CA Core+ 1.0.0 DFT-preBallot

Draft preBallot - This specification is under preBallot review and subject to change. It should not be used for implementation purposes. . . . . For a full list of available versions, see the Directory of published versions

Immunization (CA-Core)

Description

This profile applies constraints to the Immunization resource for CA Core+ to support documentation of administered vaccines in the pan-Canadian context.

References to this resource

Resource Content

ImmunizationCACore (Immunization)	I		Immunization	There are no (further) constraints on this element Element id Immunization Short description Immunization event information 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. Data type Immunization Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() ca-core-im-1: Immunization records created during an encounter event are expected to have occurrence populated. Occurrence SHALL be present if the primarySource is 'true' `Immunization.primarySource = true implies Immunization.occurrence.exists()` Mappings rim: Entity. Role, or Act workflow: Event v2: VXU_V04 rim: SubstanceAdministration pCHDCF-CACDI: Immunization
id	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. 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. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Immunization.meta Short description Metadata about the resource 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. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Immunization.implicitRules Short description A set of rules under which this content was created 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. 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id Immunization.language Short description Language of the resource content Definition The base language in which the resource is written. 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). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text		0..1	Narrative	There are no (further) constraints on this element Element id Immunization.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display 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. 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. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id Immunization.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources 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. 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. Data type Resource Mappings rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content 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). 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
identifier		0..*	Identifier	There are no (further) constraints on this element Element id Immunization.identifier Short description Business identifier Definition A unique identifier assigned to this immunization record. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.identifier w5: FiveWs.identifier rim: .id cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/id
status	S Σ ?!	1..1	codeBinding	There are no (further) constraints on this element Element id Immunization.status Short description completed \| entered-in-error \| not-done Definition Indicates the current status of the immunization event. 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. Data type code Binding A set of codes indicating the current status of an Immunization. ImmunizationStatusCodes (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.status w5: FiveWs.status rim: statusCode pCHDCF-CACDI: Immunization Status
statusReason		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.statusReason Short description Reason not done Definition Indicates the reason the immunization event was not performed. 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. Data type CodeableConcept Binding The reason why a vaccine was not administered. ImmunizationStatusReasonCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.statusReason rim: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde pCHDCF-CACDI: Immunization Reason Not Performed
vaccineCode	S Σ	1..1	CodeableConceptCACoreBinding	There are no (further) constraints on this element Element id Immunization.vaccineCode Short description Concept - reference to a terminology or just text Definition A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Comments The additionalBinding extension will be used to express the valueSet for additional negation/exclusion codes for reporting the known absence of immunizations. At the time of this release, the publisher of the current ValueSet for absence codes (IPS) is developing a SNOMED ValueSet that will replace the current http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-immunizations-uv-ips Data type CodeableConceptCACore Binding The code for vaccine product administered. VaccineAdministeredTradeNameCode (preferred) Additional bindings: VaccineHistoricalNameCode (preferred) Recommended for use when conveying vaccine generic names for scenarios when brand name is not known or does not exist (e.g., immunization history where provider does not have detail of the trade name, the product has been discontinued and/or never licensed in Canada). PassiveAdministeredImmunizingAgentCode (preferred) per pCHDCF: Alternate value sets can be used when passive immunization products are used PassiveHistoricalImmunizingAgentCode (preferred) per pCHDCF: Alternate value sets can be used when passive immunization products are used AbsentOrUnknownImmunizationUvIps (preferred) Absent or unknown codes Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.code w5: FiveWs.what[x] v2: RXA-5 rim: .code cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/realmCode/code rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD pCHDCF-CACDI: Drug
id		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccineCode.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
coding	S Σ	1..1	CodingCACore	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding Short description A reference to a code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Data type CodingCACore Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
id		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	0..1	uri	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	0..1	code	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code pCHDCF-CACDI: Drug Code
display	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName pCHDCF-CACDI: Drug English Description pCHDCF-CACDI: Drug French Description
id		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.display.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references) Data type string
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.display.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Constraints 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()`
translation	I	0..*	Extension(Complex)	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.display.extension:translation Short description Language Translation (Localization) Alternate names extensions, user content Definition Language translation from base language of resource to another language. 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. Data type Extension(Complex) Extension URL http://hl7.org/fhir/StructureDefinition/translation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: ST.translation
value		0..1	System.String	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.display.value Short description Primitive value for string Definition The actual value Data type System.String Maximum string length 1048576
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
patient	S Σ	1..1	Reference(PatientCACore)	There are no (further) constraints on this element Element id Immunization.patient Short description Who was immunized Definition The patient who either received or did not receive the immunization. Data type Reference(PatientCACore) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.subject w5: FiveWs.subject[x] v2: PID-3 rim: .partipication[ttypeCode=].role w5: FiveWs.subject pCHDCF-CACDI: Patient
id		0..1	string	There are no (further) constraints on this element Element id Immunization.patient.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.patient.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
reference	S Σ I	1..1	string	There are no (further) constraints on this element Element id Immunization.patient.reference Short description Literal reference, Relative, internal or absolute URL Definition A 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id Immunization.patient.type Short description Type the reference refers to (e.g. "Patient") Definition The 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). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id Immunization.patient.identifier Short description Logical reference, when literal reference is not known Definition An 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. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation\|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.patient.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
encounter		0..1	Reference(Encounter)	There are no (further) constraints on this element Element id Immunization.encounter Short description Encounter immunization was part of Definition The visit or admission or other contact between patient and health care provider the immunization was performed as part of. Data type Reference(Encounter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.context w5: FiveWs.context v2: PV1-19 rim: component->EncounterEvent
occurrence[x]	S Σ	1..1		There are no (further) constraints on this element Element id Immunization.occurrence[x] Short description Vaccine administration date Definition Date vaccine administered or was to be administered. 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. Sliced: Unordered, Open, by $this(Type) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.occurrence[x] w5: FiveWs.done[x] v2: RXA-3 rim: .effectiveTime cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value pCHDCF-CACDI: Patient Provided Immunization Date pCHDCF-CACDI: Event Start Date Time
(All Slices)				There are no (further) constraints on this element
id		0..1	string	There are no (further) constraints on this element Element id Immunization.occurrence[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.occurrence[x].extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
data-absent-reason	S I	0..1	Extension(code)	There are no (further) constraints on this element Element id Immunization.occurrence[x].extension:data-absent-reason Short description effective[x] absence reason Alternate names extensions, user content Definition Provides a reason why the effective date or period is missing. Comments Some Canadian implementations cannot guarantee that a procedure performed date will always be available in every instance of legacy data. Any implementers who do not require a performed date be available on every procedure need to be able to produce a dataAbsentReason extension in order to be conformant Data type Extension(code) Extension URL http://hl7.org/fhir/StructureDefinition/data-absent-reason Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: ANY.nullFlavor
occurrenceString			string	There are no (further) constraints on this element Data type string
occurrenceDateTime	Σ	0..1	dateTime	There are no (further) constraints on this element Element id Immunization.occurrence[x]:occurrenceDateTime Short description Vaccine administration date Definition Date vaccine administered or was to be administered. Comments This element is included in CACDI and is the preferred way to convey this data element. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.occurrence[x] w5: FiveWs.done[x] v2: RXA-3 rim: .effectiveTime cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value
recorded		0..1	dateTime	There are no (further) constraints on this element Element id Immunization.recorded Short description When the immunization was first captured in the subject's record Definition The date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.recorded rim: .participation[typeCode=AUT].time
primarySource	Σ	0..1	boolean	There are no (further) constraints on this element Element id Immunization.primarySource Short description Indicates context the data was recorded in 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. Comments Reflects the “reliability” of the content. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.source v2: RXA-9 rim: immunization.uncertaintycode (if primary source=false, uncertainty=U)
reportOrigin		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.reportOrigin Short description Indicates the source of a secondarily reported record 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. Comments Should not be populated if primarySource = True, not required even if primarySource = False. Data type CodeableConcept Binding The source of the data for a record which is not from a primary source. ImmunizationOriginCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.source v2: RXA-9 rim: .participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported) .participation[typeCode=INF].role[classCode=LIC] (this syntax for health care professional) .participation[typeCode=INF].role[classCode=PRS] (this syntax for family member)
id		0..1	string	There are no (further) constraints on this element Element id Immunization.reportOrigin.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.reportOrigin.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
coding	Σ	0..*	Coding	There are no (further) constraints on this element Element id Immunization.reportOrigin.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id Immunization.reportOrigin.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.reportOrigin.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	0..1	uri	There are no (further) constraints on this element Element id Immunization.reportOrigin.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.reportOrigin.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	0..1	code	There are no (further) constraints on this element Element id Immunization.reportOrigin.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code pCHDCF-CACDI: Immunization Reporting Source Code
display	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.reportOrigin.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Immunization.reportOrigin.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.reportOrigin.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
location		0..1	Reference(LocationCACore)	There are no (further) constraints on this element Element id Immunization.location Short description Where immunization occurred Definition The service delivery location where the vaccine administration occurred. Data type Reference(LocationCACore) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.location w5: FiveWs.where[x] v2: RXA-27 (or RXA-11, deprecated as of v2.7) rim: .participation[typeCode=LOC].COCT_MT240000UV
manufacturer		0..1	Reference(Organization)	There are no (further) constraints on this element Element id Immunization.manufacturer Short description Vaccine manufacturer Definition Name of vaccine manufacturer. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXA-17 rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=ORG] cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacuturerOrganization/name
lotNumber		0..1	string	There are no (further) constraints on this element Element id Immunization.lotNumber Short description Vaccine lot number Definition Lot number of the vaccine product. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXA-15 rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].id cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/lotNumberText
expirationDate		0..1	date	There are no (further) constraints on this element Element id Immunization.expirationDate Short description Vaccine expiration date Definition Date vaccine batch expires. Data type date Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXA-16 rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime
site		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.site Short description Body site vaccine was administered Definition Body site where vaccine was administered. Data type CodeableConcept Binding The site at which the vaccine was administered. CodesForImmunizationSiteOfAdministration (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXR-2 rim: observation.targetSiteCode cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/approachSiteCode/code pCHDCF-CACDI: Immunization Body Site Code
route		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.route Short description How vaccine entered body Definition The path by which the vaccine product is taken into the body. Data type CodeableConcept Binding The route by which the vaccine was administered. ImmunizationRouteCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXR-1 rim: .routeCode cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/routeCode/code pCHDCF-CACDI: Immunization Route of Administration
doseQuantity		0..1	SimpleQuantity	There are no (further) constraints on this element Element id Immunization.doseQuantity Short description Amount of vaccine administered Definition The quantity of vaccine product that was administered. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXA-6 / RXA-7 rim: .doseQuantity pCHDCF-CACDI: Immunization Dose Quantity: Decimal pCHDCF-CACDI: Immunization Dose Quantity: Unit
performer	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element id Immunization.performer Short description Who performed event Definition Indicates who performed the immunization event. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.performer v2: ORC-12 / RXA-10 rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
id		0..1	string	There are no (further) constraints on this element Element id Immunization.performer.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.performer.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.performer.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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). 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
function	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Immunization.performer.function Short description What type of performance was done Definition Describes the type of performance (e.g. ordering provider, administering provider, etc.). Data type CodeableConcept Binding The role a practitioner or organization plays in the immunization event. ImmunizationFunctionCodes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.performer.function rim: .participation.functionCode
actor	Σ	1..1	Reference(PractitionerCACore \| PractitionerRoleCACore \| OrganizationCACore)	There are no (further) constraints on this element Element id Immunization.performer.actor Short description Individual or organization who was performing Definition The practitioner or organization who performed the action. Comments When the individual practitioner who performed the action is known, it is best to send. Data type Reference(PractitionerCACore \| PractitionerRoleCACore \| OrganizationCACore) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.performer.actor w5: FiveWs.actor rim: .player pCHDCF-CACDI: Provider
note	Σ	0..*	Annotation	There are no (further) constraints on this element Element id Immunization.note Short description Additional immunization notes Definition Extra information about the immunization that is not conveyed by the other attributes. Data type Annotation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.note v2: OBX-5 : OBX-3 = 48767-8 rim: note
reasonCode		0..*	CodeableConcept	There are no (further) constraints on this element Element id Immunization.reasonCode Short description Why immunization occurred Definition Reasons why the vaccine was administered. Data type CodeableConcept Binding The reason why a vaccine was administered. ImmunizationReasonCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.reasonCode rim: [actionNegationInd=false].reasonCode
reasonReference		0..*	Reference(ConditionCACore \| Observation \| DiagnosticReport)	There are no (further) constraints on this element Element id Immunization.reasonReference Short description Why immunization occurred Definition Condition, Observation or DiagnosticReport that supports why the immunization was administered. Data type Reference(ConditionCACore \| Observation \| DiagnosticReport) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.reasonReference rim: N/A
isSubpotent	Σ ?!	0..1	boolean	There are no (further) constraints on this element Element id Immunization.isSubpotent Short description Dose potency Definition Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent. Comments Typically, the recognition of the dose being sub-potent is retrospective, after the administration (ex. notification of a manufacturer recall after administration). However, in the case of a partial administration (the patient moves unexpectedly and only some of the dose is actually administered), subpotency may be recognized immediately, but it is still important to record the event. Meaning when missing By default, a dose should be considered to be potent. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXA-20 = PA (partial administration) rim: N/A
subpotentReason		0..*	CodeableConcept	There are no (further) constraints on this element Element id Immunization.subpotentReason Short description Reason for being subpotent Definition Reason why a dose is considered to be subpotent. Data type CodeableConcept Binding The reason why a dose is considered to be subpotent. ImmunizationSubpotentReason (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A pCHDCF-CACDI: Immunization Subpotent Reason Code
education	I	0..*	BackboneElement	There are no (further) constraints on this element Element id Immunization.education Short description Educational material presented to patient Definition Educational material presented to the patient (or guardian) at the time of vaccine administration. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` imm-1: One of documentType or reference SHALL be present `documentType.exists() or reference.exists()` Mappings rim: N/A
id		0..1	string	There are no (further) constraints on this element Element id Immunization.education.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.education.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.education.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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). 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
documentType		0..1	string	There are no (further) constraints on this element Element id Immunization.education.documentType Short description Educational material document identifier Definition Identifier of the material presented to the patient. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: OBX-5 : OBX-3 = 69764-9 rim: N/A
reference		0..1	uri	There are no (further) constraints on this element Element id Immunization.education.reference Short description Educational material reference pointer Definition Reference pointer to the educational material given to the patient if the information was on line. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
publicationDate		0..1	dateTime	There are no (further) constraints on this element Element id Immunization.education.publicationDate Short description Educational material publication date Definition Date the educational material was published. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: OBX-5 : OBX-3 = 29768-9 rim: N/A
presentationDate		0..1	dateTime	There are no (further) constraints on this element Element id Immunization.education.presentationDate Short description Educational material presentation date Definition Date the educational material was given to the patient. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: OBX-5 : OBX-3 = 29769-7 rim: N/A
programEligibility		0..*	CodeableConcept	There are no (further) constraints on this element Element id Immunization.programEligibility Short description Patient eligibility for a vaccination program Definition Indicates a patient's eligibility for a funding program. Data type CodeableConcept Binding The patient's eligibility for a vaccation program. ImmunizationProgramEligibility (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: OBX-5 : OBX-3 = 64994-7 rim: N/A
fundingSource		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.fundingSource Short description Funding source for the vaccine 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). Data type CodeableConcept Binding The source of funding used to purchase the vaccine administered. ImmunizationFundingSource (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
reaction		0..*	BackboneElement	There are no (further) constraints on this element Element id Immunization.reaction Short description Details of a reaction that follows immunization Definition Categorical data indicating that an adverse event is associated in time to an immunization. Comments A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case, it should be recorded as a new AllergyIntolerance resource instance as most systems will not query against past Immunization.reaction elements. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: OBX-3 rim: Observation[classCode=obs].code pCHDCF-CACDI: Immunization Reaction
id		0..1	string	There are no (further) constraints on this element Element id Immunization.reaction.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.reaction.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.reaction.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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). 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
date		0..1	dateTime	There are no (further) constraints on this element Element id Immunization.reaction.date Short description When reaction started Definition Date of reaction to the immunization. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: OBX-14 (ideally this would be reported in an IAM segment, but IAM is not part of the HL7 v2 VXU message - most likely would appear in OBX segments if at all) rim: .effectiveTime pCHDCF-CACDI: Immunization Reaction Date
detail		0..1	Reference(Observation)	There are no (further) constraints on this element Element id Immunization.reaction.detail Short description Additional information on reaction Definition Details of the reaction. Data type Reference(Observation) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: OBX-5 rim: .value
reported		0..1	boolean	There are no (further) constraints on this element Element id Immunization.reaction.reported Short description Indicates self-reported reaction Definition Self-reported indicator. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: (HL7 v2 doesn't seem to provide for this) rim: .participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported=true)
protocolApplied		0..*	BackboneElement	There are no (further) constraints on this element Element id Immunization.protocolApplied Short description Protocol followed by the provider Definition The protocol (set of recommendations) being followed by the provider who administered the dose. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A pCHDCF-CACDI: Immunization Guideline
id		0..1	string	There are no (further) constraints on this element Element id Immunization.protocolApplied.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.protocolApplied.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.protocolApplied.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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). 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
series		0..1	string	There are no (further) constraints on this element Element id Immunization.protocolApplied.series Short description Name of vaccine series Definition One possible path to achieve presumed immunity against a disease - within the context of an authority. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
authority		0..1	Reference(Organization)	There are no (further) constraints on this element Element id Immunization.protocolApplied.authority Short description Who is responsible for publishing the recommendations Definition Indicates the authority who published the protocol (e.g. ACIP) that is being followed. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A pCHDCF-CACDI: published by Organization
targetDisease		0..*	CodeableConcept	There are no (further) constraints on this element Element id Immunization.protocolApplied.targetDisease Short description Vaccine preventatable disease being targetted Definition The vaccine preventable disease the dose is being administered against. Data type CodeableConcept Binding The vaccine preventable disease the dose is being administered for. ImmunizationTargetDiseaseCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A pCHDCF-CACDI: Immunization Guideline Target Disease
doseNumber[x]		1..1		There are no (further) constraints on this element Element id Immunization.protocolApplied.doseNumber[x] Short description Dose number within series Definition Nominal position in a series. 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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A pCHDCF-CACDI: Immunization Dose Number
doseNumberPositiveInt			positiveInt	There are no (further) constraints on this element Data type positiveInt
doseNumberString			string	There are no (further) constraints on this element Data type string
seriesDoses[x]		0..1		There are no (further) constraints on this element Element id Immunization.protocolApplied.seriesDoses[x] Short description Recommended number of doses for immunity Definition The recommended number of doses to achieve immunity. 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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A pCHDCF-CACDI: Immunization Series Recommended Doses Count
seriesDosesPositiveInt			positiveInt	There are no (further) constraints on this element Data type positiveInt
seriesDosesString			string	There are no (further) constraints on this element Data type string

