why a vaccine was not administered.
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vaccineCode | S Σ | 1..1 | CodeableConceptPSONBinding | Element idImmunization.vaccineCode Vaccine that was administered or was to be administered. IPS-UV Note: Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent/unknown code. Other coded information can be provided as well as: the Pharmaceutical and medicinal product identifiers, when available, or equivalent coded concepts; the WHO ATC codes; or any other kind of code that that identifies, classifies or cluster the administered product. DefinitionVaccine that was administered or was to be administered. PS-CA Note: Work is underway to define the pan-Canadian terminology that will be preferred and/or socialized for vaccine.code. IPS-UV Note: Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunized is provided; or the known absent/unknown. Other coded information can be provided as well as:
The value sets used for the PhPID, MPID and PCID identifiers are provisional and include only few equivalent concepts used for exemplification purposes, they will be updated with real IDMP identifiers when they will become available. Codes from the Canadian Vaccine Catalogue Generic Value Set. Use of Tradename Value Set is equivalently preferred
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.vaccineCode.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.vaccineCode.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | S Σ | 0..* | CodingPSON | Element idImmunization.vaccineCode.coding A reference to a code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. Unordered, Open, by $this(Pattern) Discriminated by bound value set Constraints
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vaccineIPSCode | Σ | 0..1 | CodingPSONBinding | Element idImmunization.vaccineCode.coding:vaccineIPSCode Optional slice for representing the code for vaccine from the SNOMED CT IPS code set DefinitionCode for a vaccine that is selected from the SNOMED CT IPS code set. Allows for alternative encodings within a code system, and translations to other code systems. 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. http://hl7.org/fhir/uv/ips/ValueSet/vaccines-uv-ips (required) Constraints
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atcClass | Σ | 0..* | CodingPSONBinding | Element idImmunization.vaccineCode.coding:atcClass Optional slice for representing the vaccine code from the WHO ATC classification DefinitionWHO ATC classification Allows for alternative encodings within a code system, and translations to other code systems. The IPS-UV considers this slice MS in STU1, however the impacts of applying MS on terminology slices have been brought forward to the IPS-UV FHIR authors and removal of the MS flag on optional slices is currently being discussed. http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips (required) Constraints
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CVCGeneric | S Σ | 0..* | CodingPSONBinding | Element idImmunization.vaccineCode.coding:CVCGeneric A reference to a code defined by a terminology system DefinitionGeneric Immunizing Agent Allows for alternative encodings within a code system, and translations to other code systems. Generic Immunizing Agents subset contains generically described vaccines and passive immunizing agents used in Canada. It is an extension of the Pan-Canadian Immunization Reference Sets Vaccine Historical Name Code and Passive Historical Immunizing Agent Code subset developed by Canada Health Infoway. Please note that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: https://cvc.canimmunize.ca/en/explore#/ http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-Generic (required) Constraints
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CVCTradename | S Σ | 0..* | CodingPSONBinding | Element idImmunization.vaccineCode.coding:CVCTradename A reference to a code defined by a terminology system DefinitionTradename Immunizing Agent Allows for alternative encodings within a code system, and translations to other code systems. Tradename Immunizing Agents subset contains tradenames of vaccines and passive immunizing agents used in Canada. It is an extension of the Pan-Canadian Immunization Reference Sets Vaccine Administered Trade Name Code and Immunioglobulin Code subset developed by Canada Health Infoway. Please note that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: https://cvc.canimmunize.ca/en/explore#/ http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-Tradename (required) Constraints
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absentOrUnknownImmunization | S Σ | 0..* | CodingPSONBinding | Element idImmunization.vaccineCode.coding:absentOrUnknownImmunization Optional slice for representing the codes for an Absent or Unknown Immunization DefinitionA reference to a code indicating that there there are no known immunizations or that this information is unknown. Allows for alternative encodings within a code system, and translations to other code systems. This slice is kept as must support to ensure that systems proving conformance can show that they can produce a value indicating that an immunization is absent or unknown (similar to approach with keeping must support flags on data absent reason extensions) http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-immunizations-uv-ips (required) Constraints
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.vaccineCode.text Plain text representation of the concept 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. 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. Very often the text is the same as a displayName of one of the codings.
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patient | S Σ I | 1..1 | Reference(PatientPSON) | Element idImmunization.patient Who was immunized DefinitionThe patient who either received or did not receive the immunization. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.patient.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.patient.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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reference | S Σ I | 1..1 | string | There are no (further) constraints on this element Element idImmunization.patient.reference Literal reference, Relative, internal or absolute URL 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. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element idImmunization.patient.type Type the reference refers to (e.g. "Patient") 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). 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. Aa resource (or, for logical models, the URI of the logical model).
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idImmunization.patient.identifier Logical reference, when literal reference is not known 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. 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).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.patient.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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.
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encounter | I | 0..1 | Reference(Encounter) | There are no (further) constraints on this element Element idImmunization.encounter Encounter immunization was part of DefinitionThe visit or admission or other contact between patient and health care provider the immunization was performed as part of. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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occurrence[x] | S Σ | 1..1 | There are no (further) constraints on this element Element idImmunization.occurrence[x] Vaccine administration date DefinitionDate vaccine administered or was to be administered. When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given. An exact date is always preferable, but the use of the String data type is acceptable when an exact date is not known. A small number of vaccines (e.g. live oral typhoid vaccine) are given as a series of patient self-administered dose over a span of time. In cases like this, often, only the first dose (typically a provider supervised dose) is recorded with the occurrence indicating the date/time of the first dose.
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.occurrence[x].id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | Element idImmunization.occurrence[x].extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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data-absent-reason | S I | 0..1 | Extension(code) | Element idImmunization.occurrence[x].extension:data-absent-reason occurrence[x] absence reason Alternate namesextensions, user content DefinitionProvides a reason why the occurrence is missing. Note to implementers: Path to this element in the FHIR Artifact is ~Immunization.occurrence[x].extension:data-absent-reason~ although it may be redering incorrectly in Simplifier. http://hl7.org/fhir/StructureDefinition/data-absent-reason Constraints
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occurrenceDateTime | dateTime | There are no (further) constraints on this element Data type | ||
occurrenceString | string | There are no (further) constraints on this element Data type | ||
recorded | 0..1 | dateTime | There are no (further) constraints on this element Element idImmunization.recorded When the immunization was first captured in the subject's record DefinitionThe date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event.
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primarySource | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idImmunization.primarySource Indicates context the data was recorded in 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. Reflects the “reliability” of the content.
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reportOrigin | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idImmunization.reportOrigin Indicates the source of a secondarily reported record DefinitionThe source of the data when the report of the immunization event is not based on information from the person who administered the vaccine. Should not be populated if primarySource = True, not required even if primarySource = False. The source of the data for a record which is not from a primary source.
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location | I | 0..1 | Reference(Location) | There are no (further) constraints on this element Element idImmunization.location Where immunization occurred DefinitionThe service delivery location where the vaccine administration occurred. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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manufacturer | I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idImmunization.manufacturer Vaccine manufacturer DefinitionName of vaccine manufacturer. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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lotNumber | 0..1 | string | There are no (further) constraints on this element Element idImmunization.lotNumber Vaccine lot number DefinitionLot number of the vaccine product. Note that FHIR strings SHALL NOT exceed 1MB in size
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expirationDate | 0..1 | date | There are no (further) constraints on this element Element idImmunization.expirationDate Vaccine expiration date DefinitionDate vaccine batch expires.
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site | 0..1 | CodeableConceptPSONBinding | Element idImmunization.site Concept - reference to a terminology or just text DefinitionA concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Code for anatomical site from the Canadian Vaccine Catalogue code set. Please note that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: https://cvc.canimmunize.ca/en/explore#/ The site at which the vaccine was administered.
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route | 0..1 | CodeableConceptPSONBinding | Element idImmunization.route Concept - reference to a terminology or just text DefinitionA concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Code for a route of administration from the Canadian Vaccine Catalogue code set. Please note that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: https://cvc.canimmunize.ca/en/explore#/ The route by which the vaccine was administered.
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doseQuantity | I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idImmunization.doseQuantity Amount of vaccine administered DefinitionThe quantity of vaccine product that was administered. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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performer | Σ | 0..1 | BackboneElement | Element idImmunization.performer Who performed event DefinitionIndicates who performed the immunization event. While the IPS-UV specification considers this a MS element, some systems will not have a field directly representing performer, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.performer.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.performer.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.performer.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers 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). 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. 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.
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function | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idImmunization.performer.function What type of performance was done DefinitionDescribes the type of performance (e.g. ordering provider, administering provider, etc.). Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The role a practitioner or organization plays in the immunization event.
