UK Core Implementation Guide 0.1.0 STU1

StructureDefinition-UKCore-Immunization

Defines the UK Core constraints and extensions on the Immunization resource for the minimal set of data to query and retrieve an individual’s immunisation information.

Profile Purpose

This profile is intended to cover the recording of current and historical administration of vaccines to individuals across all healthcare disciplines in all care settings and all regions. This profile does not support the administration of non-vaccine agents, even those that may have or claim to have immunological effects. While the terms "immunisation" and "vaccination" are not clinically identical, for the purposes of the FHIR profile, the terms are used synonymously.

Snapshot View

parentPresentI0..1Extension(boolean)
vaccinationProcedureI0..1Extension(CodeableConcept)
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
statusΣ ?! I1..1codeBinding
statusReasonI0..1CodeableConceptBinding
vaccineCodeΣ1..1CodeableConceptBinding
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
occurrenceDateTimedateTime
occurrenceStringstring
recorded0..1dateTime
primarySourceΣ0..1boolean
reportOrigin0..1CodeableConcept
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
lotNumber0..1string
expirationDate0..1date
site0..1CodeableConceptBinding
route0..1CodeableConceptBinding
doseQuantityI0..1SimpleQuantity
functionΣ0..1CodeableConceptBinding
actorΣ I1..1Reference(UK Core Practitioner | UK Core PractitionerRole | UK Core Organization)
authorStringstring
authorReferenceReference(UK Core Practitioner | UK Core Patient | UK Core RelatedPerson | UK Core Organization)
timeΣ0..1dateTime
textΣ1..1markdown
reasonCode0..*CodeableConceptBinding
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
isSubpotentΣ ?!0..1boolean
subpotentReason0..*CodeableConcept
documentType0..1string
reference0..1uri
publicationDate0..1dateTime
presentationDate0..1dateTime
programEligibility0..*CodeableConcept
fundingSource0..1CodeableConcept
date0..1dateTime
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
reported0..1boolean
series0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
targetDisease0..*CodeableConcept
doseNumberPositiveIntpositiveInt
doseNumberStringstring
seriesDosesPositiveIntpositiveInt
seriesDosesStringstring

Differential View

parentPresentI0..1Extension(boolean)
vaccinationProcedureI0..1Extension(CodeableConcept)
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
statusΣ ?! I1..1codeBinding
statusReasonI0..1CodeableConceptBinding
vaccineCodeΣ1..1CodeableConceptBinding
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
occurrenceDateTimedateTime
occurrenceStringstring
recorded0..1dateTime
primarySourceΣ0..1boolean
reportOrigin0..1CodeableConcept
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
lotNumber0..1string
expirationDate0..1date
site0..1CodeableConceptBinding
route0..1CodeableConceptBinding
doseQuantityI0..1SimpleQuantity
functionΣ0..1CodeableConceptBinding
actorΣ I1..1Reference(UK Core Practitioner | UK Core PractitionerRole | UK Core Organization)
authorStringstring
authorReferenceReference(UK Core Practitioner | UK Core Patient | UK Core RelatedPerson | UK Core Organization)
timeΣ0..1dateTime
textΣ1..1markdown
reasonCode0..*CodeableConceptBinding
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
isSubpotentΣ ?!0..1boolean
subpotentReason0..*CodeableConcept
documentType0..1string
reference0..1uri
publicationDate0..1dateTime
presentationDate0..1dateTime
programEligibility0..*CodeableConcept
fundingSource0..1CodeableConcept
date0..1dateTime
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
reported0..1boolean
series0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
targetDisease0..*CodeableConcept
doseNumberPositiveIntpositiveInt
doseNumberStringstring
seriesDosesPositiveIntpositiveInt
seriesDosesStringstring

Hybrid View

parentPresentI0..1Extension(boolean)
vaccinationProcedureI0..1Extension(CodeableConcept)
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
statusΣ ?! I1..1codeBinding
statusReasonI0..1CodeableConceptBinding
vaccineCodeΣ1..1CodeableConceptBinding
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
occurrenceDateTimedateTime
occurrenceStringstring
recorded0..1dateTime
primarySourceΣ0..1boolean
reportOrigin0..1CodeableConcept
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
lotNumber0..1string
expirationDate0..1date
site0..1CodeableConceptBinding
route0..1CodeableConceptBinding
doseQuantityI0..1SimpleQuantity
functionΣ0..1CodeableConceptBinding
actorΣ I1..1Reference(UK Core Practitioner | UK Core PractitionerRole | UK Core Organization)
authorStringstring
authorReferenceReference(UK Core Practitioner | UK Core Patient | UK Core RelatedPerson | UK Core Organization)
timeΣ0..1dateTime
textΣ1..1markdown
reasonCode0..*CodeableConceptBinding
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
isSubpotentΣ ?!0..1boolean
subpotentReason0..*CodeableConcept
documentType0..1string
reference0..1uri
publicationDate0..1dateTime
presentationDate0..1dateTime
programEligibility0..*CodeableConcept
fundingSource0..1CodeableConcept
date0..1dateTime
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
reported0..1boolean
series0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
targetDisease0..*CodeableConcept
doseNumberPositiveIntpositiveInt
doseNumberStringstring
seriesDosesPositiveIntpositiveInt
seriesDosesStringstring