ImmunizationCACore (Immunization)	I		Immunization	Element id Immunization Short description Immunization event information 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. Data type Immunization Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() ca-core-im-1: Immunization records created during an encounter event are expected to have occurrence populated. Occurrence SHALL be present if the primarySource is 'true' `Immunization.primarySource = true implies Immunization.occurrence.exists()` Mappings rim: Entity. Role, or Act workflow: Event v2: VXU_V04 rim: SubstanceAdministration pCHDCF-CACDI: Immunization
id	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. 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. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Immunization.meta Short description Metadata about the resource 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. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Immunization.implicitRules Short description A set of rules under which this content was created 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. 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id Immunization.language Short description Language of the resource content Definition The base language in which the resource is written. 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). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text		0..1	Narrative	There are no (further) constraints on this element Element id Immunization.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display 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. 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. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id Immunization.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources 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. 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. Data type Resource Mappings rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content 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). 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
identifier		0..*	Identifier	There are no (further) constraints on this element Element id Immunization.identifier Short description Business identifier Definition A unique identifier assigned to this immunization record. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.identifier w5: FiveWs.identifier rim: .id cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/id
status	S Σ ?!	1..1	codeBinding	Element id Immunization.status Short description completed \| entered-in-error \| not-done Definition Indicates the current status of the immunization event. 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. Data type code Binding A set of codes indicating the current status of an Immunization. ImmunizationStatusCodes (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.status w5: FiveWs.status rim: statusCode pCHDCF-CACDI: Immunization Status
statusReason		0..1	CodeableConcept	Element id Immunization.statusReason Short description Reason not done Definition Indicates the reason the immunization event was not performed. 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. Data type CodeableConcept Binding The reason why a vaccine was not administered. ImmunizationStatusReasonCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.statusReason rim: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde pCHDCF-CACDI: Immunization Reason Not Performed
vaccineCode	S Σ	1..1	CodeableConceptCACoreBinding	Element id Immunization.vaccineCode Short description Concept - reference to a terminology or just text Definition A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Comments The additionalBinding extension will be used to express the valueSet for additional negation/exclusion codes for reporting the known absence of immunizations. At the time of this release, the publisher of the current ValueSet for absence codes (IPS) is developing a SNOMED ValueSet that will replace the current http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-immunizations-uv-ips Data type CodeableConceptCACore Binding The code for vaccine product administered. VaccineAdministeredTradeNameCode (preferred) Additional bindings: VaccineHistoricalNameCode (preferred) Recommended for use when conveying vaccine generic names for scenarios when brand name is not known or does not exist (e.g., immunization history where provider does not have detail of the trade name, the product has been discontinued and/or never licensed in Canada). PassiveAdministeredImmunizingAgentCode (preferred) per pCHDCF: Alternate value sets can be used when passive immunization products are used PassiveHistoricalImmunizingAgentCode (preferred) per pCHDCF: Alternate value sets can be used when passive immunization products are used AbsentOrUnknownImmunizationUvIps (preferred) Absent or unknown codes Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.code w5: FiveWs.what[x] v2: RXA-5 rim: .code cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/realmCode/code rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD pCHDCF-CACDI: Drug
id		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccineCode.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
coding	S Σ	1..1	CodingCACore	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding Short description A reference to a code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Data type CodingCACore Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
id		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	0..1	uri	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	0..1	code	Element id Immunization.vaccineCode.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code pCHDCF-CACDI: Drug Code
display	Σ	0..1	string	Element id Immunization.vaccineCode.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName pCHDCF-CACDI: Drug English Description pCHDCF-CACDI: Drug French Description
id		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.display.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references) Data type string
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.display.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Constraints 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()`
translation	I	0..*	Extension(Complex)	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.display.extension:translation Short description Language Translation (Localization) Alternate names extensions, user content Definition Language translation from base language of resource to another language. 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. Data type Extension(Complex) Extension URL http://hl7.org/fhir/StructureDefinition/translation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: ST.translation
value		0..1	System.String	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.display.value Short description Primitive value for string Definition The actual value Data type System.String Maximum string length 1048576
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
patient	S Σ	1..1	Reference(PatientCACore)	Element id Immunization.patient Short description Who was immunized Definition The patient who either received or did not receive the immunization. Data type Reference(PatientCACore) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.subject w5: FiveWs.subject[x] v2: PID-3 rim: .partipication[ttypeCode=].role w5: FiveWs.subject pCHDCF-CACDI: Patient
id		0..1	string	There are no (further) constraints on this element Element id Immunization.patient.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.patient.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
reference	S Σ I	1..1	string	There are no (further) constraints on this element Element id Immunization.patient.reference Short description Literal reference, Relative, internal or absolute URL Definition A 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id Immunization.patient.type Short description Type the reference refers to (e.g. "Patient") Definition The 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). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id Immunization.patient.identifier Short description Logical reference, when literal reference is not known Definition An 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. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation\|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.patient.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
encounter		0..1	Reference(Encounter)	There are no (further) constraints on this element Element id Immunization.encounter Short description Encounter immunization was part of Definition The visit or admission or other contact between patient and health care provider the immunization was performed as part of. Data type Reference(Encounter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.context w5: FiveWs.context v2: PV1-19 rim: component->EncounterEvent
occurrence[x]	S Σ	1..1		Element id Immunization.occurrence[x] Short description Vaccine administration date Definition Date vaccine administered or was to be administered. 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. Sliced: Unordered, Open, by $this(Type) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.occurrence[x] w5: FiveWs.done[x] v2: RXA-3 rim: .effectiveTime cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value pCHDCF-CACDI: Patient Provided Immunization Date pCHDCF-CACDI: Event Start Date Time
(All Slices)				There are no (further) constraints on this element
id		0..1	string	There are no (further) constraints on this element Element id Immunization.occurrence[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.occurrence[x].extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
data-absent-reason	S I	0..1	Extension(code)	Element id Immunization.occurrence[x].extension:data-absent-reason Short description effective[x] absence reason Alternate names extensions, user content Definition Provides a reason why the effective date or period is missing. Comments Some Canadian implementations cannot guarantee that a procedure performed date will always be available in every instance of legacy data. Any implementers who do not require a performed date be available on every procedure need to be able to produce a dataAbsentReason extension in order to be conformant Data type Extension(code) Extension URL http://hl7.org/fhir/StructureDefinition/data-absent-reason Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: ANY.nullFlavor
occurrenceString			string	There are no (further) constraints on this element Data type string
occurrenceDateTime	Σ	0..1	dateTime	Element id Immunization.occurrence[x]:occurrenceDateTime Short description Vaccine administration date Definition Date vaccine administered or was to be administered. Comments This element is included in CACDI and is the preferred way to convey this data element. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.occurrence[x] w5: FiveWs.done[x] v2: RXA-3 rim: .effectiveTime cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value
recorded		0..1	dateTime	There are no (further) constraints on this element Element id Immunization.recorded Short description When the immunization was first captured in the subject's record Definition The date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.recorded rim: .participation[typeCode=AUT].time
primarySource	Σ	0..1	boolean	There are no (further) constraints on this element Element id Immunization.primarySource Short description Indicates context the data was recorded in 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. Comments Reflects the “reliability” of the content. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.source v2: RXA-9 rim: immunization.uncertaintycode (if primary source=false, uncertainty=U)
reportOrigin		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.reportOrigin Short description Indicates the source of a secondarily reported record 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. Comments Should not be populated if primarySource = True, not required even if primarySource = False. Data type CodeableConcept Binding The source of the data for a record which is not from a primary source. ImmunizationOriginCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.source v2: RXA-9 rim: .participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported) .participation[typeCode=INF].role[classCode=LIC] (this syntax for health care professional) .participation[typeCode=INF].role[classCode=PRS] (this syntax for family member)
id		0..1	string	There are no (further) constraints on this element Element id Immunization.reportOrigin.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.reportOrigin.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
coding	Σ	0..*	Coding	There are no (further) constraints on this element Element id Immunization.reportOrigin.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id Immunization.reportOrigin.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.reportOrigin.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	0..1	uri	There are no (further) constraints on this element Element id Immunization.reportOrigin.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.reportOrigin.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	0..1	code	Element id Immunization.reportOrigin.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code pCHDCF-CACDI: Immunization Reporting Source Code
display	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.reportOrigin.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Immunization.reportOrigin.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.reportOrigin.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
location		0..1	Reference(LocationCACore)	Element id Immunization.location Short description Where immunization occurred Definition The service delivery location where the vaccine administration occurred. Data type Reference(LocationCACore) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.location w5: FiveWs.where[x] v2: RXA-27 (or RXA-11, deprecated as of v2.7) rim: .participation[typeCode=LOC].COCT_MT240000UV
manufacturer		0..1	Reference(Organization)	There are no (further) constraints on this element Element id Immunization.manufacturer Short description Vaccine manufacturer Definition Name of vaccine manufacturer. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXA-17 rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=ORG] cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacuturerOrganization/name
lotNumber		0..1	string	There are no (further) constraints on this element Element id Immunization.lotNumber Short description Vaccine lot number Definition Lot number of the vaccine product. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXA-15 rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].id cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/lotNumberText
expirationDate		0..1	date	There are no (further) constraints on this element Element id Immunization.expirationDate Short description Vaccine expiration date Definition Date vaccine batch expires. Data type date Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXA-16 rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime
site		0..1	CodeableConcept	Element id Immunization.site Short description Body site vaccine was administered Definition Body site where vaccine was administered. Data type CodeableConcept Binding The site at which the vaccine was administered. CodesForImmunizationSiteOfAdministration (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXR-2 rim: observation.targetSiteCode cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/approachSiteCode/code pCHDCF-CACDI: Immunization Body Site Code
route		0..1	CodeableConcept	Element id Immunization.route Short description How vaccine entered body Definition The path by which the vaccine product is taken into the body. Data type CodeableConcept Binding The route by which the vaccine was administered. ImmunizationRouteCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXR-1 rim: .routeCode cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/routeCode/code pCHDCF-CACDI: Immunization Route of Administration
doseQuantity		0..1	SimpleQuantity	Element id Immunization.doseQuantity Short description Amount of vaccine administered Definition The quantity of vaccine product that was administered. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXA-6 / RXA-7 rim: .doseQuantity pCHDCF-CACDI: Immunization Dose Quantity: Decimal pCHDCF-CACDI: Immunization Dose Quantity: Unit
performer	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element id Immunization.performer Short description Who performed event Definition Indicates who performed the immunization event. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.performer v2: ORC-12 / RXA-10 rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
id		0..1	string	There are no (further) constraints on this element Element id Immunization.performer.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.performer.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.performer.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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). 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
function	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Immunization.performer.function Short description What type of performance was done Definition Describes the type of performance (e.g. ordering provider, administering provider, etc.). Data type CodeableConcept Binding The role a practitioner or organization plays in the immunization event. ImmunizationFunctionCodes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.performer.function rim: .participation.functionCode
actor	Σ	1..1	Reference(PractitionerCACore \| PractitionerRoleCACore \| OrganizationCACore)	Element id Immunization.performer.actor Short description Individual or organization who was performing Definition The practitioner or organization who performed the action. Comments When the individual practitioner who performed the action is known, it is best to send. Data type Reference(PractitionerCACore \| PractitionerRoleCACore \| OrganizationCACore) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.performer.actor w5: FiveWs.actor rim: .player pCHDCF-CACDI: Provider
note	Σ	0..*	Annotation	There are no (further) constraints on this element Element id Immunization.note Short description Additional immunization notes Definition Extra information about the immunization that is not conveyed by the other attributes. Data type Annotation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.note v2: OBX-5 : OBX-3 = 48767-8 rim: note
reasonCode		0..*	CodeableConcept	There are no (further) constraints on this element Element id Immunization.reasonCode Short description Why immunization occurred Definition Reasons why the vaccine was administered. Data type CodeableConcept Binding The reason why a vaccine was administered. ImmunizationReasonCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.reasonCode rim: [actionNegationInd=false].reasonCode
reasonReference		0..*	Reference(ConditionCACore \| Observation \| DiagnosticReport)	Element id Immunization.reasonReference Short description Why immunization occurred Definition Condition, Observation or DiagnosticReport that supports why the immunization was administered. Data type Reference(ConditionCACore \| Observation \| DiagnosticReport) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.reasonReference rim: N/A
isSubpotent	Σ ?!	0..1	boolean	There are no (further) constraints on this element Element id Immunization.isSubpotent Short description Dose potency Definition Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent. Comments Typically, the recognition of the dose being sub-potent is retrospective, after the administration (ex. notification of a manufacturer recall after administration). However, in the case of a partial administration (the patient moves unexpectedly and only some of the dose is actually administered), subpotency may be recognized immediately, but it is still important to record the event. Meaning when missing By default, a dose should be considered to be potent. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXA-20 = PA (partial administration) rim: N/A
subpotentReason		0..*	CodeableConcept	Element id Immunization.subpotentReason Short description Reason for being subpotent Definition Reason why a dose is considered to be subpotent. Data type CodeableConcept Binding The reason why a dose is considered to be subpotent. ImmunizationSubpotentReason (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A pCHDCF-CACDI: Immunization Subpotent Reason Code
education	I	0..*	BackboneElement	There are no (further) constraints on this element Element id Immunization.education Short description Educational material presented to patient Definition Educational material presented to the patient (or guardian) at the time of vaccine administration. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` imm-1: One of documentType or reference SHALL be present `documentType.exists() or reference.exists()` Mappings rim: N/A
id		0..1	string	There are no (further) constraints on this element Element id Immunization.education.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.education.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.education.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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). 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
documentType		0..1	string	There are no (further) constraints on this element Element id Immunization.education.documentType Short description Educational material document identifier Definition Identifier of the material presented to the patient. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: OBX-5 : OBX-3 = 69764-9 rim: N/A
reference		0..1	uri	There are no (further) constraints on this element Element id Immunization.education.reference Short description Educational material reference pointer Definition Reference pointer to the educational material given to the patient if the information was on line. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
publicationDate		0..1	dateTime	There are no (further) constraints on this element Element id Immunization.education.publicationDate Short description Educational material publication date Definition Date the educational material was published. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: OBX-5 : OBX-3 = 29768-9 rim: N/A
presentationDate		0..1	dateTime	There are no (further) constraints on this element Element id Immunization.education.presentationDate Short description Educational material presentation date Definition Date the educational material was given to the patient. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: OBX-5 : OBX-3 = 29769-7 rim: N/A
programEligibility		0..*	CodeableConcept	There are no (further) constraints on this element Element id Immunization.programEligibility Short description Patient eligibility for a vaccination program Definition Indicates a patient's eligibility for a funding program. Data type CodeableConcept Binding The patient's eligibility for a vaccation program. ImmunizationProgramEligibility (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: OBX-5 : OBX-3 = 64994-7 rim: N/A
fundingSource		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.fundingSource Short description Funding source for the vaccine 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). Data type CodeableConcept Binding The source of funding used to purchase the vaccine administered. ImmunizationFundingSource (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
reaction		0..*	BackboneElement	Element id Immunization.reaction Short description Details of a reaction that follows immunization Definition Categorical data indicating that an adverse event is associated in time to an immunization. Comments A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case, it should be recorded as a new AllergyIntolerance resource instance as most systems will not query against past Immunization.reaction elements. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: OBX-3 rim: Observation[classCode=obs].code pCHDCF-CACDI: Immunization Reaction
id		0..1	string	There are no (further) constraints on this element Element id Immunization.reaction.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.reaction.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.reaction.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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). 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
date		0..1	dateTime	Element id Immunization.reaction.date Short description When reaction started Definition Date of reaction to the immunization. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: OBX-14 (ideally this would be reported in an IAM segment, but IAM is not part of the HL7 v2 VXU message - most likely would appear in OBX segments if at all) rim: .effectiveTime pCHDCF-CACDI: Immunization Reaction Date
detail		0..1	Reference(Observation)	There are no (further) constraints on this element Element id Immunization.reaction.detail Short description Additional information on reaction Definition Details of the reaction. Data type Reference(Observation) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: OBX-5 rim: .value
reported		0..1	boolean	There are no (further) constraints on this element Element id Immunization.reaction.reported Short description Indicates self-reported reaction Definition Self-reported indicator. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: (HL7 v2 doesn't seem to provide for this) rim: .participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported=true)
protocolApplied		0..*	BackboneElement	Element id Immunization.protocolApplied Short description Protocol followed by the provider Definition The protocol (set of recommendations) being followed by the provider who administered the dose. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A pCHDCF-CACDI: Immunization Guideline
id		0..1	string	There are no (further) constraints on this element Element id Immunization.protocolApplied.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.protocolApplied.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.protocolApplied.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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). 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
series		0..1	string	There are no (further) constraints on this element Element id Immunization.protocolApplied.series Short description Name of vaccine series Definition One possible path to achieve presumed immunity against a disease - within the context of an authority. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
authority		0..1	Reference(Organization)	Element id Immunization.protocolApplied.authority Short description Who is responsible for publishing the recommendations Definition Indicates the authority who published the protocol (e.g. ACIP) that is being followed. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A pCHDCF-CACDI: published by Organization
targetDisease		0..*	CodeableConcept	Element id Immunization.protocolApplied.targetDisease Short description Vaccine preventatable disease being targetted Definition The vaccine preventable disease the dose is being administered against. Data type CodeableConcept Binding The vaccine preventable disease the dose is being administered for. ImmunizationTargetDiseaseCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A pCHDCF-CACDI: Immunization Guideline Target Disease
doseNumber[x]		1..1		Element id Immunization.protocolApplied.doseNumber[x] Short description Dose number within series Definition Nominal position in a series. 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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A pCHDCF-CACDI: Immunization Dose Number
doseNumberPositiveInt			positiveInt	There are no (further) constraints on this element Data type positiveInt
doseNumberString			string	There are no (further) constraints on this element Data type string
seriesDoses[x]		0..1		Element id Immunization.protocolApplied.seriesDoses[x] Short description Recommended number of doses for immunity Definition The recommended number of doses to achieve immunity. 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). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A pCHDCF-CACDI: Immunization Series Recommended Doses Count
seriesDosesPositiveInt			positiveInt	There are no (further) constraints on this element Data type positiveInt
seriesDosesString			string	There are no (further) constraints on this element Data type string