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actor | Σ I | 1..1 | Reference(Practitioner | PractitionerRole | Organization) | There are no (further) constraints on this element Element idImmunization.performer.actor Individual or organization who was performing DefinitionThe practitioner or organization who performed the action. When the individual practitioner who performed the action is known, it is best to send. Reference(Practitioner | PractitionerRole | Organization) Constraints
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note | Σ | 0..* | Annotation | There are no (further) constraints on this element Element idImmunization.note Additional immunization notes DefinitionExtra information about the immunization that is not conveyed by the other attributes. For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
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reasonCode | 0..* | CodeableConcept | There are no (further) constraints on this element Element idImmunization.reasonCode Why immunization occurred DefinitionReasons why the vaccine was administered. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The reason why a vaccine was administered.
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reasonReference | I | 0..* | Reference(Condition | Observation | DiagnosticReport) | There are no (further) constraints on this element Element idImmunization.reasonReference Why immunization occurred DefinitionCondition, Observation or DiagnosticReport that supports why the immunization was administered. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Condition | Observation | DiagnosticReport) Constraints
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isSubpotent | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element idImmunization.isSubpotent Dose potency DefinitionIndication if a dose is considered to be subpotent. By default, a dose should be considered to be potent. Typically, the recognition of the dose being sub-potent is retrospective, after the administration (ex. notification of a manufacturer recall after administration). However, in the case of a partial administration (the patient moves unexpectedly and only some of the dose is actually administered), subpotency may be recognized immediately, but it is still important to record the event. By default, a dose should be considered to be potent.
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subpotentReason | 0..* | CodeableConcept | There are no (further) constraints on this element Element idImmunization.subpotentReason Reason for being subpotent DefinitionReason why a dose is considered to be subpotent. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The reason why a dose is considered to be subpotent.
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education | I | 0..* | BackboneElement | There are no (further) constraints on this element Element idImmunization.education Educational material presented to patient DefinitionEducational material presented to the patient (or guardian) at the time of vaccine administration.
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.education.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.education.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.education.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers 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). 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. 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.
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documentType | 0..1 | string | There are no (further) constraints on this element Element idImmunization.education.documentType Educational material document identifier DefinitionIdentifier of the material presented to the patient. Note that FHIR strings SHALL NOT exceed 1MB in size
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reference | 0..1 | uri | There are no (further) constraints on this element Element idImmunization.education.reference Educational material reference pointer DefinitionReference pointer to the educational material given to the patient if the information was on line. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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publicationDate | 0..1 | dateTime | There are no (further) constraints on this element Element idImmunization.education.publicationDate Educational material publication date DefinitionDate the educational material was published.
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presentationDate | 0..1 | dateTime | There are no (further) constraints on this element Element idImmunization.education.presentationDate Educational material presentation date DefinitionDate the educational material was given to the patient.
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programEligibility | 0..* | CodeableConcept | There are no (further) constraints on this element Element idImmunization.programEligibility Patient eligibility for a vaccination program DefinitionIndicates a patient's eligibility for a funding program. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The patient's eligibility for a vaccation program.
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fundingSource | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idImmunization.fundingSource Funding source for the vaccine 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). Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The source of funding used to purchase the vaccine administered.
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reaction | 0..* | BackboneElement | There are no (further) constraints on this element Element idImmunization.reaction Details of a reaction that follows immunization DefinitionCategorical data indicating that an adverse event is associated in time to an immunization. A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case, it should be recorded as a new AllergyIntolerance resource instance as most systems will not query against past Immunization.reaction elements.
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.reaction.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.reaction.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.reaction.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers 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). 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. 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.
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date | 0..1 | dateTime | There are no (further) constraints on this element Element idImmunization.reaction.date When reaction started DefinitionDate of reaction to the immunization.
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detail | I | 0..1 | Reference(Observation) | There are no (further) constraints on this element Element idImmunization.reaction.detail Additional information on reaction DefinitionDetails of the reaction. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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reported | 0..1 | boolean | There are no (further) constraints on this element Element idImmunization.reaction.reported Indicates self-reported reaction DefinitionSelf-reported indicator.
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protocolApplied | 0..* | BackboneElement | There are no (further) constraints on this element Element idImmunization.protocolApplied Protocol followed by the provider DefinitionThe protocol (set of recommendations) being followed by the provider who administered the dose.
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.protocolApplied.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.protocolApplied.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.protocolApplied.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers 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). 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. 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.
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series | 0..1 | string | There are no (further) constraints on this element Element idImmunization.protocolApplied.series Name of vaccine series DefinitionOne possible path to achieve presumed immunity against a disease - within the context of an authority. Note that FHIR strings SHALL NOT exceed 1MB in size
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authority | I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idImmunization.protocolApplied.authority Who is responsible for publishing the recommendations DefinitionIndicates the authority who published the protocol (e.g. ACIP) that is being followed. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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targetDisease | 0..* | CodeableConceptPSONBinding | Element idImmunization.protocolApplied.targetDisease Concept - reference to a terminology or just text DefinitionA concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text. The vaccine preventable disease the dose is being administered for.
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.protocolApplied.targetDisease.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.protocolApplied.targetDisease.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 0..* | CodingPSON | Element idImmunization.protocolApplied.targetDisease.coding A reference to a code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. Unordered, Open, by $this(Pattern) Discriminated by bound value set Constraints
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targetDiseaseIPSCode | Σ | 0..* | CodingPSONBinding | Element idImmunization.protocolApplied.targetDisease.coding:targetDiseaseIPSCode Optional slice for representing the code for a disease the vaccination is against the IPS Value Set DefinitionCode for a disease the vaccination is against from the SNOMED CT code set. Allows for alternative encodings within a code system, and translations to other code systems. The IPS slice has replaced the GPS slice in this release to support validation tooling. http://hl7.org/fhir/uv/ips/ValueSet/targetDiseases-uv-ips (required) Constraints
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targetDiseaseCVC | Σ | 0..* | CodingPSONBinding | Element idImmunization.protocolApplied.targetDisease.coding:targetDiseaseCVC Optional slice for representing the code for a disease the vaccination is against from the Canadian Vaccine Catalogue code set. DefinitionCode for a disease the vaccination is against from the Canadian Vaccine Catalogue code set. Please note that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: https://cvc.canimmunize.ca/en/explore#/ Allows for alternative encodings within a code system, and translations to other code systems. 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. http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-Disease (required) Constraints
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.protocolApplied.targetDisease.text Plain text representation of the concept 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. 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. Very often the text is the same as a displayName of one of the codings.
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doseNumber[x] | 1..1 | There are no (further) constraints on this element Element idImmunization.protocolApplied.doseNumber[x] Dose number within series DefinitionNominal position in a series. The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).
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doseNumberPositiveInt | positiveInt | There are no (further) constraints on this element Data type | ||
doseNumberString | string | There are no (further) constraints on this element Data type | ||
seriesDoses[x] | 0..1 | There are no (further) constraints on this element Element idImmunization.protocolApplied.seriesDoses[x] Recommended number of doses for immunity DefinitionThe recommended number of doses to achieve immunity. The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).
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seriesDosesPositiveInt | positiveInt | There are no (further) constraints on this element Data type | ||
seriesDosesString | string | There are no (further) constraints on this element Data type |
Hybrid View
ImmunizationPSON (Immunization) | I | Immunization | There are no (further) constraints on this element Element idImmunization Immunization event information DefinitionDescribes the event of a patient being administered a vaccine or a record of an immunization as reported by a patient, a clinician or another party.
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id | Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
meta | S Σ | 1..1 | Meta | There are no (further) constraints on this element Element idImmunization.meta Metadata about the resource 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.
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.meta.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.meta.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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versionId | Σ | 0..1 | id | There are no (further) constraints on this element Element idImmunization.meta.versionId Version specific identifier 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. The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
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lastUpdated | Σ | 0..1 | instant | There are no (further) constraints on this element Element idImmunization.meta.lastUpdated When the resource version last changed DefinitionWhen the resource last changed - e.g. when the version changed. This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.
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source | Σ | 0..1 | uri | There are no (further) constraints on this element Element idImmunization.meta.source Identifies where the resource comes from DefinitionA uri that identifies the source system of the resource. This provides a minimal amount of Provenance 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. 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.
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profile | S Σ | 1..* | canonical(StructureDefinition) | There are no (further) constraints on this element Element idImmunization.meta.profile Profiles this resource claims to conform to DefinitionA list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set. canonical(StructureDefinition) Constraints
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security | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element idImmunization.meta.security Security Labels applied to this resource DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. 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. Security Labels from the Healthcare Privacy and Security Classification System.