Table View

Immunization..
Immunization.extension..
Immunization.extensionExtension..
Immunization.extensionExtension..
Immunization.identifier..
Immunization.identifier.assignerReference(UK Core Organization)..
Immunization.status..
Immunization.statusReason..
Immunization.vaccineCode..
Immunization.patientReference(UK Core Patient)..
Immunization.patient.type..
Immunization.patient.identifier..
Immunization.patient.identifier.assignerReference(UK Core Organization)..
Immunization.encounterReference(UK Core Encounter)..
Immunization.encounter.type..
Immunization.encounter.identifier..
Immunization.encounter.identifier.assignerReference(UK Core Organization)..
Immunization.locationReference(UK Core Location)..
Immunization.location.type..
Immunization.location.identifier..
Immunization.location.identifier.assignerReference(UK Core Organization)..
Immunization.manufacturerReference(UK Core Organization)..
Immunization.manufacturer.type..
Immunization.manufacturer.identifier..
Immunization.manufacturer.identifier.assignerReference(UK Core Organization)..
Immunization.site..
Immunization.route..
Immunization.performer..
Immunization.performer.actorReference(UK Core Practitioner | UK Core PractitionerRole | UK Core Organization)..
Immunization.note..
Immunization.note.author[x]Reference(UK Core Practitioner | UK Core Patient | UK Core RelatedPerson | UK Core Organization), string..
Immunization.reasonCode..
Immunization.reasonReferenceReference(UK Core Condition | UK Core Observation | UK Core DiagnosticReport)..
Immunization.reasonReference.type..
Immunization.reasonReference.identifier..
Immunization.reasonReference.identifier.assignerReference(UK Core Organization)..
Immunization.reaction..
Immunization.reaction.detailReference(UK Core Observation)..
Immunization.reaction.detail.type..
Immunization.reaction.detail.identifier..
Immunization.reaction.detail.identifier.assignerReference(UK Core Organization)..
Immunization.protocolApplied..
Immunization.protocolApplied.authorityReference(UK Core Organization)..
Immunization.protocolApplied.authority.type..
Immunization.protocolApplied.authority.identifier..
Immunization.protocolApplied.authority.identifier.assignerReference(UK Core Organization)..