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="immunization-ca-core" />
    <url value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/immunization-ca-core" />
    <name value="ImmunizationCACore" />
    <title value="Immunization (CA-Core)" />
    <status value="draft" />
    <experimental value="false" />
    <date value="2025-03-06" />
    <publisher value="Canada Health Infoway" />
    <contact>
        <name value="National Standards Release Centre" />
        <telecom>
            <system value="url" />
            <value value="http://www.infoway-inforoute.ca" />
        </telecom>
        <telecom>
            <system value="email" />
            <value value="standards@infoway-inforoute.ca" />
        </telecom>
    </contact>
    <description value="This profile applies constraints to the Immunization resource for CA Core+ to support documentation of administered vaccines in the pan-Canadian context." />
    <jurisdiction>
        <coding>
            <system value="urn:iso:std:iso:3166" />
            <code value="CA" />
        </coding>
    </jurisdiction>
    <copyright value="Copyright &#169; 2025+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy)." />
    <fhirVersion value="4.0.1" />
    <mapping>
        <identity value="pCHDCF-CACDI" />
        <name value="Pan-Canadian Health Data Content Framework - CACDI" />
    </mapping>
    <kind value="resource" />
    <abstract value="false" />
    <type value="Immunization" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Immunization" />
    <derivation value="constraint" />
    <snapshot>
        <element id="Immunization">
            <path value="Immunization" />
            <short value="Immunization event information" />
            <definition value="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." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Immunization" />
                <min value="0" />
                <max value="*" />
            </base>
            <constraint>
                <key value="dom-2" />
                <severity value="error" />
                <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
                <expression value="contained.contained.empty()" />
                <xpath value="not(parent::f:contained and f:contained)" />
                <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
            </constraint>
            <constraint>
                <key value="dom-3" />
                <severity value="error" />
                <human value="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" />
                <expression value="contained.where(((&#39;#&#39;+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = &#39;#&#39;).exists() or descendants().where(as(canonical) = &#39;#&#39;).exists() or descendants().where(as(canonical) = &#39;#&#39;).exists()).not()).trace(&#39;unmatched&#39;, id).empty()" />
                <xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat(&#39;#&#39;, $contained/*/id/@value) or descendant::f:reference[@value=&#39;#&#39;])]))" />
                <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
            </constraint>
            <constraint>
                <key value="dom-4" />
                <severity value="error" />
                <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
                <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" />
                <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
                <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
            </constraint>
            <constraint>
                <key value="dom-5" />
                <severity value="error" />
                <human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
                <expression value="contained.meta.security.empty()" />
                <xpath value="not(exists(f:contained/*/f:meta/f:security))" />
                <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
            </constraint>
            <constraint>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
                    <valueBoolean value="true" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
                    <valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." />
                </extension>
                <key value="dom-6" />
                <severity value="warning" />
                <human value="A resource should have narrative for robust management" />
                <expression value="text.`div`.exists()" />
                <xpath value="exists(f:text/h:div)" />
                <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
            </constraint>
            <constraint>
                <key value="ca-core-im-1" />
                <severity value="warning" />
                <human value="Immunization records created during an encounter event are expected to have occurrence populated. Occurrence SHALL be present if the primarySource is &#39;true&#39;" />
                <expression value="Immunization.primarySource = true implies Immunization.occurrence.exists()" />
                <source value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/immunization-ca-core" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="Entity. Role, or Act" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="VXU_V04" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="SubstanceAdministration" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization" />
            </mapping>
        </element>
        <element id="Immunization.id">
            <path value="Immunization.id" />
            <short value="Logical id of this artifact" />
            <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
            <comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Resource.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="true" />
        </element>
        <element id="Immunization.meta">
            <path value="Immunization.meta" />
            <short value="Metadata about the resource" />
            <definition value="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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Resource.meta" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Meta" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
        </element>
        <element id="Immunization.implicitRules">
            <path value="Immunization.implicitRules" />
            <short value="A set of rules under which this content was created" />
            <definition value="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." />
            <comment value="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&#39;s narrative along with other profiles, value sets, etc." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Resource.implicitRules" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it&#39;s meaning or interpretation" />
            <isSummary value="true" />
        </element>
        <element id="Immunization.language">
            <path value="Immunization.language" />
            <short value="Language of the resource content" />
            <definition value="The base language in which the resource is written." />
            <comment value="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)." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Resource.language" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
                    <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="Language" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
                    <valueBoolean value="true" />
                </extension>
                <strength value="preferred" />
                <description value="A human language." />
                <valueSet value="http://hl7.org/fhir/ValueSet/languages" />
            </binding>
        </element>
        <element id="Immunization.text">
            <path value="Immunization.text" />
            <short value="Text summary of the resource, for human interpretation" />
            <definition value="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 &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety." />
            <comment value="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 &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded information is added later." />
            <alias value="narrative" />
            <alias value="html" />
            <alias value="xhtml" />
            <alias value="display" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="DomainResource.text" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Narrative" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="Act.text?" />
            </mapping>
        </element>
        <element id="Immunization.contained">
            <path value="Immunization.contained" />
            <short value="Contained, inline Resources" />
            <definition value="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." />
            <comment value="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." />
            <alias value="inline resources" />
            <alias value="anonymous resources" />
            <alias value="contained resources" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="DomainResource.contained" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Resource" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.extension">
            <path value="Immunization.extension" />
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="DomainResource.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.modifierExtension">
            <path value="Immunization.modifierExtension" />
            <short value="Extensions that cannot be ignored" />
            <definition value="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&#39;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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
            <comment value="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." />
            <requirements value="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](extensibility.html#modifierExtension)." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="DomainResource.modifierExtension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.identifier">
            <path value="Immunization.identifier" />
            <short value="Business identifier" />
            <definition value="A unique identifier assigned to this immunization record." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Immunization.identifier" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Identifier" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.identifier" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.identifier" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".id" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/id" />
            </mapping>
        </element>
        <element id="Immunization.status">
            <path value="Immunization.status" />
            <short value="completed | entered-in-error | not-done" />
            <definition value="Indicates the current status of the immunization event." />
            <comment value="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." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Immunization.status" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="true" />
            <isModifierReason value="This element is labeled as a modifier because it is a status element that contains statuses entered-in-error and not-done which means that the resource should not be treated as valid" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="ImmunizationStatus" />
                </extension>
                <strength value="required" />
                <description value="A set of codes indicating the current status of an Immunization." />
                <valueSet value="http://hl7.org/fhir/ValueSet/immunization-status|4.0.1" />
            </binding>
            <mapping>
                <identity value="workflow" />
                <map value="Event.status" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.status" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="statusCode" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Status" />
            </mapping>
        </element>
        <element id="Immunization.statusReason">
            <path value="Immunization.statusReason" />
            <short value="Reason not done" />
            <definition value="Indicates the reason the immunization event was not performed." />
            <comment value="This is generally only used for the status of &quot;not-done&quot;. The reason for performing the immunization event is captured in reasonCode, not here." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.statusReason" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="ImmunizationStatusReason" />
                </extension>
                <strength value="example" />
                <description value="The reason why a vaccine was not administered." />
                <valueSet value="http://hl7.org/fhir/ValueSet/immunization-status-reason" />
            </binding>
            <mapping>
                <identity value="workflow" />
                <map value="Event.statusReason" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Reason Not Performed" />
            </mapping>
        </element>
        <element id="Immunization.vaccineCode">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.vaccineCode" />
            <short value="Concept - reference to a terminology or just  text" />
            <definition value="A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text." />
            <comment value="The additionalBinding extension will be used to express the valueSet for additional negation/exclusion codes for reporting the known absence of immunizations. At the time of this release, the publisher of the current ValueSet for absence codes (IPS) is developing a SNOMED ValueSet that will replace the current http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-immunizations-uv-ips" />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Immunization.vaccineCode" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
                <profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="VaccineCode" />
                </extension>
                <extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
                    <extension url="purpose">
                        <valueCode value="preferred" />
                    </extension>
                    <extension url="valueSet">
                        <valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/vaccinehistoricalnamecode" />
                    </extension>
                    <extension url="documentation">
                        <valueMarkdown value="Recommended for use when conveying vaccine generic names for scenarios when brand name is not known or does not exist (e.g., immunization history where provider does not have detail of the trade name, the product has been discontinued and/or never licensed in Canada)." />
                    </extension>
                </extension>
                <extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
                    <extension url="purpose">
                        <valueCode value="preferred" />
                    </extension>
                    <extension url="valueSet">
                        <valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/passiveadministeredimmunizingagentcode" />
                    </extension>
                    <extension url="documentation">
                        <valueMarkdown value="per pCHDCF: Alternate value sets can be used when passive immunization products are used" />
                    </extension>
                </extension>
                <extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
                    <extension url="purpose">
                        <valueCode value="preferred" />
                    </extension>
                    <extension url="valueSet">
                        <valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/passivehistoricalimmunizingagentcode" />
                    </extension>
                    <extension url="documentation">
                        <valueMarkdown value="per pCHDCF: Alternate value sets can be used when passive immunization products are used" />
                    </extension>
                </extension>
                <extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
                    <extension url="purpose">
                        <valueCode value="preferred" />
                    </extension>
                    <extension url="valueSet">
                        <valueCanonical value="http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-immunizations-uv-ips" />
                    </extension>
                    <extension url="documentation">
                        <valueMarkdown value="Absent or unknown codes" />
                    </extension>
                </extension>
                <strength value="preferred" />
                <description value="The code for vaccine product administered." />
                <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/vaccineadministeredtradenamecode" />
            </binding>
            <mapping>
                <identity value="workflow" />
                <map value="Event.code" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.what[x]" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXA-5" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".code" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/realmCode/code" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Drug" />
            </mapping>
        </element>
        <element id="Immunization.vaccineCode.id">
            <path value="Immunization.vaccineCode.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.vaccineCode.extension">
            <path value="Immunization.vaccineCode.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.vaccineCode.coding">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="Immunization.vaccineCode.coding" />
            <short value="A reference to a code defined by a terminology system" />
            <definition value="A reference to a code defined by a terminology system." />
            <comment value="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." />
            <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="CodeableConcept.coding" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Coding" />
                <profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/coding-ca-core" />
            </type>
            <condition value="ele-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="C*E.1-8, C*E.10-22" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="union(., ./translation)" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CV" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
            </mapping>
        </element>
        <element id="Immunization.vaccineCode.coding.id">
            <path value="Immunization.vaccineCode.coding.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.vaccineCode.coding.extension">
            <path value="Immunization.vaccineCode.coding.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.vaccineCode.coding.system">
            <path value="Immunization.vaccineCode.coding.system" />
            <short value="Identity of the terminology system" />
            <definition value="The identification of the code system that defines the meaning of the symbol in the code." />
            <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7&#39;s list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously." />
            <requirements value="Need to be unambiguous about the source of the definition of the symbol." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.system" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="C*E.3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./codeSystem" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
            </mapping>
        </element>
        <element id="Immunization.vaccineCode.coding.version">
            <path value="Immunization.vaccineCode.coding.version" />
            <short value="Version of the system - if relevant" />
            <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." />
            <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.version" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="C*E.7" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./codeSystemVersion" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
            </mapping>
        </element>
        <element id="Immunization.vaccineCode.coding.code">
            <path value="Immunization.vaccineCode.coding.code" />
            <short value="Symbol in syntax defined by the system" />
            <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." />
            <requirements value="Need to refer to a particular code in the system." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.code" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="C*E.1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./code" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Drug Code" />
            </mapping>
        </element>
        <element id="Immunization.vaccineCode.coding.display">
            <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
                <valueBoolean value="true" />
            </extension>
            <path value="Immunization.vaccineCode.coding.display" />
            <short value="Representation defined by the system" />
            <definition value="A representation of the meaning of the code in the system, following the rules of the system." />
            <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.display" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="C*E.2 - but note this is not well followed" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CV.displayName" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Drug English Description" />
                <comment value="Display may be populated with english or french description depending on the context of the primary language for the user at the time this code is selected. Secondary or translated coding.display values should be conveyed using the translation extension" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Drug French Description" />
                <comment value="Display may be populated with english or french description depending on the context of the primary language for the user at the time this code is selected. Secondary or translated coding.display values should be conveyed using the translation extension" />
            </mapping>
        </element>
        <element id="Immunization.vaccineCode.coding.display.id">
            <path value="Immunization.vaccineCode.coding.display.id" />
            <representation value="xmlAttr" />
            <short value="xml:id (or equivalent in JSON)" />
            <definition value="unique id for the element within a resource (for internal references)" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Immunization.vaccineCode.coding.display.extension">
            <path value="Immunization.vaccineCode.coding.display.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Immunization.vaccineCode.coding.display.extension:translation">
            <path value="Immunization.vaccineCode.coding.display.extension" />
            <sliceName value="translation" />
            <short value="Language Translation (Localization)" />
            <definition value="Language translation from base language of resource to another language." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/StructureDefinition/translation" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="ST.translation" />
            </mapping>
        </element>
        <element id="Immunization.vaccineCode.coding.display.value">
            <path value="Immunization.vaccineCode.coding.display.value" />
            <representation value="xmlAttr" />
            <short value="Primitive value for string" />
            <definition value="The actual value" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="string.value" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/regex">
                    <valueString value="[ \r\n\t\S]+" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <maxLength value="1048576" />
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="Immunization.vaccineCode.coding.userSelected">
            <path value="Immunization.vaccineCode.coding.userSelected" />
            <short value="If this coding was chosen directly by the user" />
            <definition value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)." />
            <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly &#39;directly chosen&#39; implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." />
            <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.userSelected" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="boolean" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="Sometimes implied by being first" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD.codingRationale" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]" />
            </mapping>
        </element>
        <element id="Immunization.vaccineCode.text">
            <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
                <valueBoolean value="true" />
            </extension>
            <path value="Immunization.vaccineCode.text" />
            <short value="Plain text representation of the concept" />
            <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." />
            <comment value="Very often the text is the same as a displayName of one of the codings." />
            <requirements value="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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="CodeableConcept.text" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="C*E.9. But note many systems use C*E.2 for this" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./originalText[mediaType/code=&quot;text/plain&quot;]/data" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
            </mapping>
        </element>
        <element id="Immunization.patient">
            <path value="Immunization.patient" />
            <short value="Who was immunized" />
            <definition value="The patient who either received or did not receive the immunization." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Immunization.patient" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.subject" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.subject[x]" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="PID-3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".partipication[ttypeCode=].role" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.subject" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Patient" />
            </mapping>
        </element>
        <element id="Immunization.patient.id">
            <path value="Immunization.patient.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.patient.extension">