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tag | Σ | 0..* | Coding | There are no (further) constraints on this element Element idImmunization.meta.tag Tags applied to this resource 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. 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. Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idImmunization.implicitRules A set of rules under which this content was created 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. 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.
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language | 0..1 | codeBinding | There are no (further) constraints on this element Element idImmunization.language Language of the resource content DefinitionThe base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language.
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text | 0..1 | Narrative | There are no (further) constraints on this element Element idImmunization.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display 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. 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.
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contained | 0..* | Resource | There are no (further) constraints on this element Element idImmunization.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources 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. 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.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content 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). 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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identifier | 0..* | Identifier | There are no (further) constraints on this element Element idImmunization.identifier Business identifier DefinitionA unique identifier assigned to this immunization record.
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status | S Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element idImmunization.status completed | entered-in-error | not-done DefinitionIndicates the current status of the immunization event. Will generally be set to show that the immunization has been completed or not done. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. A set of codes indicating the current status of an Immunization.
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statusReason | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idImmunization.statusReason Reason not done DefinitionIndicates the reason the immunization event was not performed. This is generally only used for the status of "not-done". The reason for performing the immunization event is captured in reasonCode, not here. The reason why a vaccine was not administered.
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vaccineCode | S Σ | 1..1 | CodeableConceptPSONBinding | Element idImmunization.vaccineCode Vaccine that was administered or was to be administered. IPS-UV Note: Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent/unknown code. Other coded information can be provided as well as: the Pharmaceutical and medicinal product identifiers, when available, or equivalent coded concepts; the WHO ATC codes; or any other kind of code that that identifies, classifies or cluster the administered product. DefinitionVaccine that was administered or was to be administered. PS-CA Note: Work is underway to define the pan-Canadian terminology that will be preferred and/or socialized for vaccine.code. IPS-UV Note: Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunized is provided; or the known absent/unknown. Other coded information can be provided as well as:
The value sets used for the PhPID, MPID and PCID identifiers are provisional and include only few equivalent concepts used for exemplification purposes, they will be updated with real IDMP identifiers when they will become available. Codes from the Canadian Vaccine Catalogue Generic Value Set. Use of Tradename Value Set is equivalently preferred
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.vaccineCode.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.vaccineCode.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | S Σ | 0..* | CodingPSON | Element idImmunization.vaccineCode.coding A reference to a code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. Unordered, Open, by $this(Pattern) Discriminated by bound value set Constraints
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vaccineIPSCode | Σ | 0..1 | CodingPSONBinding | Element idImmunization.vaccineCode.coding:vaccineIPSCode Optional slice for representing the code for vaccine from the SNOMED CT IPS code set DefinitionCode for a vaccine that is selected from the SNOMED CT IPS code set. Allows for alternative encodings within a code system, and translations to other code systems. 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. http://hl7.org/fhir/uv/ips/ValueSet/vaccines-uv-ips (required) Constraints
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atcClass | Σ | 0..* | CodingPSONBinding | Element idImmunization.vaccineCode.coding:atcClass Optional slice for representing the vaccine code from the WHO ATC classification DefinitionWHO ATC classification Allows for alternative encodings within a code system, and translations to other code systems. The IPS-UV considers this slice MS in STU1, however the impacts of applying MS on terminology slices have been brought forward to the IPS-UV FHIR authors and removal of the MS flag on optional slices is currently being discussed. http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips (required) Constraints
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CVCGeneric | S Σ | 0..* | CodingPSONBinding | Element idImmunization.vaccineCode.coding:CVCGeneric A reference to a code defined by a terminology system DefinitionGeneric Immunizing Agent Allows for alternative encodings within a code system, and translations to other code systems. Generic Immunizing Agents subset contains generically described vaccines and passive immunizing agents used in Canada. It is an extension of the Pan-Canadian Immunization Reference Sets Vaccine Historical Name Code and Passive Historical Immunizing Agent Code subset developed by Canada Health Infoway. Please note that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: https://cvc.canimmunize.ca/en/explore#/ http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-Generic (required) Constraints
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CVCTradename | S Σ | 0..* | CodingPSONBinding | Element idImmunization.vaccineCode.coding:CVCTradename A reference to a code defined by a terminology system DefinitionTradename Immunizing Agent Allows for alternative encodings within a code system, and translations to other code systems. Tradename Immunizing Agents subset contains tradenames of vaccines and passive immunizing agents used in Canada. It is an extension of the Pan-Canadian Immunization Reference Sets Vaccine Administered Trade Name Code and Immunioglobulin Code subset developed by Canada Health Infoway. Please note that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: https://cvc.canimmunize.ca/en/explore#/ http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-Tradename (required) Constraints
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absentOrUnknownImmunization | S Σ | 0..* | CodingPSONBinding | Element idImmunization.vaccineCode.coding:absentOrUnknownImmunization Optional slice for representing the codes for an Absent or Unknown Immunization DefinitionA reference to a code indicating that there there are no known immunizations or that this information is unknown. Allows for alternative encodings within a code system, and translations to other code systems. This slice is kept as must support to ensure that systems proving conformance can show that they can produce a value indicating that an immunization is absent or unknown (similar to approach with keeping must support flags on data absent reason extensions) http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-immunizations-uv-ips (required) Constraints
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.vaccineCode.text Plain text representation of the concept 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. 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. Very often the text is the same as a displayName of one of the codings.
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patient | S Σ I | 1..1 | Reference(PatientPSON) | Element idImmunization.patient Who was immunized DefinitionThe patient who either received or did not receive the immunization. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.patient.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.patient.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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reference | S Σ I | 1..1 | string | There are no (further) constraints on this element Element idImmunization.patient.reference Literal reference, Relative, internal or absolute URL 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. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element idImmunization.patient.type Type the reference refers to (e.g. "Patient") 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). 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. Aa resource (or, for logical models, the URI of the logical model).
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idImmunization.patient.identifier Logical reference, when literal reference is not known 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. 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).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.patient.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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.
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encounter | I | 0..1 | Reference(Encounter) | There are no (further) constraints on this element Element idImmunization.encounter Encounter immunization was part of DefinitionThe visit or admission or other contact between patient and health care provider the immunization was performed as part of. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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occurrence[x] | S Σ | 1..1 | There are no (further) constraints on this element Element idImmunization.occurrence[x] Vaccine administration date DefinitionDate vaccine administered or was to be administered. When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given. An exact date is always preferable, but the use of the String data type is acceptable when an exact date is not known. A small number of vaccines (e.g. live oral typhoid vaccine) are given as a series of patient self-administered dose over a span of time. In cases like this, often, only the first dose (typically a provider supervised dose) is recorded with the occurrence indicating the date/time of the first dose.
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.occurrence[x].id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | Element idImmunization.occurrence[x].extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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data-absent-reason | S I | 0..1 | Extension(code) | Element idImmunization.occurrence[x].extension:data-absent-reason occurrence[x] absence reason Alternate namesextensions, user content DefinitionProvides a reason why the occurrence is missing. Note to implementers: Path to this element in the FHIR Artifact is ~Immunization.occurrence[x].extension:data-absent-reason~ although it may be redering incorrectly in Simplifier. http://hl7.org/fhir/StructureDefinition/data-absent-reason Constraints
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occurrenceDateTime | dateTime | There are no (further) constraints on this element Data type | ||
occurrenceString | string | There are no (further) constraints on this element Data type | ||
recorded | 0..1 | dateTime | There are no (further) constraints on this element Element idImmunization.recorded When the immunization was first captured in the subject's record DefinitionThe date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event.
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primarySource | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idImmunization.primarySource Indicates context the data was recorded in 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. Reflects the “reliability” of the content.
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reportOrigin | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idImmunization.reportOrigin Indicates the source of a secondarily reported record DefinitionThe source of the data when the report of the immunization event is not based on information from the person who administered the vaccine. Should not be populated if primarySource = True, not required even if primarySource = False. The source of the data for a record which is not from a primary source.
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location | I | 0..1 | Reference(Location) | There are no (further) constraints on this element Element idImmunization.location Where immunization occurred DefinitionThe service delivery location where the vaccine administration occurred. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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manufacturer | I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idImmunization.manufacturer Vaccine manufacturer DefinitionName of vaccine manufacturer. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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lotNumber | 0..1 | string | There are no (further) constraints on this element Element idImmunization.lotNumber Vaccine lot number DefinitionLot number of the vaccine product. Note that FHIR strings SHALL NOT exceed 1MB in size
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expirationDate | 0..1 | date | There are no (further) constraints on this element Element idImmunization.expirationDate Vaccine expiration date DefinitionDate vaccine batch expires.