XML View

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="UKCore-Immunization" />
    <url value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Immunization" />
    <version value="2.1.0" />
    <name value="UKCoreImmunization" />
    <title value="UK Core Immunization" />
    <status value="active" />
    <date value="2021-09-10" />
    <publisher value="HL7 UK" />
    <contact>
        <name value="HL7 UK" />
        <telecom>
            <system value="email" />
            <value value="secretariat@hl7.org.uk" />
            <use value="work" />
            <rank value="1" />
        </telecom>
    </contact>
    <contact>
        <name value="NHS Digital" />
        <telecom>
            <system value="email" />
            <value value="interoperabilityteam@nhs.net" />
            <use value="work" />
            <rank value="2" />
        </telecom>
    </contact>
    <description value="Defines the UK Core constraints and extensions on the Immunization resource for the minimal set of data to query and retrieve an individual’s immunisation information." />
    <purpose value="This profile is intended to cover the recording of current and historical administration of vaccines to individuals across all healthcare disciplines in all care settings and all regions. This profile does not support the administration of non-vaccine agents, even those that may have or claim to have immunological effects. While the terms &quot;immunisation&quot; and &quot;vaccination&quot; are not clinically identical, for the purposes of the FHIR profile, the terms are used synonymously." />
    <copyright value="Copyright &#169; 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the &quot;License&quot;); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an &quot;AS IS&quot; BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7&#174; FHIR&#174; standard Copyright &#169; 2011+ HL7 The HL7&#174; FHIR&#174; standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html." />
    <fhirVersion value="4.0.1" />
    <mapping>
        <identity value="workflow" />
        <uri value="http://hl7.org/fhir/workflow" />
        <name value="Workflow Pattern" />
    </mapping>
    <mapping>
        <identity value="v2" />
        <uri value="http://hl7.org/v2" />
        <name value="HL7 v2 Mapping" />
    </mapping>
    <mapping>
        <identity value="rim" />
        <uri value="http://hl7.org/v3" />
        <name value="RIM Mapping" />
    </mapping>
    <mapping>
        <identity value="w5" />
        <uri value="http://hl7.org/fhir/fivews" />
        <name value="FiveWs Pattern Mapping" />
    </mapping>
    <mapping>
        <identity value="cda" />
        <uri value="http://hl7.org/v3/cda" />
        <name value="CDA (R2)" />
    </mapping>
    <kind value="resource" />
    <abstract value="false" />
    <type value="Immunization" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Immunization" />
    <derivation value="constraint" />
    <differential>
        <element id="Immunization.extension">
            <path value="Immunization.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <rules value="open" />
            </slicing>
        </element>
        <element id="Immunization.extension:parentPresent">
            <path value="Immunization.extension" />
            <sliceName value="parentPresent" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ParentPresent" />
            </type>
        </element>
        <element id="Immunization.extension:vaccinationProcedure">
            <path value="Immunization.extension" />
            <sliceName value="vaccinationProcedure" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-VaccinationProcedure" />
            </type>
        </element>
        <element id="Immunization.identifier.assigner">
            <path value="Immunization.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="Immunization.status">
            <path value="Immunization.status" />
            <constraint>
                <key value="ukcore-imm-1" />
                <severity value="error" />
                <human value="If the immunization was not given then Immunization.status value MUST = &#39;not-done&#39;, and the Immunization.statusReason MUST be populated" />
                <expression value="status != &#39;not-done&#39; or (status = &#39;not-done&#39; and statusReason.exists())" />
                <source value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Immunization" />
            </constraint>
        </element>
        <element id="Immunization.statusReason">
            <path value="Immunization.statusReason" />
            <constraint>
                <key value="ukcore-imm-1" />
                <severity value="error" />
                <human value="If the immunization was not given then Immunization.status value MUST = &#39;not-done&#39;, and the Immunization.statusReason MUST be populated" />
                <expression value="status != &#39;not-done&#39; or (status = &#39;not-done&#39; and statusReason.exists())" />
                <source value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Immunization" />
            </constraint>
            <binding>
                <strength value="extensible" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-ReasonImmunizationNotAdministered" />
            </binding>
        </element>
        <element id="Immunization.vaccineCode">
            <path value="Immunization.vaccineCode" />
            <binding>
                <strength value="extensible" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-VaccineCode" />
            </binding>
        </element>
        <element id="Immunization.patient">
            <path value="Immunization.patient" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" />
            </type>
        </element>
        <element id="Immunization.patient.type">
            <path value="Immunization.patient.type" />
            <binding>
                <strength value="extensible" />
                <description value="A resource (or, for logical models, the URI of the logical model)." />
            </binding>
        </element>
        <element id="Immunization.patient.identifier.assigner">
            <path value="Immunization.patient.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="Immunization.encounter">
            <path value="Immunization.encounter" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter" />
            </type>
        </element>
        <element id="Immunization.encounter.type">
            <path value="Immunization.encounter.type" />
            <binding>
                <strength value="extensible" />
                <description value="A resource (or, for logical models, the URI of the logical model)." />
            </binding>
        </element>
        <element id="Immunization.encounter.identifier.assigner">
            <path value="Immunization.encounter.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="Immunization.location">
            <path value="Immunization.location" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Location" />
            </type>
        </element>
        <element id="Immunization.location.type">
            <path value="Immunization.location.type" />
            <binding>
                <strength value="extensible" />
                <description value="A resource (or, for logical models, the URI of the logical model)." />
            </binding>
        </element>
        <element id="Immunization.location.identifier.assigner">
            <path value="Immunization.location.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="Immunization.manufacturer">
            <path value="Immunization.manufacturer" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="Immunization.manufacturer.type">
            <path value="Immunization.manufacturer.type" />
            <binding>
                <strength value="extensible" />
                <description value="A resource (or, for logical models, the URI of the logical model)." />
            </binding>
        </element>
        <element id="Immunization.manufacturer.identifier.assigner">
            <path value="Immunization.manufacturer.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="Immunization.site">
            <path value="Immunization.site" />
            <binding>
                <strength value="extensible" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-ImmunizationAdministrationBodySite" />
            </binding>
        </element>
        <element id="Immunization.route">
            <path value="Immunization.route" />
            <binding>
                <strength value="extensible" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-SubstanceOrProductAdministrationRoute" />
            </binding>
        </element>
        <element id="Immunization.performer.actor">
            <path value="Immunization.performer.actor" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="Immunization.note.author[x]">
            <path value="Immunization.note.author[x]" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
            <type>
                <code value="string" />
            </type>
        </element>
        <element id="Immunization.reasonCode">
            <path value="Immunization.reasonCode" />
            <binding>
                <strength value="extensible" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-ImmunizationExplanationReason" />
            </binding>
        </element>
        <element id="Immunization.reasonReference">
            <path value="Immunization.reasonReference" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Condition" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-DiagnosticReport" />
            </type>
        </element>
        <element id="Immunization.reasonReference.type">
            <path value="Immunization.reasonReference.type" />
            <binding>
                <strength value="extensible" />
                <description value="A resource (or, for logical models, the URI of the logical model)." />
            </binding>
        </element>
        <element id="Immunization.reasonReference.identifier.assigner">
            <path value="Immunization.reasonReference.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="Immunization.reaction.detail">
            <path value="Immunization.reaction.detail" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation" />
            </type>
        </element>
        <element id="Immunization.reaction.detail.type">
            <path value="Immunization.reaction.detail.type" />
            <binding>
                <strength value="extensible" />
                <description value="A resource (or, for logical models, the URI of the logical model)." />
            </binding>
        </element>
        <element id="Immunization.reaction.detail.identifier.assigner">
            <path value="Immunization.reaction.detail.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="Immunization.protocolApplied.authority">
            <path value="Immunization.protocolApplied.authority" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="Immunization.protocolApplied.authority.type">
            <path value="Immunization.protocolApplied.authority.type" />
            <binding>
                <strength value="extensible" />
                <description value="A resource (or, for logical models, the URI of the logical model)." />
            </binding>
        </element>
        <element id="Immunization.protocolApplied.authority.identifier.assigner">
            <path value="Immunization.protocolApplied.authority.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
    </differential>
</StructureDefinition>