            <path value="Immunization.patient.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.patient.reference">
            <path value="Immunization.patient.reference" />
            <short value="Literal reference, Relative, internal or absolute URL" />
            <definition value="A 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 &#39;#&#39;) refer to contained resources." />
            <comment value="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 &quot;/[type]/[id]&quot; then it should be assumed that the reference is to a FHIR RESTful server." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Reference.reference" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ref-1" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.patient.type">
            <path value="Immunization.patient.type" />
            <short value="Type the reference refers to (e.g. &quot;Patient&quot;)" />
            <definition value="The 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.\n\nThe 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. &quot;Patient&quot; 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)." />
            <comment value="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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Reference.type" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="FHIRResourceTypeExt" />
                </extension>
                <strength value="extensible" />
                <description value="Aa resource (or, for logical models, the URI of the logical model)." />
                <valueSet value="http://hl7.org/fhir/ValueSet/resource-types" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.patient.identifier">
            <path value="Immunization.patient.identifier" />
            <short value="Logical reference, when literal reference is not known" />
            <definition value="An 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." />
            <comment value="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. \n\nWhen 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\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference 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)." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Reference.identifier" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Identifier" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value=".identifier" />
            </mapping>
        </element>
        <element id="Immunization.patient.display">
            <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
                <valueBoolean value="true" />
            </extension>
            <path value="Immunization.patient.display" />
            <short value="Text alternative for the resource" />
            <definition value="Plain text narrative that identifies the resource in addition to the resource reference." />
            <comment value="This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what&#39;s being referenced, not to fully describe it." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Reference.display" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.encounter">
            <path value="Immunization.encounter" />
            <short value="Encounter immunization was part of" />
            <definition value="The visit or admission or other contact between patient and health care provider the immunization was performed as part of." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.encounter" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.context" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.context" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="PV1-19" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="component-&gt;EncounterEvent" />
            </mapping>
        </element>
        <element id="Immunization.occurrence[x]">
            <path value="Immunization.occurrence[x]" />
            <slicing>
                <discriminator>
                    <type value="type" />
                    <path value="$this" />
                </discriminator>
                <ordered value="false" />
                <rules value="open" />
            </slicing>
            <short value="Vaccine administration date" />
            <definition value="Date vaccine administered or was to be administered." />
            <comment value="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." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Immunization.occurrence[x]" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <type>
                <code value="string" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.occurrence[x]" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.done[x]" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXA-3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".effectiveTime" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Patient Provided Immunization Date" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Event Start Date Time" />
            </mapping>
        </element>
        <element id="Immunization.occurrence[x].id">
            <path value="Immunization.occurrence[x].id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.occurrence[x].extension">
            <path value="Immunization.occurrence[x].extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.occurrence[x].extension:data-absent-reason">
            <path value="Immunization.occurrence[x].extension" />
            <sliceName value="data-absent-reason" />
            <short value="effective[x] absence reason" />
            <definition value="Provides a reason why the effective date or period is missing." />
            <comment value="Some Canadian implementations cannot guarantee that a procedure performed date will always be available in every instance of legacy data. Any implementers who do not require a performed date be available on every procedure need to be able to produce a dataAbsentReason extension in order to be conformant" />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/StructureDefinition/data-absent-reason" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="ANY.nullFlavor" />
            </mapping>
        </element>
        <element id="Immunization.occurrence[x]:occurrenceDateTime">
            <path value="Immunization.occurrence[x]" />
            <sliceName value="occurrenceDateTime" />
            <short value="Vaccine administration date" />
            <definition value="Date vaccine administered or was to be administered." />
            <comment value="This element is included in CACDI and is the preferred way to convey this data element." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.occurrence[x]" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.occurrence[x]" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.done[x]" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXA-3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".effectiveTime" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value" />
            </mapping>
        </element>
        <element id="Immunization.recorded">
            <path value="Immunization.recorded" />
            <short value="When the immunization was first captured in the subject&#39;s record" />
            <definition value="The date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.recorded" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.recorded" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=AUT].time" />
            </mapping>
        </element>
        <element id="Immunization.primarySource">
            <path value="Immunization.primarySource" />
            <short value="Indicates context the data was recorded in" />
            <definition value="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." />
            <comment value="Reflects the “reliability” of the content." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.primarySource" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="boolean" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.source" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXA-9" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="immunization.uncertaintycode (if primary source=false, uncertainty=U)" />
            </mapping>
        </element>
        <element id="Immunization.reportOrigin">
            <path value="Immunization.reportOrigin" />
            <short value="Indicates the source of a secondarily reported record" />
            <definition value="The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine." />
            <comment value="Should not be populated if primarySource = True, not required even if primarySource = False." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.reportOrigin" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="ImmunizationReportOrigin" />
                </extension>
                <strength value="example" />
                <description value="The source of the data for a record which is not from a primary source." />
                <valueSet value="http://hl7.org/fhir/ValueSet/immunization-origin" />
            </binding>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.source" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXA-9" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".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)" />
            </mapping>
        </element>
        <element id="Immunization.reportOrigin.id">
            <path value="Immunization.reportOrigin.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.reportOrigin.extension">
            <path value="Immunization.reportOrigin.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.reportOrigin.coding">
            <path value="Immunization.reportOrigin.coding" />
            <short value="Code defined by a terminology system" />
            <definition value="A reference to a code defined by a terminology system." />
            <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." />
            <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="CodeableConcept.coding" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Coding" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="C*E.1-8, C*E.10-22" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="union(., ./translation)" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
            </mapping>
        </element>
        <element id="Immunization.reportOrigin.coding.id">
            <path value="Immunization.reportOrigin.coding.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.reportOrigin.coding.extension">
            <path value="Immunization.reportOrigin.coding.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.reportOrigin.coding.system">
            <path value="Immunization.reportOrigin.coding.system" />
            <short value="Identity of the terminology system" />
            <definition value="The identification of the code system that defines the meaning of the symbol in the code." />
            <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7&#39;s list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously." />
            <requirements value="Need to be unambiguous about the source of the definition of the symbol." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.system" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="C*E.3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./codeSystem" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
            </mapping>
        </element>
        <element id="Immunization.reportOrigin.coding.version">
            <path value="Immunization.reportOrigin.coding.version" />
            <short value="Version of the system - if relevant" />
            <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." />
            <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.version" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="C*E.7" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./codeSystemVersion" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
            </mapping>
        </element>
        <element id="Immunization.reportOrigin.coding.code">
            <path value="Immunization.reportOrigin.coding.code" />
            <short value="Symbol in syntax defined by the system" />
            <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." />
            <requirements value="Need to refer to a particular code in the system." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.code" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="C*E.1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./code" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Reporting Source Code" />
            </mapping>
        </element>
        <element id="Immunization.reportOrigin.coding.display">
            <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
                <valueBoolean value="true" />
            </extension>
            <path value="Immunization.reportOrigin.coding.display" />
            <short value="Representation defined by the system" />
            <definition value="A representation of the meaning of the code in the system, following the rules of the system." />
            <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.display" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="C*E.2 - but note this is not well followed" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CV.displayName" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
            </mapping>
        </element>
        <element id="Immunization.reportOrigin.coding.userSelected">
            <path value="Immunization.reportOrigin.coding.userSelected" />
            <short value="If this coding was chosen directly by the user" />
            <definition value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)." />
            <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly &#39;directly chosen&#39; implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." />
            <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.userSelected" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="boolean" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="Sometimes implied by being first" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD.codingRationale" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]" />
            </mapping>
        </element>
        <element id="Immunization.reportOrigin.text">
            <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
                <valueBoolean value="true" />
            </extension>
            <path value="Immunization.reportOrigin.text" />
            <short value="Plain text representation of the concept" />
            <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." />
            <comment value="Very often the text is the same as a displayName of one of the codings." />
            <requirements value="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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="CodeableConcept.text" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="C*E.9. But note many systems use C*E.2 for this" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./originalText[mediaType/code=&quot;text/plain&quot;]/data" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
            </mapping>
        </element>
        <element id="Immunization.location">
            <path value="Immunization.location" />
            <short value="Where immunization occurred" />
            <definition value="The service delivery location where the vaccine administration occurred." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.location" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/location-ca-core" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.location" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.where[x]" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXA-27  (or RXA-11, deprecated as of v2.7)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=LOC].COCT_MT240000UV" />
            </mapping>
        </element>
        <element id="Immunization.manufacturer">
            <path value="Immunization.manufacturer" />
            <short value="Vaccine manufacturer" />
            <definition value="Name of vaccine manufacturer." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.manufacturer" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="v2" />
                <map value="RXA-17" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=ORG]" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacuturerOrganization/name" />
            </mapping>
        </element>
        <element id="Immunization.lotNumber">
            <path value="Immunization.lotNumber" />
            <short value="Vaccine lot number" />
            <definition value="Lot number of the  vaccine product." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.lotNumber" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="v2" />
                <map value="RXA-15" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].id" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/lotNumberText" />
            </mapping>
        </element>
        <element id="Immunization.expirationDate">
            <path value="Immunization.expirationDate" />
            <short value="Vaccine expiration date" />
            <definition value="Date vaccine batch expires." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.expirationDate" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="date" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="v2" />
                <map value="RXA-16" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime" />
            </mapping>
        </element>
        <element id="Immunization.site">
            <path value="Immunization.site" />
            <short value="Body site vaccine  was administered" />
            <definition value="Body site where vaccine was administered." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.site" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="ImmunizationSite" />
                </extension>
                <strength value="example" />
                <description value="The site at which the vaccine was administered." />
                <valueSet value="http://hl7.org/fhir/ValueSet/immunization-site" />
            </binding>
            <mapping>
                <identity value="v2" />
                <map value="RXR-2" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="observation.targetSiteCode" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/approachSiteCode/code" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Body Site Code" />
            </mapping>
        </element>
        <element id="Immunization.route">
            <path value="Immunization.route" />
            <short value="How vaccine entered body" />
            <definition value="The path by which the vaccine product is taken into the body." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.route" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="ImmunizationRoute" />
                </extension>
                <strength value="example" />
                <description value="The route by which the vaccine was administered." />
                <valueSet value="http://hl7.org/fhir/ValueSet/immunization-route" />
            </binding>
            <mapping>
                <identity value="v2" />
                <map value="RXR-1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".routeCode" />
            </mapping>
            <mapping>
                <identity value="cda" />
                <map value="ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/routeCode/code" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Route of Administration" />
            </mapping>
        </element>
        <element id="Immunization.doseQuantity">
            <path value="Immunization.doseQuantity" />
            <short value="Amount of vaccine administered" />
            <definition value="The quantity of vaccine product that was administered." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.doseQuantity" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Quantity" />
                <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="v2" />
                <map value="RXA-6 / RXA-7" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".doseQuantity" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Dose Quantity: Decimal" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Dose Quantity: Unit" />
            </mapping>
        </element>
        <element id="Immunization.performer">
            <path value="Immunization.performer" />
            <short value="Who performed event" />
            <definition value="Indicates who performed the immunization event." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Immunization.performer" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="BackboneElement" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.performer" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="ORC-12 / RXA-10" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]" />
            </mapping>
        </element>
        <element id="Immunization.performer.id">
            <path value="Immunization.performer.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.performer.extension">
            <path value="Immunization.performer.extension" />
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.performer.modifierExtension">
            <path value="Immunization.performer.modifierExtension" />
            <short value="Extensions that cannot be ignored even if unrecognized" />
            <definition value="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&#39;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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
            <comment value="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." />
            <requirements value="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](extensibility.html#modifierExtension)." />
            <alias value="extensions" />
            <alias value="user content" />
            <alias value="modifiers" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="BackboneElement.modifierExtension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.performer.function">
            <path value="Immunization.performer.function" />
            <short value="What type of performance was done" />
            <definition value="Describes the type of performance (e.g. ordering provider, administering provider, etc.)." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.performer.function" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="ImmunizationFunction" />
                </extension>
                <strength value="extensible" />
                <description value="The role a practitioner or organization plays in the immunization event." />
                <valueSet value="http://hl7.org/fhir/ValueSet/immunization-function" />
            </binding>
            <mapping>
                <identity value="workflow" />
                <map value="Event.performer.function" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation.functionCode" />
            </mapping>
        </element>
        <element id="Immunization.performer.actor">
            <path value="Immunization.performer.actor" />
            <short value="Individual or organization who was performing" />
            <definition value="The practitioner or organization who performed the action." />
            <comment value="When the individual practitioner who performed the action is known, it is best to send." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Immunization.performer.actor" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitioner-ca-core" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitionerRole-ca-core" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.performer.actor" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.actor" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".player" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Provider" />
            </mapping>
        </element>
        <element id="Immunization.note">
            <path value="Immunization.note" />
            <short value="Additional immunization notes" />
            <definition value="Extra information about the immunization that is not conveyed by the other attributes." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Immunization.note" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Annotation" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.note" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="OBX-5 : OBX-3 = 48767-8" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="note" />
            </mapping>
        </element>
        <element id="Immunization.reasonCode">
            <path value="Immunization.reasonCode" />
            <short value="Why immunization occurred" />
            <definition value="Reasons why the vaccine was administered." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Immunization.reasonCode" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="ImmunizationReason" />
                </extension>
                <strength value="example" />
                <description value="The reason why a vaccine was administered." />
                <valueSet value="http://hl7.org/fhir/ValueSet/immunization-reason" />
            </binding>
            <mapping>
                <identity value="workflow" />
                <map value="Event.reasonCode" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="[actionNegationInd=false].reasonCode" />
            </mapping>
        </element>
        <element id="Immunization.reasonReference">
            <path value="Immunization.reasonReference" />
            <short value="Why immunization occurred" />
            <definition value="Condition, Observation or DiagnosticReport that supports why the immunization was administered." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Immunization.reasonReference" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/condition-ca-core" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.reasonReference" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.isSubpotent">
            <path value="Immunization.isSubpotent" />
            <short value="Dose potency" />
            <definition value="Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent." />
            <comment value="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." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.isSubpotent" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="boolean" />
            </type>
            <meaningWhenMissing value="By default, a dose should be considered to be potent." />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="This element is labeled as a modifier because an immunization event with a subpotent vaccine doesn&#39;t protect the patient the same way as a potent dose." />
            <isSummary value="true" />
            <mapping>
                <identity value="v2" />
                <map value="RXA-20 = PA (partial administration)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.subpotentReason">
            <path value="Immunization.subpotentReason" />