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site | 0..1 | CodeableConceptPSONBinding | Element idImmunization.site Concept - reference to a terminology or just text DefinitionA concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Code for anatomical site from the Canadian Vaccine Catalogue code set. Please note that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: https://cvc.canimmunize.ca/en/explore#/ The site at which the vaccine was administered.
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route | 0..1 | CodeableConceptPSONBinding | Element idImmunization.route Concept - reference to a terminology or just text DefinitionA concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Code for a route of administration from the Canadian Vaccine Catalogue code set. Please note that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: https://cvc.canimmunize.ca/en/explore#/ The route by which the vaccine was administered.
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doseQuantity | I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idImmunization.doseQuantity Amount of vaccine administered DefinitionThe quantity of vaccine product that was administered. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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performer | Σ | 0..1 | BackboneElement | Element idImmunization.performer Who performed event DefinitionIndicates who performed the immunization event. While the IPS-UV specification considers this a MS element, some systems will not have a field directly representing performer, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.performer.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.performer.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.performer.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers 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). 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. 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.
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function | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idImmunization.performer.function What type of performance was done DefinitionDescribes the type of performance (e.g. ordering provider, administering provider, etc.). Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The role a practitioner or organization plays in the immunization event.
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actor | Σ I | 1..1 | Reference(Practitioner | PractitionerRole | Organization) | There are no (further) constraints on this element Element idImmunization.performer.actor Individual or organization who was performing DefinitionThe practitioner or organization who performed the action. When the individual practitioner who performed the action is known, it is best to send. Reference(Practitioner | PractitionerRole | Organization) Constraints
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note | Σ | 0..* | Annotation | There are no (further) constraints on this element Element idImmunization.note Additional immunization notes DefinitionExtra information about the immunization that is not conveyed by the other attributes. For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
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reasonCode | 0..* | CodeableConcept | There are no (further) constraints on this element Element idImmunization.reasonCode Why immunization occurred DefinitionReasons why the vaccine was administered. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The reason why a vaccine was administered.
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reasonReference | I | 0..* | Reference(Condition | Observation | DiagnosticReport) | There are no (further) constraints on this element Element idImmunization.reasonReference Why immunization occurred DefinitionCondition, Observation or DiagnosticReport that supports why the immunization was administered. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Condition | Observation | DiagnosticReport) Constraints
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isSubpotent | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element idImmunization.isSubpotent Dose potency DefinitionIndication if a dose is considered to be subpotent. By default, a dose should be considered to be potent. Typically, the recognition of the dose being sub-potent is retrospective, after the administration (ex. notification of a manufacturer recall after administration). However, in the case of a partial administration (the patient moves unexpectedly and only some of the dose is actually administered), subpotency may be recognized immediately, but it is still important to record the event. By default, a dose should be considered to be potent.
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subpotentReason | 0..* | CodeableConcept | There are no (further) constraints on this element Element idImmunization.subpotentReason Reason for being subpotent DefinitionReason why a dose is considered to be subpotent. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The reason why a dose is considered to be subpotent.
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education | I | 0..* | BackboneElement | There are no (further) constraints on this element Element idImmunization.education Educational material presented to patient DefinitionEducational material presented to the patient (or guardian) at the time of vaccine administration.
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.education.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.education.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.education.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers 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). 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. 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.
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documentType | 0..1 | string | There are no (further) constraints on this element Element idImmunization.education.documentType Educational material document identifier DefinitionIdentifier of the material presented to the patient. Note that FHIR strings SHALL NOT exceed 1MB in size
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reference | 0..1 | uri | There are no (further) constraints on this element Element idImmunization.education.reference Educational material reference pointer DefinitionReference pointer to the educational material given to the patient if the information was on line. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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publicationDate | 0..1 | dateTime | There are no (further) constraints on this element Element idImmunization.education.publicationDate Educational material publication date DefinitionDate the educational material was published.
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presentationDate | 0..1 | dateTime | There are no (further) constraints on this element Element idImmunization.education.presentationDate Educational material presentation date DefinitionDate the educational material was given to the patient.
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programEligibility | 0..* | CodeableConcept | There are no (further) constraints on this element Element idImmunization.programEligibility Patient eligibility for a vaccination program DefinitionIndicates a patient's eligibility for a funding program. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The patient's eligibility for a vaccation program.
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fundingSource | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idImmunization.fundingSource Funding source for the vaccine 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). Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The source of funding used to purchase the vaccine administered.
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reaction | 0..* | BackboneElement | There are no (further) constraints on this element Element idImmunization.reaction Details of a reaction that follows immunization DefinitionCategorical data indicating that an adverse event is associated in time to an immunization. A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case, it should be recorded as a new AllergyIntolerance resource instance as most systems will not query against past Immunization.reaction elements.
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.reaction.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.reaction.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.reaction.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers 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). 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. 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.
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date | 0..1 | dateTime | There are no (further) constraints on this element Element idImmunization.reaction.date When reaction started DefinitionDate of reaction to the immunization.
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detail | I | 0..1 | Reference(Observation) | There are no (further) constraints on this element Element idImmunization.reaction.detail Additional information on reaction DefinitionDetails of the reaction. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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reported | 0..1 | boolean | There are no (further) constraints on this element Element idImmunization.reaction.reported Indicates self-reported reaction DefinitionSelf-reported indicator.
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protocolApplied | 0..* | BackboneElement | There are no (further) constraints on this element Element idImmunization.protocolApplied Protocol followed by the provider DefinitionThe protocol (set of recommendations) being followed by the provider who administered the dose.
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.protocolApplied.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.protocolApplied.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.protocolApplied.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers 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). 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. 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.
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series | 0..1 | string | There are no (further) constraints on this element Element idImmunization.protocolApplied.series Name of vaccine series DefinitionOne possible path to achieve presumed immunity against a disease - within the context of an authority. Note that FHIR strings SHALL NOT exceed 1MB in size
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authority | I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idImmunization.protocolApplied.authority Who is responsible for publishing the recommendations DefinitionIndicates the authority who published the protocol (e.g. ACIP) that is being followed. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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targetDisease | 0..* | CodeableConceptPSONBinding | Element idImmunization.protocolApplied.targetDisease Concept - reference to a terminology or just text DefinitionA concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text. The vaccine preventable disease the dose is being administered for.
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.protocolApplied.targetDisease.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.protocolApplied.targetDisease.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 0..* | CodingPSON | Element idImmunization.protocolApplied.targetDisease.coding A reference to a code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. Unordered, Open, by $this(Pattern) Discriminated by bound value set Constraints
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targetDiseaseIPSCode | Σ | 0..* | CodingPSONBinding | Element idImmunization.protocolApplied.targetDisease.coding:targetDiseaseIPSCode Optional slice for representing the code for a disease the vaccination is against the IPS Value Set DefinitionCode for a disease the vaccination is against from the SNOMED CT code set. Allows for alternative encodings within a code system, and translations to other code systems. The IPS slice has replaced the GPS slice in this release to support validation tooling. http://hl7.org/fhir/uv/ips/ValueSet/targetDiseases-uv-ips (required) Constraints
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targetDiseaseCVC | Σ | 0..* | CodingPSONBinding | Element idImmunization.protocolApplied.targetDisease.coding:targetDiseaseCVC Optional slice for representing the code for a disease the vaccination is against from the Canadian Vaccine Catalogue code set. DefinitionCode for a disease the vaccination is against from the Canadian Vaccine Catalogue code set. Please note that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: https://cvc.canimmunize.ca/en/explore#/ Allows for alternative encodings within a code system, and translations to other code systems. 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. http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-Disease (required) Constraints
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.protocolApplied.targetDisease.text Plain text representation of the concept 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. 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. Very often the text is the same as a displayName of one of the codings.
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doseNumber[x] | 1..1 | There are no (further) constraints on this element Element idImmunization.protocolApplied.doseNumber[x] Dose number within series DefinitionNominal position in a series. The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).
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doseNumberPositiveInt | positiveInt | There are no (further) constraints on this element Data type | ||
doseNumberString | string | There are no (further) constraints on this element Data type | ||
seriesDoses[x] | 0..1 | There are no (further) constraints on this element Element idImmunization.protocolApplied.seriesDoses[x] Recommended number of doses for immunity DefinitionThe recommended number of doses to achieve immunity. The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).
