Immunization |
Definition | Describes the event of a patient being administered a vaccine or a record of an immunization as reported by a patient, a clinician or another party. |
Cardinality | 0...* |
Invariants | - dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty() - dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() - dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() - dom-6: A resource should have narrative for robust management
text.`div`.exists() - dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty() - ukcore-imm-001: If the immunization was not given, then `Immunization.status` value SHALL = 'not-done', and the `Immunization.statusReason` SHALL be populated
(status != 'not-done') or (status = 'not-done' and statusReason.exists())
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Mappings | - rim: Entity. Role, or Act
- workflow: Event
- v2: VXU_V04
- rim: SubstanceAdministration
|
Immunization.id |
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. |
Cardinality | 0...1 |
Type | string |
Summary | True |
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
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Immunization.meta |
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. |
Cardinality | 0...1 |
Type | Meta |
Summary | True |
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | |
Immunization.implicitRules |
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. |
Cardinality | 0...1 |
Type | uri |
Modifier | True |
Summary | True |
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | |
Immunization.language |
Definition | The base language in which the resource is written. |
Cardinality | 0...1 |
Type | code |
Binding | CommonLanguages (preferred) |
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | |
Immunization.text |
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. |
Cardinality | 0...1 |
Type | Narrative |
Alias | narrative, html, xhtml, display |
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- rim: N/A
- rim: Act.text?
|
Immunization.contained |
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. |
Cardinality | 0...* |
Type | Resource |
Alias | inline resources, anonymous resources, contained resources |
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
|
Mappings | - rim: Entity. Role, or Act
- rim: N/A
|
Immunization.extension |
Definition | May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
|
Slicing | Unordered, Open, by url(Value) |
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
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Mappings | |
Immunization.extension:parentPresent |
Definition | Was a parent of the patient present at an immunisation? |
Cardinality | 0...1 |
Type | Extension(boolean) |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
|
Mappings | |
Immunization.extension:vaccinationProcedure |
Definition | An extension to hold an immunization procedure code. |
Cardinality | 0...1 |
Type | Extension(CodeableConcept) |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
|
Mappings | |
Immunization.modifierExtension |
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Alias | extensions, user content |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
|
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
|
Slicing | Unordered, Open, by url(Value) |
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
|
Mappings | |
Immunization.identifier |
Definition | A unique identifier assigned to this immunization record. |
Cardinality | 0...* |
Type | Identifier |
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd: Identifier
- workflow: Event.identifier
- w5: FiveWs.identifier
- rim: .id
- cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/id
|
Immunization.status |
Definition | Indicates the current status of the immunization event. |
Cardinality | 1...1 |
Type | code |
Binding | A set of codes indicating the current status of an Immunization.
ImmunizationStatusCodes (required) |
Must Support | True |
Modifier | True |
Summary | True |
Comments | Will generally be set to show that the immunization has been completed or not done. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- workflow: Event.status
- w5: FiveWs.status
- rim: statusCode
|
Immunization.statusReason |
Definition | Indicates the reason the immunization event was not performed. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | The reason why a vaccine was not administered.
UKCoreReasonImmunizationNotAdministered (preferred) |
Comments | This is generally only used for the status of "not-done". The reason for performing the immunization event is captured in reasonCode, not here.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- workflow: Event.statusReason
- rim: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
|
Immunization.vaccineCode |
Definition | Vaccine that was administered or was to be administered. |
Cardinality | 1...1 |
Type | CodeableConcept |
Binding | The code for vaccine product administered.