            <short value="Reason for being subpotent" />
            <definition value="Reason why a dose is considered to be subpotent." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Immunization.subpotentReason" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="SubpotentReason" />
                </extension>
                <strength value="example" />
                <description value="The reason why a dose is considered to be subpotent." />
                <valueSet value="http://hl7.org/fhir/ValueSet/immunization-subpotent-reason" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Subpotent Reason Code" />
            </mapping>
        </element>
        <element id="Immunization.education">
            <path value="Immunization.education" />
            <short value="Educational material presented to patient" />
            <definition value="Educational material presented to the patient (or guardian) at the time of vaccine administration." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Immunization.education" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="BackboneElement" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="imm-1" />
                <severity value="error" />
                <human value="One of documentType or reference SHALL be present" />
                <expression value="documentType.exists() or reference.exists()" />
                <xpath value="exists(f:documentType) or exists(f:reference)" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.education.id">
            <path value="Immunization.education.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.education.extension">
            <path value="Immunization.education.extension" />
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.education.modifierExtension">
            <path value="Immunization.education.modifierExtension" />
            <short value="Extensions that cannot be ignored even if unrecognized" />
            <definition value="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&#39;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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
            <comment value="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." />
            <requirements value="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](extensibility.html#modifierExtension)." />
            <alias value="extensions" />
            <alias value="user content" />
            <alias value="modifiers" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="BackboneElement.modifierExtension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.education.documentType">
            <path value="Immunization.education.documentType" />
            <short value="Educational material document identifier" />
            <definition value="Identifier of the material presented to the patient." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.education.documentType" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="v2" />
                <map value="OBX-5 : OBX-3 = 69764-9" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.education.reference">
            <path value="Immunization.education.reference" />
            <short value="Educational material reference pointer" />
            <definition value="Reference pointer to the educational material given to the patient if the information was on line." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.education.reference" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.education.publicationDate">
            <path value="Immunization.education.publicationDate" />
            <short value="Educational material publication date" />
            <definition value="Date the educational material was published." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.education.publicationDate" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="v2" />
                <map value="OBX-5 : OBX-3 = 29768-9" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.education.presentationDate">
            <path value="Immunization.education.presentationDate" />
            <short value="Educational material presentation date" />
            <definition value="Date the educational material was given to the patient." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.education.presentationDate" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="v2" />
                <map value="OBX-5 : OBX-3 = 29769-7" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.programEligibility">
            <path value="Immunization.programEligibility" />
            <short value="Patient eligibility for a vaccination program" />
            <definition value="Indicates a patient&#39;s eligibility for a funding program." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Immunization.programEligibility" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="ProgramEligibility" />
                </extension>
                <strength value="example" />
                <description value="The patient&#39;s eligibility for a vaccation program." />
                <valueSet value="http://hl7.org/fhir/ValueSet/immunization-program-eligibility" />
            </binding>
            <mapping>
                <identity value="v2" />
                <map value="OBX-5 : OBX-3 = 64994-7" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.fundingSource">
            <path value="Immunization.fundingSource" />
            <short value="Funding source for the vaccine" />
            <definition value="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)." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.fundingSource" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="FundingSource" />
                </extension>
                <strength value="example" />
                <description value="The source of funding used to purchase the vaccine administered." />
                <valueSet value="http://hl7.org/fhir/ValueSet/immunization-funding-source" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.reaction">
            <path value="Immunization.reaction" />
            <short value="Details of a reaction that follows immunization" />
            <definition value="Categorical data indicating that an adverse event is associated in time to an immunization." />
            <comment value="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." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Immunization.reaction" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="BackboneElement" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="v2" />
                <map value="OBX-3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Observation[classCode=obs].code" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Reaction" />
            </mapping>
        </element>
        <element id="Immunization.reaction.id">
            <path value="Immunization.reaction.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.reaction.extension">
            <path value="Immunization.reaction.extension" />
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.reaction.modifierExtension">
            <path value="Immunization.reaction.modifierExtension" />
            <short value="Extensions that cannot be ignored even if unrecognized" />
            <definition value="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&#39;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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
            <comment value="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." />
            <requirements value="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](extensibility.html#modifierExtension)." />
            <alias value="extensions" />
            <alias value="user content" />
            <alias value="modifiers" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="BackboneElement.modifierExtension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.reaction.date">
            <path value="Immunization.reaction.date" />
            <short value="When reaction started" />
            <definition value="Date of reaction to the immunization." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.reaction.date" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="v2" />
                <map value="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)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".effectiveTime" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Reaction Date" />
            </mapping>
        </element>
        <element id="Immunization.reaction.detail">
            <path value="Immunization.reaction.detail" />
            <short value="Additional information on reaction" />
            <definition value="Details of the reaction." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.reaction.detail" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="v2" />
                <map value="OBX-5" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".value" />
            </mapping>
        </element>
        <element id="Immunization.reaction.reported">
            <path value="Immunization.reaction.reported" />
            <short value="Indicates self-reported reaction" />
            <definition value="Self-reported indicator." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.reaction.reported" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="boolean" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="v2" />
                <map value="(HL7 v2 doesn&#39;t seem to provide for this)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported=true)" />
            </mapping>
        </element>
        <element id="Immunization.protocolApplied">
            <path value="Immunization.protocolApplied" />
            <short value="Protocol followed by the provider" />
            <definition value="The protocol (set of recommendations) being followed by the provider who administered the dose." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Immunization.protocolApplied" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="BackboneElement" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Guideline" />
            </mapping>
        </element>
        <element id="Immunization.protocolApplied.id">
            <path value="Immunization.protocolApplied.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.protocolApplied.extension">
            <path value="Immunization.protocolApplied.extension" />
            <short value="Additional content defined by implementations" />
            <definition value="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." />
            <comment value="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." />
            <alias value="extensions" />
            <alias value="user content" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="Immunization.protocolApplied.modifierExtension">
            <path value="Immunization.protocolApplied.modifierExtension" />
            <short value="Extensions that cannot be ignored even if unrecognized" />
            <definition value="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&#39;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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
            <comment value="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." />
            <requirements value="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](extensibility.html#modifierExtension)." />
            <alias value="extensions" />
            <alias value="user content" />
            <alias value="modifiers" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="BackboneElement.modifierExtension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.protocolApplied.series">
            <path value="Immunization.protocolApplied.series" />
            <short value="Name of vaccine series" />
            <definition value="One possible path to achieve presumed immunity against a disease - within the context of an authority." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.protocolApplied.series" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="Immunization.protocolApplied.authority">
            <path value="Immunization.protocolApplied.authority" />
            <short value="Who is responsible for publishing the recommendations" />
            <definition value="Indicates the authority who published the protocol (e.g. ACIP) that is being followed." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.protocolApplied.authority" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="published by Organization" />
            </mapping>
        </element>
        <element id="Immunization.protocolApplied.targetDisease">
            <path value="Immunization.protocolApplied.targetDisease" />
            <short value="Vaccine preventatable disease being targetted" />
            <definition value="The vaccine preventable disease the dose is being administered against." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Immunization.protocolApplied.targetDisease" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="TargetDisease" />
                </extension>
                <strength value="example" />
                <description value="The vaccine preventable disease the dose is being administered for." />
                <valueSet value="http://hl7.org/fhir/ValueSet/immunization-target-disease" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Guideline Target Disease" />
            </mapping>
        </element>
        <element id="Immunization.protocolApplied.doseNumber[x]">
            <path value="Immunization.protocolApplied.doseNumber[x]" />
            <short value="Dose number within series" />
            <definition value="Nominal position in a series." />
            <comment value="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)." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Immunization.protocolApplied.doseNumber[x]" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="positiveInt" />
            </type>
            <type>
                <code value="string" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Dose Number" />
            </mapping>
        </element>
        <element id="Immunization.protocolApplied.seriesDoses[x]">
            <path value="Immunization.protocolApplied.seriesDoses[x]" />
            <short value="Recommended number of doses for immunity" />
            <definition value="The recommended number of doses to achieve immunity." />
            <comment value="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)." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Immunization.protocolApplied.seriesDoses[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="positiveInt" />
            </type>
            <type>
                <code value="string" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Series Recommended Doses Count" />
            </mapping>
        </element>
    </snapshot>
    <differential>
        <element id="Immunization">
            <path value="Immunization" />
            <constraint>
                <key value="ca-core-im-1" />
                <severity value="warning" />
                <human value="Immunization records created during an encounter event are expected to have occurrence populated. Occurrence SHALL be present if the primarySource is &#39;true&#39;" />
                <expression value="Immunization.primarySource = true implies Immunization.occurrence.exists()" />
                <source value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/immunization-ca-core" />
            </constraint>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization" />
            </mapping>
        </element>
        <element id="Immunization.status">
            <path value="Immunization.status" />
            <mustSupport value="true" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Status" />
            </mapping>
        </element>
        <element id="Immunization.statusReason">
            <path value="Immunization.statusReason" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Reason Not Performed" />
            </mapping>
        </element>
        <element id="Immunization.vaccineCode">
            <path value="Immunization.vaccineCode" />
            <comment value="The additionalBinding extension will be used to express the valueSet for additional negation/exclusion codes for reporting the known absence of immunizations. At the time of this release, the publisher of the current ValueSet for absence codes (IPS) is developing a SNOMED ValueSet that will replace the current http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-immunizations-uv-ips" />
            <type>
                <code value="CodeableConcept" />
                <profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
            </type>
            <mustSupport value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
                    <extension url="purpose">
                        <valueCode value="preferred" />
                    </extension>
                    <extension url="valueSet">
                        <valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/vaccinehistoricalnamecode" />
                    </extension>
                    <extension url="documentation">
                        <valueMarkdown value="Recommended for use when conveying vaccine generic names for scenarios when brand name is not known or does not exist (e.g., immunization history where provider does not have detail of the trade name, the product has been discontinued and/or never licensed in Canada)." />
                    </extension>
                </extension>
                <extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
                    <extension url="purpose">
                        <valueCode value="preferred" />
                    </extension>
                    <extension url="valueSet">
                        <valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/passiveadministeredimmunizingagentcode" />
                    </extension>
                    <extension url="documentation">
                        <valueMarkdown value="per pCHDCF: Alternate value sets can be used when passive immunization products are used" />
                    </extension>
                </extension>
                <extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
                    <extension url="purpose">
                        <valueCode value="preferred" />
                    </extension>
                    <extension url="valueSet">
                        <valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/passivehistoricalimmunizingagentcode" />
                    </extension>
                    <extension url="documentation">
                        <valueMarkdown value="per pCHDCF: Alternate value sets can be used when passive immunization products are used" />
                    </extension>
                </extension>
                <extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
                    <extension url="purpose">
                        <valueCode value="preferred" />
                    </extension>
                    <extension url="valueSet">
                        <valueCanonical value="http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-immunizations-uv-ips" />
                    </extension>
                    <extension url="documentation">
                        <valueMarkdown value="Absent or unknown codes" />
                    </extension>
                </extension>
                <strength value="preferred" />
                <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/vaccineadministeredtradenamecode" />
            </binding>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Drug" />
            </mapping>
        </element>
        <element id="Immunization.vaccineCode.coding">
            <path value="Immunization.vaccineCode.coding" />
            <min value="1" />
            <max value="1" />
            <mustSupport value="true" />
        </element>
        <element id="Immunization.vaccineCode.coding.code">
            <path value="Immunization.vaccineCode.coding.code" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Drug Code" />
            </mapping>
        </element>
        <element id="Immunization.vaccineCode.coding.display">
            <path value="Immunization.vaccineCode.coding.display" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Drug English Description" />
                <comment value="Display may be populated with english or french description depending on the context of the primary language for the user at the time this code is selected. Secondary or translated coding.display values should be conveyed using the translation extension" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Drug French Description" />
                <comment value="Display may be populated with english or french description depending on the context of the primary language for the user at the time this code is selected. Secondary or translated coding.display values should be conveyed using the translation extension" />
            </mapping>
        </element>
        <element id="Immunization.patient">
            <path value="Immunization.patient" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Patient" />
            </mapping>
        </element>
        <element id="Immunization.patient.reference">
            <path value="Immunization.patient.reference" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="Immunization.occurrence[x]">
            <path value="Immunization.occurrence[x]" />
            <slicing>
                <discriminator>
                    <type value="type" />
                    <path value="$this" />
                </discriminator>
                <ordered value="false" />
                <rules value="open" />
            </slicing>
            <mustSupport value="true" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Patient Provided Immunization Date" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Event Start Date Time" />
            </mapping>
        </element>
        <element id="Immunization.occurrence[x].extension:data-absent-reason">
            <path value="Immunization.occurrence[x].extension" />
            <sliceName value="data-absent-reason" />
            <short value="effective[x] absence reason" />
            <definition value="Provides a reason why the effective date or period is missing." />
            <comment value="Some Canadian implementations cannot guarantee that a procedure performed date will always be available in every instance of legacy data. Any implementers who do not require a performed date be available on every procedure need to be able to produce a dataAbsentReason extension in order to be conformant" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/StructureDefinition/data-absent-reason" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="Immunization.occurrence[x]:occurrenceDateTime">
            <path value="Immunization.occurrence[x]" />
            <sliceName value="occurrenceDateTime" />
            <comment value="This element is included in CACDI and is the preferred way to convey this data element." />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="dateTime" />
            </type>
        </element>
        <element id="Immunization.reportOrigin.coding.code">
            <path value="Immunization.reportOrigin.coding.code" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Reporting Source Code" />
            </mapping>
        </element>
        <element id="Immunization.location">
            <path value="Immunization.location" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/location-ca-core" />
            </type>
        </element>
        <element id="Immunization.site">
            <path value="Immunization.site" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Body Site Code" />
            </mapping>
        </element>
        <element id="Immunization.route">
            <path value="Immunization.route" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Route of Administration" />
            </mapping>
        </element>
        <element id="Immunization.doseQuantity">
            <path value="Immunization.doseQuantity" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Dose Quantity: Decimal" />
            </mapping>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Dose Quantity: Unit" />
            </mapping>
        </element>
        <element id="Immunization.performer.actor">
            <path value="Immunization.performer.actor" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitioner-ca-core" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitionerRole-ca-core" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core" />
            </type>
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Provider" />
            </mapping>
        </element>
        <element id="Immunization.reasonReference">
            <path value="Immunization.reasonReference" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/condition-ca-core" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport" />
            </type>
        </element>
        <element id="Immunization.subpotentReason">
            <path value="Immunization.subpotentReason" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Subpotent Reason Code" />
            </mapping>
        </element>
        <element id="Immunization.reaction">
            <path value="Immunization.reaction" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Reaction" />
            </mapping>
        </element>
        <element id="Immunization.reaction.date">
            <path value="Immunization.reaction.date" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Reaction Date" />
            </mapping>
        </element>
        <element id="Immunization.protocolApplied">
            <path value="Immunization.protocolApplied" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Guideline" />
            </mapping>
        </element>
        <element id="Immunization.protocolApplied.authority">
            <path value="Immunization.protocolApplied.authority" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="published by Organization" />
            </mapping>
        </element>
        <element id="Immunization.protocolApplied.targetDisease">
            <path value="Immunization.protocolApplied.targetDisease" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Guideline Target Disease" />
            </mapping>
        </element>
        <element id="Immunization.protocolApplied.doseNumber[x]">
            <path value="Immunization.protocolApplied.doseNumber[x]" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Dose Number" />
            </mapping>
        </element>
        <element id="Immunization.protocolApplied.seriesDoses[x]">
            <path value="Immunization.protocolApplied.seriesDoses[x]" />
            <mapping>
                <identity value="pCHDCF-CACDI" />
                <map value="Immunization Series Recommended Doses Count" />
            </mapping>
        </element>
    </differential>
</StructureDefinition>