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seriesDosesPositiveInt | positiveInt | There are no (further) constraints on this element Data type | ||
seriesDosesString | string | There are no (further) constraints on this element Data type |
Snapshot View
ImmunizationPSON (Immunization) | I | Immunization | There are no (further) constraints on this element Element idImmunization Immunization event information DefinitionDescribes the event of a patient being administered a vaccine or a record of an immunization as reported by a patient, a clinician or another party.
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id | Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
meta | S Σ | 1..1 | Meta | There are no (further) constraints on this element Element idImmunization.meta Metadata about the resource 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.
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.meta.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.meta.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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versionId | Σ | 0..1 | id | There are no (further) constraints on this element Element idImmunization.meta.versionId Version specific identifier 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. The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
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lastUpdated | Σ | 0..1 | instant | There are no (further) constraints on this element Element idImmunization.meta.lastUpdated When the resource version last changed DefinitionWhen the resource last changed - e.g. when the version changed. This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.
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source | Σ | 0..1 | uri | There are no (further) constraints on this element Element idImmunization.meta.source Identifies where the resource comes from DefinitionA uri that identifies the source system of the resource. This provides a minimal amount of Provenance 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. 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.
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profile | S Σ | 1..* | canonical(StructureDefinition) | There are no (further) constraints on this element Element idImmunization.meta.profile Profiles this resource claims to conform to DefinitionA list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set. canonical(StructureDefinition) Constraints
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security | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element idImmunization.meta.security Security Labels applied to this resource DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. 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. Security Labels from the Healthcare Privacy and Security Classification System.
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tag | Σ | 0..* | Coding | There are no (further) constraints on this element Element idImmunization.meta.tag Tags applied to this resource 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. 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. Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idImmunization.implicitRules A set of rules under which this content was created 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. 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.
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language | 0..1 | codeBinding | There are no (further) constraints on this element Element idImmunization.language Language of the resource content DefinitionThe base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language.
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text | 0..1 | Narrative | There are no (further) constraints on this element Element idImmunization.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display 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. 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.
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contained | 0..* | Resource | There are no (further) constraints on this element Element idImmunization.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources 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. 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.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content 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). 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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identifier | 0..* | Identifier | There are no (further) constraints on this element Element idImmunization.identifier Business identifier DefinitionA unique identifier assigned to this immunization record.
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status | S Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element idImmunization.status completed | entered-in-error | not-done DefinitionIndicates the current status of the immunization event. Will generally be set to show that the immunization has been completed or not done. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. A set of codes indicating the current status of an Immunization.
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statusReason | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idImmunization.statusReason Reason not done DefinitionIndicates the reason the immunization event was not performed. This is generally only used for the status of "not-done". The reason for performing the immunization event is captured in reasonCode, not here. The reason why a vaccine was not administered.
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vaccineCode | S Σ | 1..1 | CodeableConceptPSONBinding | Element idImmunization.vaccineCode Vaccine that was administered or was to be administered. IPS-UV Note: Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent/unknown code. Other coded information can be provided as well as: the Pharmaceutical and medicinal product identifiers, when available, or equivalent coded concepts; the WHO ATC codes; or any other kind of code that that identifies, classifies or cluster the administered product. DefinitionVaccine that was administered or was to be administered. PS-CA Note: Work is underway to define the pan-Canadian terminology that will be preferred and/or socialized for vaccine.code. IPS-UV Note: Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunized is provided; or the known absent/unknown. Other coded information can be provided as well as:
The value sets used for the PhPID, MPID and PCID identifiers are provisional and include only few equivalent concepts used for exemplification purposes, they will be updated with real IDMP identifiers when they will become available. Codes from the Canadian Vaccine Catalogue Generic Value Set. Use of Tradename Value Set is equivalently preferred
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.vaccineCode.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.vaccineCode.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | S Σ | 0..* | CodingPSON | Element idImmunization.vaccineCode.coding A reference to a code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. Unordered, Open, by $this(Pattern) Discriminated by bound value set Constraints
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vaccineIPSCode | Σ | 0..1 | CodingPSONBinding | Element idImmunization.vaccineCode.coding:vaccineIPSCode Optional slice for representing the code for vaccine from the SNOMED CT IPS code set DefinitionCode for a vaccine that is selected from the SNOMED CT IPS code set. Allows for alternative encodings within a code system, and translations to other code systems. 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. http://hl7.org/fhir/uv/ips/ValueSet/vaccines-uv-ips (required) Constraints
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atcClass | Σ | 0..* | CodingPSONBinding | Element idImmunization.vaccineCode.coding:atcClass Optional slice for representing the vaccine code from the WHO ATC classification DefinitionWHO ATC classification Allows for alternative encodings within a code system, and translations to other code systems. The IPS-UV considers this slice MS in STU1, however the impacts of applying MS on terminology slices have been brought forward to the IPS-UV FHIR authors and removal of the MS flag on optional slices is currently being discussed. http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips (required) Constraints
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CVCGeneric | S Σ | 0..* | CodingPSONBinding | Element idImmunization.vaccineCode.coding:CVCGeneric A reference to a code defined by a terminology system DefinitionGeneric Immunizing Agent Allows for alternative encodings within a code system, and translations to other code systems. Generic Immunizing Agents subset contains generically described vaccines and passive immunizing agents used in Canada. It is an extension of the Pan-Canadian Immunization Reference Sets Vaccine Historical Name Code and Passive Historical Immunizing Agent Code subset developed by Canada Health Infoway. Please note that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: https://cvc.canimmunize.ca/en/explore#/ http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-Generic (required) Constraints
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CVCTradename | S Σ | 0..* | CodingPSONBinding | Element idImmunization.vaccineCode.coding:CVCTradename A reference to a code defined by a terminology system DefinitionTradename Immunizing Agent Allows for alternative encodings within a code system, and translations to other code systems. Tradename Immunizing Agents subset contains tradenames of vaccines and passive immunizing agents used in Canada. It is an extension of the Pan-Canadian Immunization Reference Sets Vaccine Administered Trade Name Code and Immunioglobulin Code subset developed by Canada Health Infoway. Please note that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: https://cvc.canimmunize.ca/en/explore#/ http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-Tradename (required) Constraints
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absentOrUnknownImmunization | S Σ | 0..* | CodingPSONBinding | Element idImmunization.vaccineCode.coding:absentOrUnknownImmunization Optional slice for representing the codes for an Absent or Unknown Immunization DefinitionA reference to a code indicating that there there are no known immunizations or that this information is unknown. Allows for alternative encodings within a code system, and translations to other code systems. This slice is kept as must support to ensure that systems proving conformance can show that they can produce a value indicating that an immunization is absent or unknown (similar to approach with keeping must support flags on data absent reason extensions) http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-immunizations-uv-ips (required) Constraints
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.vaccineCode.text Plain text representation of the concept 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. 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. Very often the text is the same as a displayName of one of the codings.
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patient | S Σ I | 1..1 | Reference(PatientPSON) | Element idImmunization.patient Who was immunized DefinitionThe patient who either received or did not receive the immunization. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.patient.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.patient.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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reference | S Σ I | 1..1 | string | There are no (further) constraints on this element Element idImmunization.patient.reference Literal reference, Relative, internal or absolute URL 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. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element idImmunization.patient.type Type the reference refers to (e.g. "Patient") 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). 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. Aa resource (or, for logical models, the URI of the logical model).
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idImmunization.patient.identifier Logical reference, when literal reference is not known 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. 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).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.patient.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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.
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encounter | I | 0..1 | Reference(Encounter) | There are no (further) constraints on this element Element idImmunization.encounter Encounter immunization was part of DefinitionThe visit or admission or other contact between patient and health care provider the immunization was performed as part of. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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occurrence[x] | S Σ | 1..1 | There are no (further) constraints on this element Element idImmunization.occurrence[x] Vaccine administration date DefinitionDate vaccine administered or was to be administered. When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given. An exact date is always preferable, but the use of the String data type is acceptable when an exact date is not known. A small number of vaccines (e.g. live oral typhoid vaccine) are given as a series of patient self-administered dose over a span of time. In cases like this, often, only the first dose (typically a provider supervised dose) is recorded with the occurrence indicating the date/time of the first dose.
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.occurrence[x].id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | Element idImmunization.occurrence[x].extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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data-absent-reason | S I | 0..1 | Extension(code) | Element idImmunization.occurrence[x].extension:data-absent-reason occurrence[x] absence reason Alternate namesextensions, user content DefinitionProvides a reason why the occurrence is missing. Note to implementers: Path to this element in the FHIR Artifact is ~Immunization.occurrence[x].extension:data-absent-reason~ although it may be redering incorrectly in Simplifier. http://hl7.org/fhir/StructureDefinition/data-absent-reason Constraints
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occurrenceDateTime | dateTime | There are no (further) constraints on this element Data type | ||
occurrenceString | string | There are no (further) constraints on this element Data type | ||
recorded | 0..1 | dateTime | There are no (further) constraints on this element Element idImmunization.recorded When the immunization was first captured in the subject's record DefinitionThe date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event.