UKCoreVaccineCode (preferred) |
Must Support | True |
Summary | True |
Comments | 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.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- workflow: Event.code
- w5: FiveWs.what[x]
- v2: RXA-5
- rim: .code
- cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/realmCode/code
|
Immunization.patient |
Definition | The patient who either received or did not receive the immunization. |
Cardinality | 1...1 |
Type | Reference(Patient) |
Must Support | True |
Summary | True |
Comments | 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.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
|
Mappings | - rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- workflow: Event.subject
- w5: FiveWs.subject[x]
- v2: PID-3
- rim: .partipication[ttypeCode=].role
- w5: FiveWs.subject
|
Immunization.encounter |
Definition | The visit or admission or other contact between patient and health care provider the immunization was performed as part of. |
Cardinality | 0...1 |
Type | Reference(Encounter) |
Comments | 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.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
|
Mappings | - rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- workflow: Event.context
- w5: FiveWs.context
- v2: PV1-19
- rim: component->EncounterEvent
|
Immunization.occurrence[x] |
Definition | Date vaccine administered or was to be administered. |
Cardinality | 1...1 |
Type | dateTime |
Must Support | True |
Summary | True |
Comments | When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given. An exact date is always preferable, but the use of the String data type is acceptable when an exact date is not known. A small number of vaccines (e.g. live oral typhoid vaccine) are given as a series of patient self-administered dose over a span of time. In cases like this, often, only the first dose (typically a provider supervised dose) is recorded with the occurrence indicating the date/time of the first dose.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- workflow: Event.occurrence[x]
- w5: FiveWs.done[x]
- v2: RXA-3
- rim: .effectiveTime
- cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value
|
Immunization.recorded |
Definition | The date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event. |
Cardinality | 0...1 |
Type | dateTime |
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- w5: FiveWs.recorded
- rim: .participation[typeCode=AUT].time
|
Immunization.primarySource |
Definition | An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded. |
Cardinality | 0...1 |
Type | boolean |
Summary | True |
Comments | Reflects the “reliability” of the content.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- w5: FiveWs.source
- v2: RXA-9
- rim: immunization.uncertaintycode (if primary source=false, uncertainty=U)
|
Immunization.reportOrigin |
Definition | The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | The source of the data for a record which is not from a primary source.
ImmunizationOriginCodes (example) |
Comments | Should not be populated if primarySource = True, not required even if primarySource = False.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- w5: FiveWs.source
- v2: RXA-9
- rim: .participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported) .participation[typeCode=INF].role[classCode=LIC] (this syntax for health care professional) .participation[typeCode=INF].role[classCode=PRS] (this syntax for family member)
|
Immunization.location |
Definition | The service delivery location where the vaccine administration occurred. |
Cardinality | 0...1 |
Type | Reference(Location) |
Comments | 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.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
|
Mappings | - rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- workflow: Event.location
- w5: FiveWs.where[x]
- v2: RXA-27 (or RXA-11, deprecated as of v2.7)
- rim: .participation[typeCode=LOC].COCT_MT240000UV
|
Immunization.manufacturer |
Definition | Name of vaccine manufacturer. |
Cardinality | 0...1 |
Type | Reference(Organization) |
Must Support | True |
Comments | 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.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
|
Mappings | - rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- v2: RXA-17
- rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=ORG]
- cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacuturerOrganization/name
|
Immunization.lotNumber |
Definition | Lot number of the vaccine product. |
Cardinality | 0...1 |
Type | string |
Must Support | True |
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- v2: RXA-15
- rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].id
- cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/lotNumberText
|
Immunization.expirationDate |
Definition | Date vaccine batch expires. |
Cardinality | 0...1 |
Type | date |
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- v2: RXA-16
- rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime
|
Immunization.site |
Definition | Body site where vaccine was administered. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | The site at which the vaccine was administered.
UKCoreImmunizationAdministrationBodySite (preferred) |
Comments | 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.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2: RXR-2
- rim: observation.targetSiteCode
- cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/approachSiteCode/code
|
Immunization.route |
Definition | The path by which the vaccine product is taken into the body. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | The route by which the vaccine was administered.