{
    "resourceType": "StructureDefinition",
    "id": "immunization-ca-core",
    "url": "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/immunization-ca-core",
    "name": "ImmunizationCACore",
    "title": "Immunization (CA-Core)",
    "status": "draft",
    "experimental": false,
    "date": "2025-03-06",
    "publisher": "Canada Health Infoway",
    "contact":  [
        {
            "name": "National Standards Release Centre",
            "telecom":  [
                {
                    "system": "url",
                    "value": "http://www.infoway-inforoute.ca"
                },
                {
                    "system": "email",
                    "value": "standards@infoway-inforoute.ca"
                }
            ]
        }
    ],
    "description": "This profile applies constraints to the Immunization resource for CA Core+ to support documentation of administered vaccines in the pan-Canadian context.",
    "jurisdiction":  [
        {
            "coding":  [
                {
                    "system": "urn:iso:std:iso:3166",
                    "code": "CA"
                }
            ]
        }
    ],
    "copyright": "Copyright © 2025+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy).",
    "fhirVersion": "4.0.1",
    "mapping":  [
        {
            "identity": "pCHDCF-CACDI",
            "name": "Pan-Canadian Health Data Content Framework - CACDI"
        }
    ],
    "kind": "resource",
    "abstract": false,
    "type": "Immunization",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Immunization",
    "derivation": "constraint",
    "snapshot": {
        "element":  [
            {
                "id": "Immunization",
                "path": "Immunization",
                "short": "Immunization event information",
                "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.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Immunization",
                    "min": 0,
                    "max": "*"
                },
                "constraint":  [
                    {
                        "key": "dom-2",
                        "severity": "error",
                        "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
                        "expression": "contained.contained.empty()",
                        "xpath": "not(parent::f:contained and f:contained)",
                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    },
                    {
                        "key": "dom-3",
                        "severity": "error",
                        "human": "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",
                        "expression": "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()",
                        "xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    },
                    {
                        "key": "dom-4",
                        "severity": "error",
                        "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
                        "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
                        "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    },
                    {
                        "key": "dom-5",
                        "severity": "error",
                        "human": "If a resource is contained in another resource, it SHALL NOT have a security label",
                        "expression": "contained.meta.security.empty()",
                        "xpath": "not(exists(f:contained/*/f:meta/f:security))",
                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    },
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
                                "valueBoolean": true
                            },
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
                                "valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
                            }
                        ],
                        "key": "dom-6",
                        "severity": "warning",
                        "human": "A resource should have narrative for robust management",
                        "expression": "text.`div`.exists()",
                        "xpath": "exists(f:text/h:div)",
                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    },
                    {
                        "key": "ca-core-im-1",
                        "severity": "warning",
                        "human": "Immunization records created during an encounter event are expected to have occurrence populated. Occurrence SHALL be present if the primarySource is 'true'",
                        "expression": "Immunization.primarySource = true implies Immunization.occurrence.exists()",
                        "source": "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/immunization-ca-core"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "Entity. Role, or Act"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event"
                    },
                    {
                        "identity": "v2",
                        "map": "VXU_V04"
                    },
                    {
                        "identity": "rim",
                        "map": "SubstanceAdministration"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization"
                    }
                ]
            },
            {
                "id": "Immunization.id",
                "path": "Immunization.id",
                "short": "Logical id of this artifact",
                "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
                "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Resource.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": true
            },
            {
                "id": "Immunization.meta",
                "path": "Immunization.meta",
                "short": "Metadata about the resource",
                "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Resource.meta",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Meta"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true
            },
            {
                "id": "Immunization.implicitRules",
                "path": "Immunization.implicitRules",
                "short": "A set of rules under which this content was created",
                "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.",
                "comment": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Resource.implicitRules",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
                "isSummary": true
            },
            {
                "id": "Immunization.language",
                "path": "Immunization.language",
                "short": "Language of the resource content",
                "definition": "The base language in which the resource is written.",
                "comment": "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).",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Resource.language",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
                            "valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
                        },
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "Language"
                        },
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
                            "valueBoolean": true
                        }
                    ],
                    "strength": "preferred",
                    "description": "A human language.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/languages"
                }
            },
            {
                "id": "Immunization.text",
                "path": "Immunization.text",
                "short": "Text summary of the resource, for human interpretation",
                "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.",
                "comment": "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.",
                "alias":  [
                    "narrative",
                    "html",
                    "xhtml",
                    "display"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "DomainResource.text",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Narrative"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "Act.text?"
                    }
                ]
            },
            {
                "id": "Immunization.contained",
                "path": "Immunization.contained",
                "short": "Contained, inline Resources",
                "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.",
                "comment": "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.",
                "alias":  [
                    "inline resources",
                    "anonymous resources",
                    "contained resources"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.contained",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Resource"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.extension",
                "path": "Immunization.extension",
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.modifierExtension",
                "path": "Immunization.modifierExtension",
                "short": "Extensions that cannot be ignored",
                "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
                "comment": "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.",
                "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](extensibility.html#modifierExtension).",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.modifierExtension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.identifier",
                "path": "Immunization.identifier",
                "short": "Business identifier",
                "definition": "A unique identifier assigned to this immunization record.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Immunization.identifier",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Identifier"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.identifier"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.identifier"
                    },
                    {
                        "identity": "rim",
                        "map": ".id"
                    },
                    {
                        "identity": "cda",
                        "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/id"
                    }
                ]
            },
            {
                "id": "Immunization.status",
                "path": "Immunization.status",
                "short": "completed | entered-in-error | not-done",
                "definition": "Indicates the current status of the immunization event.",
                "comment": "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.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Immunization.status",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": true,
                "isModifierReason": "This element is labeled as a modifier because it is a status element that contains statuses entered-in-error and not-done which means that the resource should not be treated as valid",
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "ImmunizationStatus"
                        }
                    ],
                    "strength": "required",
                    "description": "A set of codes indicating the current status of an Immunization.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/immunization-status|4.0.1"
                },
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.status"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.status"
                    },
                    {
                        "identity": "rim",
                        "map": "statusCode"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Status"
                    }
                ]
            },
            {
                "id": "Immunization.statusReason",
                "path": "Immunization.statusReason",
                "short": "Reason not done",
                "definition": "Indicates the reason the immunization event was not performed.",
                "comment": "This is generally only used for the status of \"not-done\". The reason for performing the immunization event is captured in reasonCode, not here.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.statusReason",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "ImmunizationStatusReason"
                        }
                    ],
                    "strength": "example",
                    "description": "The reason why a vaccine was not administered.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/immunization-status-reason"
                },
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.statusReason"
                    },
                    {
                        "identity": "rim",
                        "map": ".inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Reason Not Performed"
                    }
                ]
            },
            {
                "id": "Immunization.vaccineCode",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.vaccineCode",
                "short": "Concept - reference to a terminology or just  text",
                "definition": "A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.",
                "comment": "The additionalBinding extension will be used to express the valueSet for additional negation/exclusion codes for reporting the known absence of immunizations. At the time of this release, the publisher of the current ValueSet for absence codes (IPS) is developing a SNOMED ValueSet that will replace the current http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-immunizations-uv-ips",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Immunization.vaccineCode",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept",
                        "profile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "VaccineCode"
                        },
                        {
                            "extension":  [
                                {
                                    "url": "purpose",
                                    "valueCode": "preferred"
                                },
                                {
                                    "url": "valueSet",
                                    "valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/vaccinehistoricalnamecode"
                                },
                                {
                                    "url": "documentation",
                                    "valueMarkdown": "Recommended for use when conveying vaccine generic names for scenarios when brand name is not known or does not exist (e.g., immunization history where provider does not have detail of the trade name, the product has been discontinued and/or never licensed in Canada)."
                                }
                            ],
                            "url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
                        },
                        {
                            "extension":  [
                                {
                                    "url": "purpose",
                                    "valueCode": "preferred"
                                },
                                {
                                    "url": "valueSet",
                                    "valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/passiveadministeredimmunizingagentcode"
                                },
                                {
                                    "url": "documentation",
                                    "valueMarkdown": "per pCHDCF: Alternate value sets can be used when passive immunization products are used"
                                }
                            ],
                            "url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
                        },
                        {
                            "extension":  [
                                {
                                    "url": "purpose",
                                    "valueCode": "preferred"
                                },
                                {
                                    "url": "valueSet",
                                    "valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/passivehistoricalimmunizingagentcode"
                                },
                                {
                                    "url": "documentation",
                                    "valueMarkdown": "per pCHDCF: Alternate value sets can be used when passive immunization products are used"
                                }
                            ],
                            "url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
                        },
                        {
                            "extension":  [
                                {
                                    "url": "purpose",
                                    "valueCode": "preferred"
                                },
                                {
                                    "url": "valueSet",
                                    "valueCanonical": "http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-immunizations-uv-ips"
                                },
                                {
                                    "url": "documentation",
                                    "valueMarkdown": "Absent or unknown codes"
                                }
                            ],
                            "url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
                        }
                    ],
                    "strength": "preferred",
                    "description": "The code for vaccine product administered.",
                    "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/vaccineadministeredtradenamecode"
                },
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.code"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.what[x]"
                    },
                    {
                        "identity": "v2",
                        "map": "RXA-5"
                    },
                    {
                        "identity": "rim",
                        "map": ".code"
                    },
                    {
                        "identity": "cda",
                        "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/realmCode/code"
                    },
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Drug"
                    }
                ]
            },
            {
                "id": "Immunization.vaccineCode.id",
                "path": "Immunization.vaccineCode.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.vaccineCode.extension",
                "path": "Immunization.vaccineCode.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.vaccineCode.coding",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "Immunization.vaccineCode.coding",
                "short": "A reference to a code defined by a terminology system",
                "definition": "A reference to a code defined by a terminology system.",
                "comment": "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.",
                "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "CodeableConcept.coding",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Coding",
                        "profile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/coding-ca-core"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "C*E.1-8, C*E.10-22"
                    },
                    {
                        "identity": "rim",
                        "map": "union(., ./translation)"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
                    },
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
                    },
                    {
                        "identity": "rim",
                        "map": "CV"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
                    }
                ]
            },
            {
                "id": "Immunization.vaccineCode.coding.id",
                "path": "Immunization.vaccineCode.coding.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.vaccineCode.coding.extension",
                "path": "Immunization.vaccineCode.coding.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.vaccineCode.coding.system",
                "path": "Immunization.vaccineCode.coding.system",
                "short": "Identity of the terminology system",
                "definition": "The identification of the code system that defines the meaning of the symbol in the code.",
                "comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
                "requirements": "Need to be unambiguous about the source of the definition of the symbol.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.system",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "C*E.3"
                    },
                    {
                        "identity": "rim",
                        "map": "./codeSystem"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"
                    }
                ]
            },
            {
                "id": "Immunization.vaccineCode.coding.version",
                "path": "Immunization.vaccineCode.coding.version",
                "short": "Version of the system - if relevant",
                "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
                "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.version",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "C*E.7"
                    },
                    {
                        "identity": "rim",
                        "map": "./codeSystemVersion"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"
                    }
                ]
            },
            {
                "id": "Immunization.vaccineCode.coding.code",
                "path": "Immunization.vaccineCode.coding.code",
                "short": "Symbol in syntax defined by the system",
                "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
                "requirements": "Need to refer to a particular code in the system.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.code",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "C*E.1"
                    },
                    {
                        "identity": "rim",
                        "map": "./code"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Drug Code"
                    }
                ]
            },
            {
                "id": "Immunization.vaccineCode.coding.display",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
                        "valueBoolean": true
                    }
                ],
                "path": "Immunization.vaccineCode.coding.display",
                "short": "Representation defined by the system",
                "definition": "A representation of the meaning of the code in the system, following the rules of the system.",
                "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.display",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "C*E.2 - but note this is not well followed"
                    },
                    {
                        "identity": "rim",
                        "map": "CV.displayName"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Drug English Description",
                        "comment": "Display may be populated with english or french description depending on the context of the primary language for the user at the time this code is selected. Secondary or translated coding.display values should be conveyed using the translation extension"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Drug French Description",
                        "comment": "Display may be populated with english or french description depending on the context of the primary language for the user at the time this code is selected. Secondary or translated coding.display values should be conveyed using the translation extension"
                    }
                ]
            },
            {
                "id": "Immunization.vaccineCode.coding.display.id",
                "path": "Immunization.vaccineCode.coding.display.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "xml:id (or equivalent in JSON)",
                "definition": "unique id for the element within a resource (for internal references)",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Immunization.vaccineCode.coding.display.extension",
                "path": "Immunization.vaccineCode.coding.display.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Immunization.vaccineCode.coding.display.extension:translation",
                "path": "Immunization.vaccineCode.coding.display.extension",
                "sliceName": "translation",
                "short": "Language Translation (Localization)",
                "definition": "Language translation from base language of resource to another language.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/translation"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "ST.translation"
                    }
                ]
            },
            {
                "id": "Immunization.vaccineCode.coding.display.value",
                "path": "Immunization.vaccineCode.coding.display.value",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Primitive value for string",
                "definition": "The actual value",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "string.value",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            },
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/regex",
                                "valueString": "[ \\r\\n\\t\\S]+"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "maxLength": 1048576,
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "Immunization.vaccineCode.coding.userSelected",
                "path": "Immunization.vaccineCode.coding.userSelected",
                "short": "If this coding was chosen directly by the user",
                "definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
                "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
                "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.userSelected",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "boolean"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "Sometimes implied by being first"
                    },
                    {
                        "identity": "rim",
                        "map": "CD.codingRationale"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [     fhir:source \"true\";     fhir:target dt:CDCoding.codingRationale\\#O   ]"
                    }
                ]
            },
            {
                "id": "Immunization.vaccineCode.text",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
                        "valueBoolean": true
                    }
                ],
                "path": "Immunization.vaccineCode.text",
                "short": "Plain text representation of the concept",
                "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
                "comment": "Very often the text is the same as a displayName of one of the codings.",
                "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "CodeableConcept.text",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "C*E.9. But note many systems use C*E.2 for this"
                    },
                    {
                        "identity": "rim",
                        "map": "./originalText[mediaType/code=\"text/plain\"]/data"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
                    }
                ]
            },
            {
                "id": "Immunization.patient",
                "path": "Immunization.patient",
                "short": "Who was immunized",
                "definition": "The patient who either received or did not receive the immunization.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Immunization.patient",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.subject"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.subject[x]"
                    },
                    {
                        "identity": "v2",
                        "map": "PID-3"
                    },
                    {
                        "identity": "rim",
                        "map": ".partipication[ttypeCode=].role"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.subject"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Patient"
                    }
                ]
            },
            {
                "id": "Immunization.patient.id",
                "path": "Immunization.patient.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.patient.extension",