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primarySource | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idImmunization.primarySource Indicates context the data was recorded in 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. Reflects the “reliability” of the content.
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reportOrigin | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idImmunization.reportOrigin Indicates the source of a secondarily reported record DefinitionThe source of the data when the report of the immunization event is not based on information from the person who administered the vaccine. Should not be populated if primarySource = True, not required even if primarySource = False. The source of the data for a record which is not from a primary source.
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location | I | 0..1 | Reference(Location) | There are no (further) constraints on this element Element idImmunization.location Where immunization occurred DefinitionThe service delivery location where the vaccine administration occurred. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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manufacturer | I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idImmunization.manufacturer Vaccine manufacturer DefinitionName of vaccine manufacturer. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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lotNumber | 0..1 | string | There are no (further) constraints on this element Element idImmunization.lotNumber Vaccine lot number DefinitionLot number of the vaccine product. Note that FHIR strings SHALL NOT exceed 1MB in size
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expirationDate | 0..1 | date | There are no (further) constraints on this element Element idImmunization.expirationDate Vaccine expiration date DefinitionDate vaccine batch expires.
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site | 0..1 | CodeableConceptPSONBinding | Element idImmunization.site Concept - reference to a terminology or just text DefinitionA concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Code for anatomical site from the Canadian Vaccine Catalogue code set. Please note that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: https://cvc.canimmunize.ca/en/explore#/ The site at which the vaccine was administered.
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route | 0..1 | CodeableConceptPSONBinding | Element idImmunization.route Concept - reference to a terminology or just text DefinitionA concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Code for a route of administration from the Canadian Vaccine Catalogue code set. Please note that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: https://cvc.canimmunize.ca/en/explore#/ The route by which the vaccine was administered.
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doseQuantity | I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idImmunization.doseQuantity Amount of vaccine administered DefinitionThe quantity of vaccine product that was administered. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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performer | Σ | 0..1 | BackboneElement | Element idImmunization.performer Who performed event DefinitionIndicates who performed the immunization event. While the IPS-UV specification considers this a MS element, some systems will not have a field directly representing performer, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.performer.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.performer.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.performer.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers 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). 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. 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.
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function | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idImmunization.performer.function What type of performance was done DefinitionDescribes the type of performance (e.g. ordering provider, administering provider, etc.). Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The role a practitioner or organization plays in the immunization event.
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actor | Σ I | 1..1 | Reference(Practitioner | PractitionerRole | Organization) | There are no (further) constraints on this element Element idImmunization.performer.actor Individual or organization who was performing DefinitionThe practitioner or organization who performed the action. When the individual practitioner who performed the action is known, it is best to send. Reference(Practitioner | PractitionerRole | Organization) Constraints
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note | Σ | 0..* | Annotation | There are no (further) constraints on this element Element idImmunization.note Additional immunization notes DefinitionExtra information about the immunization that is not conveyed by the other attributes. For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
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reasonCode | 0..* | CodeableConcept | There are no (further) constraints on this element Element idImmunization.reasonCode Why immunization occurred DefinitionReasons why the vaccine was administered. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The reason why a vaccine was administered.
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reasonReference | I | 0..* | Reference(Condition | Observation | DiagnosticReport) | There are no (further) constraints on this element Element idImmunization.reasonReference Why immunization occurred DefinitionCondition, Observation or DiagnosticReport that supports why the immunization was administered. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Condition | Observation | DiagnosticReport) Constraints
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isSubpotent | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element idImmunization.isSubpotent Dose potency DefinitionIndication if a dose is considered to be subpotent. By default, a dose should be considered to be potent. Typically, the recognition of the dose being sub-potent is retrospective, after the administration (ex. notification of a manufacturer recall after administration). However, in the case of a partial administration (the patient moves unexpectedly and only some of the dose is actually administered), subpotency may be recognized immediately, but it is still important to record the event. By default, a dose should be considered to be potent.
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subpotentReason | 0..* | CodeableConcept | There are no (further) constraints on this element Element idImmunization.subpotentReason Reason for being subpotent DefinitionReason why a dose is considered to be subpotent. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The reason why a dose is considered to be subpotent.
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education | I | 0..* | BackboneElement | There are no (further) constraints on this element Element idImmunization.education Educational material presented to patient DefinitionEducational material presented to the patient (or guardian) at the time of vaccine administration.
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.education.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.education.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.education.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers 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). 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. 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.
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documentType | 0..1 | string | There are no (further) constraints on this element Element idImmunization.education.documentType Educational material document identifier DefinitionIdentifier of the material presented to the patient. Note that FHIR strings SHALL NOT exceed 1MB in size
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reference | 0..1 | uri | There are no (further) constraints on this element Element idImmunization.education.reference Educational material reference pointer DefinitionReference pointer to the educational material given to the patient if the information was on line. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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publicationDate | 0..1 | dateTime | There are no (further) constraints on this element Element idImmunization.education.publicationDate Educational material publication date DefinitionDate the educational material was published.
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presentationDate | 0..1 | dateTime | There are no (further) constraints on this element Element idImmunization.education.presentationDate Educational material presentation date DefinitionDate the educational material was given to the patient.
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programEligibility | 0..* | CodeableConcept | There are no (further) constraints on this element Element idImmunization.programEligibility Patient eligibility for a vaccination program DefinitionIndicates a patient's eligibility for a funding program. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The patient's eligibility for a vaccation program.
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fundingSource | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idImmunization.fundingSource Funding source for the vaccine 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). Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The source of funding used to purchase the vaccine administered.
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reaction | 0..* | BackboneElement | There are no (further) constraints on this element Element idImmunization.reaction Details of a reaction that follows immunization DefinitionCategorical data indicating that an adverse event is associated in time to an immunization. A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case, it should be recorded as a new AllergyIntolerance resource instance as most systems will not query against past Immunization.reaction elements.
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.reaction.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.reaction.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.reaction.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers 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). 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. 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.
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date | 0..1 | dateTime | There are no (further) constraints on this element Element idImmunization.reaction.date When reaction started DefinitionDate of reaction to the immunization.
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detail | I | 0..1 | Reference(Observation) | There are no (further) constraints on this element Element idImmunization.reaction.detail Additional information on reaction DefinitionDetails of the reaction. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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reported | 0..1 | boolean | There are no (further) constraints on this element Element idImmunization.reaction.reported Indicates self-reported reaction DefinitionSelf-reported indicator.
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protocolApplied | 0..* | BackboneElement | There are no (further) constraints on this element Element idImmunization.protocolApplied Protocol followed by the provider DefinitionThe protocol (set of recommendations) being followed by the provider who administered the dose.
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.protocolApplied.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.protocolApplied.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.protocolApplied.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers 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). 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. 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.
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series | 0..1 | string | There are no (further) constraints on this element Element idImmunization.protocolApplied.series Name of vaccine series DefinitionOne possible path to achieve presumed immunity against a disease - within the context of an authority. Note that FHIR strings SHALL NOT exceed 1MB in size
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authority | I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idImmunization.protocolApplied.authority Who is responsible for publishing the recommendations DefinitionIndicates the authority who published the protocol (e.g. ACIP) that is being followed. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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targetDisease | 0..* | CodeableConceptPSONBinding | Element idImmunization.protocolApplied.targetDisease Concept - reference to a terminology or just text DefinitionA concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text. The vaccine preventable disease the dose is being administered for.