UKCoreSubstanceOrProductAdministrationRoute (preferred) |
Comments | 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.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2: RXR-1
- rim: .routeCode
- cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/routeCode/code
|
Immunization.doseQuantity |
Definition | The quantity of vaccine product that was administered. |
Cardinality | 0...1 |
Type | SimpleQuantity |
Must Support | True |
Comments | 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.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists() - sqty-1: The comparator is not used on a SimpleQuantity
comparator.empty()
|
Mappings | - rim: n/a
- v2: SN (see also Range) or CQ
- rim: PQ, IVL<PQ>, MO, CO, depending on the values
- v2: RXA-6 / RXA-7
- rim: .doseQuantity
|
Immunization.performer |
Definition | Indicates who performed the immunization event. |
Cardinality | 0...* |
Type | BackboneElement |
Summary | True |
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- workflow: Event.performer
- v2: ORC-12 / RXA-10
- rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
|
Immunization.performer.id |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings | |
Immunization.performer.extension |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
|
Slicing | Unordered, Open, by url(Value) |
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
|
Mappings | |
Immunization.performer.modifierExtension |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
|
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
|
Mappings | |
Immunization.performer.function |
Definition | Describes the type of performance (e.g. ordering provider, administering provider, etc.). |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | The role a practitioner or organization plays in the immunization event.
ImmunizationFunctionCodes (extensible) |
Summary | True |
Comments | 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.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- workflow: Event.performer.function
- rim: .participation.functionCode
|
Immunization.performer.actor |
Definition | The practitioner or organization who performed the action. |
Cardinality | 1...1 |
Type | Reference(Practitioner | PractitionerRole | Organization) |
Summary | True |
Comments | When the individual practitioner who performed the action is known, it is best to send.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
|
Mappings | - rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- workflow: Event.performer.actor
- w5: FiveWs.actor
- rim: .player
|
Immunization.note |
Definition | Extra information about the immunization that is not conveyed by the other attributes. |
Cardinality | 0...* |
Type | Annotation |
Summary | True |
Comments | 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).
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- v2: N/A
- rim: Act
- workflow: Event.note
- v2: OBX-5 : OBX-3 = 48767-8
- rim: note
|
Immunization.reasonCode |
Definition | Reasons why the vaccine was administered. |
Cardinality | 0...* |
Type | CodeableConcept |
Binding | The reason why a vaccine was administered.
UKCoreImmunizationExplanationReason (preferred) |
Comments | 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.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- workflow: Event.reasonCode
- rim: [actionNegationInd=false].reasonCode
|
Immunization.reasonReference |
Definition | Condition, Observation or DiagnosticReport that supports why the immunization was administered. |
Cardinality | 0...* |
Type | Reference(Condition | Observation | DiagnosticReport) |
Comments | 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.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
|
Mappings | - rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- workflow: Event.reasonReference
- rim: N/A
|
Immunization.isSubpotent |
Definition | Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent. |
Cardinality | 0...1 |
Type | boolean |
Modifier | True |
Summary | True |
Comments | Typically, the recognition of the dose being sub-potent is retrospective, after the administration (ex. notification of a manufacturer recall after administration). However, in the case of a partial administration (the patient moves unexpectedly and only some of the dose is actually administered), subpotency may be recognized immediately, but it is still important to record the event.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- v2: RXA-20 = PA (partial administration)
- rim: N/A
|
Immunization.subpotentReason |
Definition | Reason why a dose is considered to be subpotent. |
Cardinality | 0...* |
Type | CodeableConcept |
Binding | The reason why a dose is considered to be subpotent.
ImmunizationSubpotentReason (example) |
Comments | 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.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- rim: N/A
|
Immunization.education |
Definition | Educational material presented to the patient (or guardian) at the time of vaccine administration. |
Cardinality | 0...* |
Type | BackboneElement |
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - imm-1: One of documentType or reference SHALL be present
documentType.exists() or reference.exists()
|
Mappings | |
Immunization.education.id |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings | |
Immunization.education.extension |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
|
Slicing | Unordered, Open, by url(Value) |
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
|
Mappings | |
Immunization.education.modifierExtension |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
|
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
|
Mappings | |
Immunization.education.documentType |
Definition | Identifier of the material presented to the patient. |
Cardinality | 0...1 |
Type | string |
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- v2: OBX-5 : OBX-3 = 69764-9
- rim: N/A
|
Immunization.education.reference |
Definition | Reference pointer to the educational material given to the patient if the information was on line. |
Cardinality | 0...1 |
Type | uri |
Comments | see http://en.wikipedia.org/wiki/Uniform_resource_identifier
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | |
Immunization.education.publicationDate |
Definition | Date the educational material was published. |
Cardinality | 0...1 |
Type | dateTime |
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- v2: OBX-5 : OBX-3 = 29768-9
- rim: N/A
|
Immunization.education.presentationDate |
Definition | Date the educational material was given to the patient. |
Cardinality | 0...1 |
Type | dateTime |
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- v2: OBX-5 : OBX-3 = 29769-7
- rim: N/A
|
Immunization.programEligibility |
Definition | Indicates a patient's eligibility for a funding program. |
Cardinality | 0...* |
Type | CodeableConcept |
Binding | The patient's eligibility for a vaccation program.