                "path": "Immunization.patient.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.patient.reference",
                "path": "Immunization.patient.reference",
                "short": "Literal reference, Relative, internal or absolute URL",
                "definition": "A 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.",
                "comment": "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.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Reference.reference",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ref-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.patient.type",
                "path": "Immunization.patient.type",
                "short": "Type the reference refers to (e.g. \"Patient\")",
                "definition": "The 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.\n\nThe 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).",
                "comment": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Reference.type",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "FHIRResourceTypeExt"
                        }
                    ],
                    "strength": "extensible",
                    "description": "Aa resource (or, for logical models, the URI of the logical model).",
                    "valueSet": "http://hl7.org/fhir/ValueSet/resource-types"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.patient.identifier",
                "path": "Immunization.patient.identifier",
                "short": "Logical reference, when literal reference is not known",
                "definition": "An 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.",
                "comment": "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. \n\nWhen 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\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference 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).",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Reference.identifier",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Identifier"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": ".identifier"
                    }
                ]
            },
            {
                "id": "Immunization.patient.display",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
                        "valueBoolean": true
                    }
                ],
                "path": "Immunization.patient.display",
                "short": "Text alternative for the resource",
                "definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
                "comment": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Reference.display",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.encounter",
                "path": "Immunization.encounter",
                "short": "Encounter immunization was part of",
                "definition": "The visit or admission or other contact between patient and health care provider the immunization was performed as part of.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.encounter",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Encounter"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.context"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.context"
                    },
                    {
                        "identity": "v2",
                        "map": "PV1-19"
                    },
                    {
                        "identity": "rim",
                        "map": "component->EncounterEvent"
                    }
                ]
            },
            {
                "id": "Immunization.occurrence[x]",
                "path": "Immunization.occurrence[x]",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "type",
                            "path": "$this"
                        }
                    ],
                    "ordered": false,
                    "rules": "open"
                },
                "short": "Vaccine administration date",
                "definition": "Date vaccine administered or was to be administered.",
                "comment": "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.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Immunization.occurrence[x]",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    },
                    {
                        "code": "string"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.occurrence[x]"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.done[x]"
                    },
                    {
                        "identity": "v2",
                        "map": "RXA-3"
                    },
                    {
                        "identity": "rim",
                        "map": ".effectiveTime"
                    },
                    {
                        "identity": "cda",
                        "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Patient Provided Immunization Date"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Event Start Date Time"
                    }
                ]
            },
            {
                "id": "Immunization.occurrence[x].id",
                "path": "Immunization.occurrence[x].id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.occurrence[x].extension",
                "path": "Immunization.occurrence[x].extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.occurrence[x].extension:data-absent-reason",
                "path": "Immunization.occurrence[x].extension",
                "sliceName": "data-absent-reason",
                "short": "effective[x] absence reason",
                "definition": "Provides a reason why the effective date or period is missing.",
                "comment": "Some Canadian implementations cannot guarantee that a procedure performed date will always be available in every instance of legacy data. Any implementers who do not require a performed date be available on every procedure need to be able to produce a dataAbsentReason extension in order to be conformant",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/data-absent-reason"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "ANY.nullFlavor"
                    }
                ]
            },
            {
                "id": "Immunization.occurrence[x]:occurrenceDateTime",
                "path": "Immunization.occurrence[x]",
                "sliceName": "occurrenceDateTime",
                "short": "Vaccine administration date",
                "definition": "Date vaccine administered or was to be administered.",
                "comment": "This element is included in CACDI and is the preferred way to convey this data element.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.occurrence[x]",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.occurrence[x]"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.done[x]"
                    },
                    {
                        "identity": "v2",
                        "map": "RXA-3"
                    },
                    {
                        "identity": "rim",
                        "map": ".effectiveTime"
                    },
                    {
                        "identity": "cda",
                        "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value"
                    }
                ]
            },
            {
                "id": "Immunization.recorded",
                "path": "Immunization.recorded",
                "short": "When the immunization was first captured in the subject's record",
                "definition": "The date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.recorded",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "w5",
                        "map": "FiveWs.recorded"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=AUT].time"
                    }
                ]
            },
            {
                "id": "Immunization.primarySource",
                "path": "Immunization.primarySource",
                "short": "Indicates context the data was recorded in",
                "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.",
                "comment": "Reflects the “reliability” of the content.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.primarySource",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "boolean"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "w5",
                        "map": "FiveWs.source"
                    },
                    {
                        "identity": "v2",
                        "map": "RXA-9"
                    },
                    {
                        "identity": "rim",
                        "map": "immunization.uncertaintycode (if primary source=false, uncertainty=U)"
                    }
                ]
            },
            {
                "id": "Immunization.reportOrigin",
                "path": "Immunization.reportOrigin",
                "short": "Indicates the source of a secondarily reported record",
                "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.",
                "comment": "Should not be populated if primarySource = True, not required even if primarySource = False.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.reportOrigin",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "ImmunizationReportOrigin"
                        }
                    ],
                    "strength": "example",
                    "description": "The source of the data for a record which is not from a primary source.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/immunization-origin"
                },
                "mapping":  [
                    {
                        "identity": "w5",
                        "map": "FiveWs.source"
                    },
                    {
                        "identity": "v2",
                        "map": "RXA-9"
                    },
                    {
                        "identity": "rim",
                        "map": ".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)"
                    }
                ]
            },
            {
                "id": "Immunization.reportOrigin.id",
                "path": "Immunization.reportOrigin.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.reportOrigin.extension",
                "path": "Immunization.reportOrigin.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.reportOrigin.coding",
                "path": "Immunization.reportOrigin.coding",
                "short": "Code defined by a terminology system",
                "definition": "A reference to a code defined by a terminology system.",
                "comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
                "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "CodeableConcept.coding",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Coding"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "C*E.1-8, C*E.10-22"
                    },
                    {
                        "identity": "rim",
                        "map": "union(., ./translation)"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
                    }
                ]
            },
            {
                "id": "Immunization.reportOrigin.coding.id",
                "path": "Immunization.reportOrigin.coding.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.reportOrigin.coding.extension",
                "path": "Immunization.reportOrigin.coding.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.reportOrigin.coding.system",
                "path": "Immunization.reportOrigin.coding.system",
                "short": "Identity of the terminology system",
                "definition": "The identification of the code system that defines the meaning of the symbol in the code.",
                "comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
                "requirements": "Need to be unambiguous about the source of the definition of the symbol.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.system",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "C*E.3"
                    },
                    {
                        "identity": "rim",
                        "map": "./codeSystem"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"
                    }
                ]
            },
            {
                "id": "Immunization.reportOrigin.coding.version",
                "path": "Immunization.reportOrigin.coding.version",
                "short": "Version of the system - if relevant",
                "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
                "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.version",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "C*E.7"
                    },
                    {
                        "identity": "rim",
                        "map": "./codeSystemVersion"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"
                    }
                ]
            },
            {
                "id": "Immunization.reportOrigin.coding.code",
                "path": "Immunization.reportOrigin.coding.code",
                "short": "Symbol in syntax defined by the system",
                "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
                "requirements": "Need to refer to a particular code in the system.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.code",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "C*E.1"
                    },
                    {
                        "identity": "rim",
                        "map": "./code"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Reporting Source Code"
                    }
                ]
            },
            {
                "id": "Immunization.reportOrigin.coding.display",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
                        "valueBoolean": true
                    }
                ],
                "path": "Immunization.reportOrigin.coding.display",
                "short": "Representation defined by the system",
                "definition": "A representation of the meaning of the code in the system, following the rules of the system.",
                "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.display",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "C*E.2 - but note this is not well followed"
                    },
                    {
                        "identity": "rim",
                        "map": "CV.displayName"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"
                    }
                ]
            },
            {
                "id": "Immunization.reportOrigin.coding.userSelected",
                "path": "Immunization.reportOrigin.coding.userSelected",
                "short": "If this coding was chosen directly by the user",
                "definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
                "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
                "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.userSelected",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "boolean"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "Sometimes implied by being first"
                    },
                    {
                        "identity": "rim",
                        "map": "CD.codingRationale"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [     fhir:source \"true\";     fhir:target dt:CDCoding.codingRationale\\#O   ]"
                    }
                ]
            },
            {
                "id": "Immunization.reportOrigin.text",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
                        "valueBoolean": true
                    }
                ],
                "path": "Immunization.reportOrigin.text",
                "short": "Plain text representation of the concept",
                "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
                "comment": "Very often the text is the same as a displayName of one of the codings.",
                "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "CodeableConcept.text",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "C*E.9. But note many systems use C*E.2 for this"
                    },
                    {
                        "identity": "rim",
                        "map": "./originalText[mediaType/code=\"text/plain\"]/data"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
                    }
                ]
            },
            {
                "id": "Immunization.location",
                "path": "Immunization.location",
                "short": "Where immunization occurred",
                "definition": "The service delivery location where the vaccine administration occurred.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.location",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/location-ca-core"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.location"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.where[x]"
                    },
                    {
                        "identity": "v2",
                        "map": "RXA-27  (or RXA-11, deprecated as of v2.7)"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=LOC].COCT_MT240000UV"
                    }
                ]
            },
            {
                "id": "Immunization.manufacturer",
                "path": "Immunization.manufacturer",
                "short": "Vaccine manufacturer",
                "definition": "Name of vaccine manufacturer.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.manufacturer",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Organization"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "RXA-17"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=ORG]"
                    },
                    {
                        "identity": "cda",
                        "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacuturerOrganization/name"
                    }
                ]
            },
            {
                "id": "Immunization.lotNumber",
                "path": "Immunization.lotNumber",
                "short": "Vaccine lot number",
                "definition": "Lot number of the  vaccine product.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.lotNumber",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "RXA-15"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].id"
                    },
                    {
                        "identity": "cda",
                        "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/lotNumberText"
                    }
                ]
            },
            {
                "id": "Immunization.expirationDate",
                "path": "Immunization.expirationDate",
                "short": "Vaccine expiration date",
                "definition": "Date vaccine batch expires.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.expirationDate",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "date"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "RXA-16"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime"
                    }
                ]
            },
            {
                "id": "Immunization.site",
                "path": "Immunization.site",
                "short": "Body site vaccine  was administered",
                "definition": "Body site where vaccine was administered.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.site",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "ImmunizationSite"
                        }
                    ],
                    "strength": "example",
                    "description": "The site at which the vaccine was administered.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/immunization-site"
                },
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "RXR-2"
                    },
                    {
                        "identity": "rim",
                        "map": "observation.targetSiteCode"
                    },
                    {
                        "identity": "cda",
                        "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/approachSiteCode/code"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Body Site Code"
                    }
                ]
            },
            {
                "id": "Immunization.route",
                "path": "Immunization.route",
                "short": "How vaccine entered body",
                "definition": "The path by which the vaccine product is taken into the body.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.route",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "ImmunizationRoute"
                        }
                    ],
                    "strength": "example",
                    "description": "The route by which the vaccine was administered.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/immunization-route"
                },
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "RXR-1"
                    },
                    {
                        "identity": "rim",
                        "map": ".routeCode"
                    },
                    {
                        "identity": "cda",
                        "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/routeCode/code"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Route of Administration"
                    }
                ]
            },
            {
                "id": "Immunization.doseQuantity",
                "path": "Immunization.doseQuantity",
                "short": "Amount of vaccine administered",
                "definition": "The quantity of vaccine product that was administered.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.doseQuantity",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Quantity",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "RXA-6 / RXA-7"
                    },
                    {
                        "identity": "rim",
                        "map": ".doseQuantity"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Dose Quantity: Decimal"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Dose Quantity: Unit"
                    }
                ]
            },
            {
                "id": "Immunization.performer",
                "path": "Immunization.performer",
                "short": "Who performed event",
                "definition": "Indicates who performed the immunization event.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Immunization.performer",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "BackboneElement"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.performer"
                    },
                    {
                        "identity": "v2",
                        "map": "ORC-12 / RXA-10"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]"
                    }
                ]
            },
            {
                "id": "Immunization.performer.id",
                "path": "Immunization.performer.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.performer.extension",
                "path": "Immunization.performer.extension",
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.performer.modifierExtension",
                "path": "Immunization.performer.modifierExtension",
                "short": "Extensions that cannot be ignored even if unrecognized",
                "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
                "comment": "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.",
                "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](extensibility.html#modifierExtension).",
                "alias":  [
                    "extensions",
                    "user content",
                    "modifiers"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "BackboneElement.modifierExtension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.performer.function",
                "path": "Immunization.performer.function",
                "short": "What type of performance was done",
                "definition": "Describes the type of performance (e.g. ordering provider, administering provider, etc.).",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.performer.function",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "ImmunizationFunction"
                        }
                    ],
                    "strength": "extensible",
                    "description": "The role a practitioner or organization plays in the immunization event.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/immunization-function"
                },
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.performer.function"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation.functionCode"
                    }
                ]
            },
            {
                "id": "Immunization.performer.actor",
                "path": "Immunization.performer.actor",
                "short": "Individual or organization who was performing",
                "definition": "The practitioner or organization who performed the action.",
                "comment": "When the individual practitioner who performed the action is known, it is best to send.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Immunization.performer.actor",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitioner-ca-core",
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitionerRole-ca-core",
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.performer.actor"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.actor"
                    },
                    {
                        "identity": "rim",
                        "map": ".player"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Provider"
                    }
                ]
            },
            {
                "id": "Immunization.note",
                "path": "Immunization.note",
                "short": "Additional immunization notes",
                "definition": "Extra information about the immunization that is not conveyed by the other attributes.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Immunization.note",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Annotation"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.note"
                    },
                    {
                        "identity": "v2",
                        "map": "OBX-5 : OBX-3 = 48767-8"
                    },
                    {
                        "identity": "rim",
                        "map": "note"
                    }
                ]
            },
            {
                "id": "Immunization.reasonCode",
                "path": "Immunization.reasonCode",
                "short": "Why immunization occurred",
                "definition": "Reasons why the vaccine was administered.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Immunization.reasonCode",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "ImmunizationReason"
                        }
                    ],
                    "strength": "example",
                    "description": "The reason why a vaccine was administered.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/immunization-reason"
                },
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.reasonCode"
                    },
                    {
                        "identity": "rim",
                        "map": "[actionNegationInd=false].reasonCode"
                    }
                ]
            },
            {
                "id": "Immunization.reasonReference",
                "path": "Immunization.reasonReference",
                "short": "Why immunization occurred",
                "definition": "Condition, Observation or DiagnosticReport that supports why the immunization was administered.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Immunization.reasonReference",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/condition-ca-core",
                            "http://hl7.org/fhir/StructureDefinition/Observation",
                            "http://hl7.org/fhir/StructureDefinition/DiagnosticReport"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.reasonReference"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.isSubpotent",
                "path": "Immunization.isSubpotent",
                "short": "Dose potency",
                "definition": "Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent.",
                "comment": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.isSubpotent",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "boolean"
                    }
                ],
                "meaningWhenMissing": "By default, a dose should be considered to be potent.",
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "This element is labeled as a modifier because an immunization event with a subpotent vaccine doesn't protect the patient the same way as a potent dose.",