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id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.protocolApplied.targetDisease.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.protocolApplied.targetDisease.extension Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 0..* | CodingPSON | Element idImmunization.protocolApplied.targetDisease.coding A reference to a code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. Unordered, Open, by $this(Pattern) Discriminated by bound value set Constraints
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targetDiseaseIPSCode | Σ | 0..* | CodingPSONBinding | Element idImmunization.protocolApplied.targetDisease.coding:targetDiseaseIPSCode Optional slice for representing the code for a disease the vaccination is against the IPS Value Set DefinitionCode for a disease the vaccination is against from the SNOMED CT code set. Allows for alternative encodings within a code system, and translations to other code systems. The IPS slice has replaced the GPS slice in this release to support validation tooling. http://hl7.org/fhir/uv/ips/ValueSet/targetDiseases-uv-ips (required) Constraints
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targetDiseaseCVC | Σ | 0..* | CodingPSONBinding | Element idImmunization.protocolApplied.targetDisease.coding:targetDiseaseCVC Optional slice for representing the code for a disease the vaccination is against from the Canadian Vaccine Catalogue code set. DefinitionCode for a disease the vaccination is against from the Canadian Vaccine Catalogue code set. Please note that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: https://cvc.canimmunize.ca/en/explore#/ Allows for alternative encodings within a code system, and translations to other code systems. 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. http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-Disease (required) Constraints
|
text | S Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.protocolApplied.targetDisease.text Plain text representation of the concept 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. 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. Very often the text is the same as a displayName of one of the codings.
|
doseNumber[x] | 1..1 | There are no (further) constraints on this element Element idImmunization.protocolApplied.doseNumber[x] Dose number within series DefinitionNominal position in a series. The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).
| ||
doseNumberPositiveInt | positiveInt | There are no (further) constraints on this element Data type | ||
doseNumberString | string | There are no (further) constraints on this element Data type | ||
seriesDoses[x] | 0..1 | There are no (further) constraints on this element Element idImmunization.protocolApplied.seriesDoses[x] Recommended number of doses for immunity DefinitionThe recommended number of doses to achieve immunity. The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).
| ||
seriesDosesPositiveInt | positiveInt | There are no (further) constraints on this element Data type | ||
seriesDosesString | string | There are no (further) constraints on this element Data type |
Table View
Immunization | .. | |
Immunization.meta | 1.. | |
Immunization.meta.profile | 1.. | |
Immunization.status | .. | |
Immunization.vaccineCode | CodeableConceptPSON | 1..1 |
Immunization.vaccineCode.coding | CodingPSON | .. |
Immunization.vaccineCode.coding | ..1 | |
Immunization.vaccineCode.coding | .. | |
Immunization.vaccineCode.coding | .. | |
Immunization.vaccineCode.coding | .. | |
Immunization.vaccineCode.coding | .. | |
Immunization.patient | Reference(PatientPSON) | .. |
Immunization.patient.reference | 1.. | |
Immunization.occurrence[x] | 1..1 | |
Immunization.occurrence[x].extension | .. | |
Immunization.occurrence[x].extension | Extension | ..1 |
Immunization.site | CodeableConceptPSON | .. |
Immunization.route | CodeableConceptPSON | .. |
Immunization.performer | ..1 | |
Immunization.protocolApplied | .. | |
Immunization.protocolApplied.targetDisease | CodeableConceptPSON | 0.. |
Immunization.protocolApplied.targetDisease.coding | CodingPSON | .. |
Immunization.protocolApplied.targetDisease.coding | .. | |
Immunization.protocolApplied.targetDisease.coding | .. |
JSON View
{ "resourceType": "StructureDefinition", "id": "ca-on-ps-profile-immunization", "url": "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-immunization", "version": "0.10.0", "name": "ImmunizationPSON", "title": "Immunization (PS-ON)", "status": "draft", "date": "2024-02-01T19:39:15.322061+00:00", "publisher": "Ontario Health", "description": "This profile defines a set of constraints to the FHIR Immunization resource for use in Ontario Patient Summaries (PS-ON). It refines constraints applied to the Immunization resource by the PS-CA project to represent a record of immunization in the patient summary. It is informed by the constraints of the [Immunization-UV-IPS profile](http://hl7.org/fhir/uv/ips/StructureDefinition-Immunization-uv-ips.html) and the [Canadian Baseline Profile](http://build.fhir.org/ig/HL7-Canada/ca-baseline/branches/master/StructureDefinition-profile-immunization.html) to allow for cross-border and cross-jurisdiction sharing of Medication Summary information. It describes the event of a patient being administered a vaccination or a record of a vaccination as reported by a patient, a clinician or another party.", "fhirVersion": "4.0.1", "kind": "resource", "abstract": false, "type": "Immunization", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Immunization", "derivation": "constraint", "differential": { "element": [ { "id": "Immunization.meta", "path": "Immunization.meta", "min": 1, "mustSupport": true }, { "id": "Immunization.meta.profile", "path": "Immunization.meta.profile", "min": 1, "mustSupport": true }, { "id": "Immunization.status", "path": "Immunization.status", "mustSupport": true }, { "id": "Immunization.vaccineCode", "path": "Immunization.vaccineCode", "short": "Vaccine that was administered or was to be administered. IPS-UV Note: Several kinds of vaccine product coding could be provided.\n\nThe IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent/unknown code.\n\nOther coded information can be provided as well as: the Pharmaceutical and medicinal product identifiers, when available, or equivalent coded concepts; the WHO ATC codes; or any other kind of code that that identifies, classifies or cluster the administered product.", "definition": "Vaccine that was administered or was to be administered.", "comment": "PS-CA Note: Work is underway to define the pan-Canadian terminology that will be preferred and/or socialized for vaccine.code. IPS-UV Note: Several kinds of vaccine product coding could be provided.\n\nThe IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunized is provided; or the known absent/unknown.\n\nOther coded information can be provided as well as:\n 1. The IDMP Pharmaceutical Product Identifier (PhPID), Level 1, [Substance(s)]. Example: Amoxicillin and Clavulanate Potassium; or any other equivalent coded concept.\n 1. The IDMP Pharmaceutical Product Identifier (PhPID), Level 2 [Substance(s) + Strength + reference strength]. Example: Amoxicillin 875 mg and Clavulanate Potassium 125 mg; or any other equivalent coded concept.\n 1. The IDMP Pharmaceutical Product Identifier (PhPID), Level 3 [Substance(s) + administrable dose form]. Example: Amoxicillin and Clavulanate Potassium, Oral Tablet; or any other equivalent coded concept.\n 1. The IDMP Pharmaceutical Product Identifier (PhPID), Level 4 [Substance(s) + strength + reference strength + administrable dose form]. Example: Amoxicillin 875 mg and clavulanate potassium 125 mg, oral tablet; or any other equivalent coded concept.\n 1. The IDMP Medicinal Product Identifier (MPID) or any equivalent Medicinal Product Identifier. IDMP MPID uniquely identifies a Medicinal Product, reflecting (but not replacing) any other authorization numbers allocated by a regulator. MPID implies one (set of) PhPID. The MPID shall use a common segment pattern related to a Medicinal Product, which, when each segment is valued shall define a specific MPID concept.\n 1. The IDMP Packaged Medicinal Product Identifier (PCID) or any equivalent Packaged Medicinal Product Identifier. Uniquely identifies a Medicinal Product based on its packaging. This implies one MPID can be associated with more than one PCID, if the same Medicinal Product has more than one type of package.\n 1. Any other kind of code that that identifies, classifies or clusters the administered product (e.g. the medicinal product or the product class).\n\nThe value sets used for the PhPID, MPID and PCID identifiers are provisional and include only few equivalent concepts used for exemplification purposes, they will be updated with real IDMP identifiers when they will become available.", "min": 1, "max": "1", "type": [ { "code": "CodeableConcept", "profile": [ "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-codeableconcept" ] } ], "mustSupport": true, "binding": { "strength": "preferred", "description": "Codes from the Canadian Vaccine Catalogue Generic Value Set. Use of Tradename Value Set is equivalently preferred", "valueSet": "http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-Generic" } }, { "id": "Immunization.vaccineCode.coding", "path": "Immunization.vaccineCode.coding", "slicing": { "discriminator": [ { "type": "pattern", "path": "$this" } ], "description": "Discriminated by bound value set", "rules": "open" }, "type": [ { "code": "Coding", "profile": [ "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-coding" ] } ], "mustSupport": true }, { "id": "Immunization.vaccineCode.coding:vaccineIPSCode", "path": "Immunization.vaccineCode.coding", "sliceName": "vaccineIPSCode", "short": "Optional slice for representing the code for vaccine from the SNOMED CT IPS code set", "definition": "Code for a vaccine that is selected from the SNOMED CT IPS code set.", "max": "1", "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "vaccineIPS" } ], "strength": "required", "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/vaccines-uv-ips" } }, { "id": "Immunization.vaccineCode.coding:atcClass", "path": "Immunization.vaccineCode.coding", "sliceName": "atcClass", "short": "Optional slice for representing the vaccine code from the WHO ATC classification", "definition": "WHO ATC classification", "comment": "The IPS-UV considers this slice MS in STU1, however the impacts of applying MS on terminology slices have been brought forward to the IPS-UV FHIR authors and removal of the MS flag on optional slices is currently being