ImmunizationProgramEligibility (example) |
Comments | 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.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2: OBX-5 : OBX-3 = 64994-7
- rim: N/A
|
Immunization.fundingSource |
Definition | Indicates the source of the vaccine actually administered. This may be different than the patient eligibility (e.g. the patient may be eligible for a publically purchased vaccine but due to inventory issues, vaccine purchased with private funds was actually administered). |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | The source of funding used to purchase the vaccine administered.
ImmunizationFundingSource (example) |
Comments | 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.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- rim: N/A
|
Immunization.reaction |
Definition | Categorical data indicating that an adverse event is associated in time to an immunization. |
Cardinality | 0...* |
Type | BackboneElement |
Comments | A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case, it should be recorded as a new AllergyIntolerance resource instance as most systems will not query against past Immunization.reaction elements.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- v2: OBX-3
- rim: Observation[classCode=obs].code
|
Immunization.reaction.id |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings | |
Immunization.reaction.extension |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
|
Slicing | Unordered, Open, by url(Value) |
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
|
Mappings | |
Immunization.reaction.modifierExtension |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
|
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
|
Mappings | |
Immunization.reaction.date |
Definition | Date of reaction to the immunization. |
Cardinality | 0...1 |
Type | dateTime |
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- v2: OBX-14 (ideally this would be reported in an IAM segment, but IAM is not part of the HL7 v2 VXU message - most likely would appear in OBX segments if at all)
- rim: .effectiveTime
|
Immunization.reaction.detail |
Definition | Details of the reaction. |
Cardinality | 0...1 |
Type | Reference(Observation) |
Comments | 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.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
|
Mappings | - rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- v2: OBX-5
- rim: .value
|
Immunization.reaction.reported |
Definition | Self-reported indicator. |
Cardinality | 0...1 |
Type | boolean |
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- v2: (HL7 v2 doesn't seem to provide for this)
- rim: .participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported=true)
|
Immunization.protocolApplied |
Definition | The protocol (set of recommendations) being followed by the provider who administered the dose. |
Cardinality | 0...* |
Type | BackboneElement |
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | |
Immunization.protocolApplied.id |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings | |
Immunization.protocolApplied.extension |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
|
Slicing | Unordered, Open, by url(Value) |
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
|
Mappings | |
Immunization.protocolApplied.modifierExtension |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
|
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
|
Mappings | |
Immunization.protocolApplied.series |
Definition | One possible path to achieve presumed immunity against a disease - within the context of an authority. |
Cardinality | 0...1 |
Type | string |
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | |
Immunization.protocolApplied.authority |
Definition | Indicates the authority who published the protocol (e.g. ACIP) that is being followed. |
Cardinality | 0...1 |
Type | Reference(Organization) |
Comments | 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.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
|
Mappings | - rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- rim: N/A
|
Immunization.protocolApplied.targetDisease |
Definition | The vaccine preventable disease the dose is being administered against. |
Cardinality | 0...* |
Type | CodeableConcept |
Binding | The vaccine preventable disease the dose is being administered for.
ImmunizationTargetDiseaseCodes (example) |
Comments | 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.
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | - rim: n/a
- v2: CE/CNE/CWE
- rim: CD
- orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
- rim: N/A
|
Immunization.protocolApplied.doseNumber[x] |
Definition | Nominal position in a series. |
Cardinality | 1...1 |
Type | positiveInt |
Comments | The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | |
Immunization.protocolApplied.seriesDoses[x] |
Definition | The recommended number of doses to achieve immunity. |
Cardinality | 0...1 |
Type | positiveInt |
Comments | The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).
|
Invariants | - ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
Mappings | |