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "RXA-20 = PA (partial administration)"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.subpotentReason",
                "path": "Immunization.subpotentReason",
                "short": "Reason for being subpotent",
                "definition": "Reason why a dose is considered to be subpotent.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Immunization.subpotentReason",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "SubpotentReason"
                        }
                    ],
                    "strength": "example",
                    "description": "The reason why a dose is considered to be subpotent.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/immunization-subpotent-reason"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Subpotent Reason Code"
                    }
                ]
            },
            {
                "id": "Immunization.education",
                "path": "Immunization.education",
                "short": "Educational material presented to patient",
                "definition": "Educational material presented to the patient (or guardian) at the time of vaccine administration.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Immunization.education",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "BackboneElement"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "imm-1",
                        "severity": "error",
                        "human": "One of documentType or reference SHALL be present",
                        "expression": "documentType.exists() or reference.exists()",
                        "xpath": "exists(f:documentType) or exists(f:reference)"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.education.id",
                "path": "Immunization.education.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.education.extension",
                "path": "Immunization.education.extension",
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.education.modifierExtension",
                "path": "Immunization.education.modifierExtension",
                "short": "Extensions that cannot be ignored even if unrecognized",
                "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
                "comment": "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.",
                "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](extensibility.html#modifierExtension).",
                "alias":  [
                    "extensions",
                    "user content",
                    "modifiers"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "BackboneElement.modifierExtension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.education.documentType",
                "path": "Immunization.education.documentType",
                "short": "Educational material document identifier",
                "definition": "Identifier of the material presented to the patient.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.education.documentType",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "OBX-5 : OBX-3 = 69764-9"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.education.reference",
                "path": "Immunization.education.reference",
                "short": "Educational material reference pointer",
                "definition": "Reference pointer to the educational material given to the patient if the information was on line.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.education.reference",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.education.publicationDate",
                "path": "Immunization.education.publicationDate",
                "short": "Educational material publication date",
                "definition": "Date the educational material was published.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.education.publicationDate",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "OBX-5 : OBX-3 = 29768-9"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.education.presentationDate",
                "path": "Immunization.education.presentationDate",
                "short": "Educational material presentation date",
                "definition": "Date the educational material was given to the patient.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.education.presentationDate",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "OBX-5 : OBX-3 = 29769-7"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.programEligibility",
                "path": "Immunization.programEligibility",
                "short": "Patient eligibility for a vaccination program",
                "definition": "Indicates a patient's eligibility for a funding program.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Immunization.programEligibility",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "ProgramEligibility"
                        }
                    ],
                    "strength": "example",
                    "description": "The patient's eligibility for a vaccation program.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/immunization-program-eligibility"
                },
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "OBX-5 : OBX-3 = 64994-7"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.fundingSource",
                "path": "Immunization.fundingSource",
                "short": "Funding source for the vaccine",
                "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).",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.fundingSource",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "FundingSource"
                        }
                    ],
                    "strength": "example",
                    "description": "The source of funding used to purchase the vaccine administered.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/immunization-funding-source"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.reaction",
                "path": "Immunization.reaction",
                "short": "Details of a reaction that follows immunization",
                "definition": "Categorical data indicating that an adverse event is associated in time to an immunization.",
                "comment": "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.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Immunization.reaction",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "BackboneElement"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "OBX-3"
                    },
                    {
                        "identity": "rim",
                        "map": "Observation[classCode=obs].code"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Reaction"
                    }
                ]
            },
            {
                "id": "Immunization.reaction.id",
                "path": "Immunization.reaction.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.reaction.extension",
                "path": "Immunization.reaction.extension",
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.reaction.modifierExtension",
                "path": "Immunization.reaction.modifierExtension",
                "short": "Extensions that cannot be ignored even if unrecognized",
                "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
                "comment": "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.",
                "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](extensibility.html#modifierExtension).",
                "alias":  [
                    "extensions",
                    "user content",
                    "modifiers"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "BackboneElement.modifierExtension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.reaction.date",
                "path": "Immunization.reaction.date",
                "short": "When reaction started",
                "definition": "Date of reaction to the immunization.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.reaction.date",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "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)"
                    },
                    {
                        "identity": "rim",
                        "map": ".effectiveTime"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Reaction Date"
                    }
                ]
            },
            {
                "id": "Immunization.reaction.detail",
                "path": "Immunization.reaction.detail",
                "short": "Additional information on reaction",
                "definition": "Details of the reaction.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.reaction.detail",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Observation"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "OBX-5"
                    },
                    {
                        "identity": "rim",
                        "map": ".value"
                    }
                ]
            },
            {
                "id": "Immunization.reaction.reported",
                "path": "Immunization.reaction.reported",
                "short": "Indicates self-reported reaction",
                "definition": "Self-reported indicator.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.reaction.reported",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "boolean"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "v2",
                        "map": "(HL7 v2 doesn't seem to provide for this)"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported=true)"
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied",
                "path": "Immunization.protocolApplied",
                "short": "Protocol followed by the provider",
                "definition": "The protocol (set of recommendations) being followed by the provider who administered the dose.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Immunization.protocolApplied",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "BackboneElement"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Guideline"
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied.id",
                "path": "Immunization.protocolApplied.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied.extension",
                "path": "Immunization.protocolApplied.extension",
                "short": "Additional content defined by implementations",
                "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.",
                "comment": "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.",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied.modifierExtension",
                "path": "Immunization.protocolApplied.modifierExtension",
                "short": "Extensions that cannot be ignored even if unrecognized",
                "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
                "comment": "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.",
                "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](extensibility.html#modifierExtension).",
                "alias":  [
                    "extensions",
                    "user content",
                    "modifiers"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "BackboneElement.modifierExtension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied.series",
                "path": "Immunization.protocolApplied.series",
                "short": "Name of vaccine series",
                "definition": "One possible path to achieve presumed immunity against a disease - within the context of an authority.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.protocolApplied.series",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied.authority",
                "path": "Immunization.protocolApplied.authority",
                "short": "Who is responsible for publishing the recommendations",
                "definition": "Indicates the authority who published the protocol (e.g. ACIP) that is being followed.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.protocolApplied.authority",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Organization"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "published by Organization"
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied.targetDisease",
                "path": "Immunization.protocolApplied.targetDisease",
                "short": "Vaccine preventatable disease being targetted",
                "definition": "The vaccine preventable disease the dose is being administered against.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Immunization.protocolApplied.targetDisease",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "TargetDisease"
                        }
                    ],
                    "strength": "example",
                    "description": "The vaccine preventable disease the dose is being administered for.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/immunization-target-disease"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Guideline Target Disease"
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied.doseNumber[x]",
                "path": "Immunization.protocolApplied.doseNumber[x]",
                "short": "Dose number within series",
                "definition": "Nominal position in a series.",
                "comment": "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).",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Immunization.protocolApplied.doseNumber[x]",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "positiveInt"
                    },
                    {
                        "code": "string"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Dose Number"
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied.seriesDoses[x]",
                "path": "Immunization.protocolApplied.seriesDoses[x]",
                "short": "Recommended number of doses for immunity",
                "definition": "The recommended number of doses to achieve immunity.",
                "comment": "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).",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Immunization.protocolApplied.seriesDoses[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "positiveInt"
                    },
                    {
                        "code": "string"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Series Recommended Doses Count"
                    }
                ]
            }
        ]
    },
    "differential": {
        "element":  [
            {
                "id": "Immunization",
                "path": "Immunization",
                "constraint":  [
                    {
                        "key": "ca-core-im-1",
                        "severity": "warning",
                        "human": "Immunization records created during an encounter event are expected to have occurrence populated. Occurrence SHALL be present if the primarySource is 'true'",
                        "expression": "Immunization.primarySource = true implies Immunization.occurrence.exists()",
                        "source": "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/immunization-ca-core"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization"
                    }
                ]
            },
            {
                "id": "Immunization.status",
                "path": "Immunization.status",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Status"
                    }
                ]
            },
            {
                "id": "Immunization.statusReason",
                "path": "Immunization.statusReason",
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Reason Not Performed"
                    }
                ]
            },
            {
                "id": "Immunization.vaccineCode",
                "path": "Immunization.vaccineCode",
                "comment": "The additionalBinding extension will be used to express the valueSet for additional negation/exclusion codes for reporting the known absence of immunizations. At the time of this release, the publisher of the current ValueSet for absence codes (IPS) is developing a SNOMED ValueSet that will replace the current http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-immunizations-uv-ips",
                "type":  [
                    {
                        "code": "CodeableConcept",
                        "profile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
                        ]
                    }
                ],
                "mustSupport": true,
                "binding": {
                    "extension":  [
                        {
                            "extension":  [
                                {
                                    "url": "purpose",
                                    "valueCode": "preferred"
                                },
                                {
                                    "url": "valueSet",
                                    "valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/vaccinehistoricalnamecode"
                                },
                                {
                                    "url": "documentation",
                                    "valueMarkdown": "Recommended for use when conveying vaccine generic names for scenarios when brand name is not known or does not exist (e.g., immunization history where provider does not have detail of the trade name, the product has been discontinued and/or never licensed in Canada)."
                                }
                            ],
                            "url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
                        },
                        {
                            "extension":  [
                                {
                                    "url": "purpose",
                                    "valueCode": "preferred"
                                },
                                {
                                    "url": "valueSet",
                                    "valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/passiveadministeredimmunizingagentcode"
                                },
                                {
                                    "url": "documentation",
                                    "valueMarkdown": "per pCHDCF: Alternate value sets can be used when passive immunization products are used"
                                }
                            ],
                            "url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
                        },
                        {
                            "extension":  [
                                {
                                    "url": "purpose",
                                    "valueCode": "preferred"
                                },
                                {
                                    "url": "valueSet",
                                    "valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/passivehistoricalimmunizingagentcode"
                                },
                                {
                                    "url": "documentation",
                                    "valueMarkdown": "per pCHDCF: Alternate value sets can be used when passive immunization products are used"
                                }
                            ],
                            "url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
                        },
                        {
                            "extension":  [
                                {
                                    "url": "purpose",
                                    "valueCode": "preferred"
                                },
                                {
                                    "url": "valueSet",
                                    "valueCanonical": "http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-immunizations-uv-ips"
                                },
                                {
                                    "url": "documentation",
                                    "valueMarkdown": "Absent or unknown codes"
                                }
                            ],
                            "url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
                        }
                    ],
                    "strength": "preferred",
                    "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/vaccineadministeredtradenamecode"
                },
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Drug"
                    }
                ]
            },
            {
                "id": "Immunization.vaccineCode.coding",
                "path": "Immunization.vaccineCode.coding",
                "min": 1,
                "max": "1",
                "mustSupport": true
            },
            {
                "id": "Immunization.vaccineCode.coding.code",
                "path": "Immunization.vaccineCode.coding.code",
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Drug Code"
                    }
                ]
            },
            {
                "id": "Immunization.vaccineCode.coding.display",
                "path": "Immunization.vaccineCode.coding.display",
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Drug English Description",
                        "comment": "Display may be populated with english or french description depending on the context of the primary language for the user at the time this code is selected. Secondary or translated coding.display values should be conveyed using the translation extension"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Drug French Description",
                        "comment": "Display may be populated with english or french description depending on the context of the primary language for the user at the time this code is selected. Secondary or translated coding.display values should be conveyed using the translation extension"
                    }
                ]
            },
            {
                "id": "Immunization.patient",
                "path": "Immunization.patient",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core"
                        ]
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Patient"
                    }
                ]
            },
            {
                "id": "Immunization.patient.reference",
                "path": "Immunization.patient.reference",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Immunization.occurrence[x]",
                "path": "Immunization.occurrence[x]",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "type",
                            "path": "$this"
                        }
                    ],
                    "ordered": false,
                    "rules": "open"
                },
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Patient Provided Immunization Date"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Event Start Date Time"
                    }
                ]
            },
            {
                "id": "Immunization.occurrence[x].extension:data-absent-reason",
                "path": "Immunization.occurrence[x].extension",
                "sliceName": "data-absent-reason",
                "short": "effective[x] absence reason",
                "definition": "Provides a reason why the effective date or period is missing.",
                "comment": "Some Canadian implementations cannot guarantee that a procedure performed date will always be available in every instance of legacy data. Any implementers who do not require a performed date be available on every procedure need to be able to produce a dataAbsentReason extension in order to be conformant",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/data-absent-reason"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "Immunization.occurrence[x]:occurrenceDateTime",
                "path": "Immunization.occurrence[x]",
                "sliceName": "occurrenceDateTime",
                "comment": "This element is included in CACDI and is the preferred way to convey this data element.",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ]
            },
            {
                "id": "Immunization.reportOrigin.coding.code",
                "path": "Immunization.reportOrigin.coding.code",
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Reporting Source Code"
                    }
                ]
            },
            {
                "id": "Immunization.location",
                "path": "Immunization.location",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/location-ca-core"
                        ]
                    }
                ]
            },
            {
                "id": "Immunization.site",
                "path": "Immunization.site",
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Body Site Code"
                    }
                ]
            },
            {
                "id": "Immunization.route",
                "path": "Immunization.route",
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Route of Administration"
                    }
                ]
            },
            {
                "id": "Immunization.doseQuantity",
                "path": "Immunization.doseQuantity",
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Dose Quantity: Decimal"
                    },
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Dose Quantity: Unit"
                    }
                ]
            },
            {
                "id": "Immunization.performer.actor",
                "path": "Immunization.performer.actor",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitioner-ca-core",
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitionerRole-ca-core",
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core"
                        ]
                    }
                ],
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Provider"
                    }
                ]
            },
            {
                "id": "Immunization.reasonReference",
                "path": "Immunization.reasonReference",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/condition-ca-core",
                            "http://hl7.org/fhir/StructureDefinition/Observation",
                            "http://hl7.org/fhir/StructureDefinition/DiagnosticReport"
                        ]
                    }
                ]
            },
            {
                "id": "Immunization.subpotentReason",
                "path": "Immunization.subpotentReason",
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Subpotent Reason Code"
                    }
                ]
            },
            {
                "id": "Immunization.reaction",
                "path": "Immunization.reaction",
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Reaction"
                    }
                ]
            },
            {
                "id": "Immunization.reaction.date",
                "path": "Immunization.reaction.date",
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Reaction Date"
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied",
                "path": "Immunization.protocolApplied",
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Guideline"
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied.authority",
                "path": "Immunization.protocolApplied.authority",
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "published by Organization"
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied.targetDisease",
                "path": "Immunization.protocolApplied.targetDisease",
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Guideline Target Disease"
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied.doseNumber[x]",
                "path": "Immunization.protocolApplied.doseNumber[x]",
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Dose Number"
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied.seriesDoses[x]",
                "path": "Immunization.protocolApplied.seriesDoses[x]",
                "mapping":  [
                    {
                        "identity": "pCHDCF-CACDI",
                        "map": "Immunization Series Recommended Doses Count"
                    }
                ]
            }
        ]
    }
}

Terminology bindings

Path	Conformance	ValueSet
Immunization.vaccineCode	preferred	https://fhir.infoway-inforoute.ca/ValueSet/vaccineadministeredtradenamecode

Constraints

Path	Id	Grade	Details	Expression
Immunization	ca-core-im-1	warning	Immunization records created during an encounter event are expected to have occurrence populated. Occurrence SHALL be present if the primarySource is 'true'	Immunization.primarySource = true implies Immunization.occurrence.exists()

Immunization (CA-Core)

Links

Profile

Derived from

Examples

Description

References to this resource

Resource Content

Terminology bindings

Constraints