discussed.", "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "WHO ATC" } ], "strength": "required", "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips" } }, { "id": "Immunization.vaccineCode.coding:Generic", "path": "Immunization.vaccineCode.coding", "sliceName": "CVCGeneric", "definition": "Generic Immunizing Agent", "comment": "Generic Immunizing Agents subset contains generically described vaccines and passive immunizing agents used in Canada. It is an extension of the Pan-Canadian Immunization Reference Sets Vaccine Historical Name Code and Passive Historical Immunizing Agent Code subset developed by Canada Health Infoway. **Please note** that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: [https://cvc.canimmunize.ca/en/explore#/](https://cvc.canimmunize.ca/en/explore#/)", "mustSupport": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "CVCGeneric" } ], "strength": "required", "valueSet": "http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-Generic" } }, { "id": "Immunization.vaccineCode.coding:Tradename", "path": "Immunization.vaccineCode.coding", "sliceName": "CVCTradename", "definition": "Tradename Immunizing Agent", "comment": "Tradename Immunizing Agents subset contains tradenames of vaccines and passive immunizing agents used in Canada. It is an extension of the Pan-Canadian Immunization Reference Sets Vaccine Administered Trade Name Code and Immunioglobulin Code subset developed by Canada Health Infoway. **Please note** that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: [https://cvc.canimmunize.ca/en/explore#/](https://cvc.canimmunize.ca/en/explore#/)", "mustSupport": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "CVCTradename" } ], "strength": "required", "valueSet": "http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-Tradename" } }, { "id": "Immunization.vaccineCode.coding:absentOrUnknownImmunization", "path": "Immunization.vaccineCode.coding", "sliceName": "absentOrUnknownImmunization", "short": "Optional slice for representing the codes for an Absent or Unknown Immunization", "definition": "A reference to a code indicating that there there are no known immunizations or that this information is unknown.", "comment": "This slice is kept as must support to ensure that systems proving conformance can show that they can produce a value indicating that an immunization is absent or unknown (similar to approach with keeping must support flags on data absent reason extensions)", "mustSupport": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "Absent Unknown Immunization" } ], "strength": "required", "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-immunizations-uv-ips" } }, { "id": "Immunization.patient", "path": "Immunization.patient", "type": [ { "code": "Reference", "targetProfile": [ "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-patient" ] } ], "mustSupport": true }, { "id": "Immunization.patient.reference", "path": "Immunization.patient.reference", "min": 1, "mustSupport": true }, { "id": "Immunization.occurrence[x]", "path": "Immunization.occurrence[x]", "min": 1, "max": "1", "mustSupport": true }, { "id": "Immunization.occurrence[x].extension", "path": "Immunization.occurrence[x].extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "ordered": false, "rules": "open" } }, { "id": "Immunization.occurrence[x].extension:data-absent-reason", "path": "Immunization.occurrence[x].extension", "sliceName": "data-absent-reason", "short": "occurrence[x] absence reason", "definition": "Provides a reason why the occurrence is missing.", "comment": "**Note to implementers:** Path to this element in the FHIR Artifact is ~Immunization.occurrence[x].extension:data-absent-reason~ although it may be redering incorrectly in Simplifier.", "max": "1", "type": [ { "code": "Extension", "profile": [ "http://hl7.org/fhir/StructureDefinition/data-absent-reason" ] } ], "mustSupport": true }, { "id": "Immunization.site", "path": "Immunization.site", "comment": "Code for anatomical site from the Canadian Vaccine Catalogue code set. **Please note** that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: [https://cvc.canimmunize.ca/en/explore#/](https://cvc.canimmunize.ca/en/explore#/)", "type": [ { "code": "CodeableConcept", "profile": [ "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-codeableconcept" ] } ], "binding": { "strength": "preferred", "valueSet": "http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-AnatomicalSite" } }, { "id": "Immunization.route", "path": "Immunization.route", "comment": "Code for a route of administration from the Canadian Vaccine Catalogue code set. **Please note** that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: [https://cvc.canimmunize.ca/en/explore#/](https://cvc.canimmunize.ca/en/explore#/)", "type": [ { "code": "CodeableConcept", "profile": [ "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-codeableconcept" ] } ], "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "ImmunizationRoute" } ], "strength": "preferred", "valueSet": "http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-RouteOfAdmin" } }, { "id": "Immunization.performer", "path": "Immunization.performer", "comment": "While the IPS-UV specification considers this a MS element, some systems will not have a field directly representing performer, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance", "max": "1" }, { "id": "Immunization.protocolApplied.targetDisease", "path": "Immunization.protocolApplied.targetDisease", "min": 0, "type": [ { "code": "CodeableConcept", "profile": [ "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-codeableconcept" ] } ], "binding": { "strength": "preferred", "valueSet": "http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-Disease" } }, { "id": "Immunization.protocolApplied.targetDisease.coding", "path": "Immunization.protocolApplied.targetDisease.coding", "slicing": { "discriminator": [ { "type": "pattern", "path": "$this" } ], "description": "Discriminated by bound value set", "rules": "open" }, "type": [ { "code": "Coding", "profile": [ "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-coding" ] } ] }, { "id": "Immunization.protocolApplied.targetDisease.coding:targetDiseaseIPSCode", "path": "Immunization.protocolApplied.targetDisease.coding", "sliceName": "targetDiseaseIPSCode", "short": "Optional slice for representing the code for a disease the vaccination is against the IPS Value Set", "definition": "Code for a disease the vaccination is against from the SNOMED CT code set.", "comment": "The IPS slice has replaced the GPS slice in this release to support validation tooling.", "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "TargetDiseasesUvIps" } ], "strength": "required", "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/targetDiseases-uv-ips" } }, { "id": "Immunization.protocolApplied.targetDisease.coding:CVC", "path": "Immunization.protocolApplied.targetDisease.coding", "sliceName": "targetDiseaseCVC", "short": "Optional slice for representing the code for a disease the vaccination is against from the Canadian Vaccine Catalogue code set.", "definition": "Code for a disease the vaccination is against from the Canadian Vaccine Catalogue code set. **Please note** that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: [https://cvc.canimmunize.ca/en/explore#/](https://cvc.canimmunize.ca/en/explore#/)", "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "TargetDiseasesCVC" } ], "strength": "required", "valueSet": "http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-Disease" } } ] } }
Usage
The Immunization Resource is used to populate entries in the Immunization section of a Patient Summary.
Notes
.id
- Definition: Logical id of this artifact
- used to uniquely identify the resource
- if a persistent identity for the resource is not available to use when constructing the composition Bundle, a UUID SHOULD be used in this element (with a corresponding value in
Bundle.entry.fullUrl
) - Where
.id
is populated with a persistent identifier, consumers SHALL NOT expect to be able to resolve the resource and SHALL always use the version of the resource contained in the Bundle to render the composition.
.meta.profile
- used to declare conformance to this profile
- populate with a fixed value:
http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-immunization|0.9.1
.meta.versionId
- SHALL be populated by the Patient Summary Repository server
- consuming systems can expect this element to be populated when retrieving patient summary instances from the repository
- source systems do not need to populate this element prior to submission
.status
- it is expected that immunizations recorded in the patient summary will have a status of "completed". "entered-in-error" or "not-done" may be used rarely.
- mustSupport element in international patient summary
.vaccineCode
- SHALL be used to either:
- identify the vaccine in the entry, or
- to explicitly state that the patient has no known or unknown immunizations when the section in the patient summary does not contain a vaccine
- in situations where a vaccine is present:
- a description SHALL be provided in
.text
for display - a coded value SHOULD also be provided in
.coding
- a description SHALL be provided in
- in situations where a vaccine is not present, this SHALL be coveyed using
.coding
from the prescribed valueSet- in situations where the EMR cannot distinguish between no-known and no information about patient immunizations, then the code for no information should be used. In the instance where a patient is KNOWN to have no immunizations, the no-known code should be used.
- the "CVCGeneric" and "CVCTradename" slices provide the preferred choice of terminology for this element in Ontario
- mustSupport element in international patient summary
.patient
- SHALL provide a
.reference
to the samePatient
resource identified inComposition.subject
- mustSupport element in international patient summary
occurrence
- SHALL be used to indicate when the immunization was administered
- mustSupport element in international patient summary
- SHALL contain either an occurrenceDateTime or occurrenceString or a data-absent-reason
occurrence.dataAbsentReason
- NOTE: There is currently a rendering issue with this profile; the dataAbsentReason extension should be rendering under the
.occurrence
element - If no data is available about when the vaccine was administered, dataAbsentReason SHOULD be used to indicate why this information is absent
- If no immunizations are present (i.e.
.vaccineCode
is used to convey absent or unknown),.dataAbsentReason
SHALL be set to "not-applicable" - mustSupport element in international patient summary