JSON View

{
    "resourceType": "StructureDefinition",
    "id": "UKCore-Immunization",
    "url": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Immunization",
    "version": "2.1.0",
    "name": "UKCoreImmunization",
    "title": "UK Core Immunization",
    "status": "active",
    "date": "2021-09-10",
    "publisher": "HL7 UK",
    "contact":  [
        {
            "name": "HL7 UK",
            "telecom":  [
                {
                    "system": "email",
                    "value": "secretariat@hl7.org.uk",
                    "use": "work",
                    "rank": 1
                }
            ]
        },
        {
            "name": "NHS Digital",
            "telecom":  [
                {
                    "system": "email",
                    "value": "interoperabilityteam@nhs.net",
                    "use": "work",
                    "rank": 2
                }
            ]
        }
    ],
    "description": "Defines the UK Core constraints and extensions on the Immunization resource for the minimal set of data to query and retrieve an individual’s immunisation information.",
    "purpose": "This profile is intended to cover the recording of current and historical administration of vaccines to individuals across all healthcare disciplines in all care settings and all regions. This profile does not support the administration of non-vaccine agents, even those that may have or claim to have immunological effects. While the terms \"immunisation\" and \"vaccination\" are not clinically identical, for the purposes of the FHIR profile, the terms are used synonymously.",
    "copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html.",
    "fhirVersion": "4.0.1",
    "mapping":  [
        {
            "identity": "workflow",
            "uri": "http://hl7.org/fhir/workflow",
            "name": "Workflow Pattern"
        },
        {
            "identity": "v2",
            "uri": "http://hl7.org/v2",
            "name": "HL7 v2 Mapping"
        },
        {
            "identity": "rim",
            "uri": "http://hl7.org/v3",
            "name": "RIM Mapping"
        },
        {
            "identity": "w5",
            "uri": "http://hl7.org/fhir/fivews",
            "name": "FiveWs Pattern Mapping"
        },
        {
            "identity": "cda",
            "uri": "http://hl7.org/v3/cda",
            "name": "CDA (R2)"
        }
    ],
    "kind": "resource",
    "abstract": false,
    "type": "Immunization",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Immunization",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Immunization.extension",
                "path": "Immunization.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "rules": "open"
                }
            },
            {
                "id": "Immunization.extension:parentPresent",
                "path": "Immunization.extension",
                "sliceName": "parentPresent",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ParentPresent"
                        ]
                    }
                ]
            },
            {
                "id": "Immunization.extension:vaccinationProcedure",
                "path": "Immunization.extension",
                "sliceName": "vaccinationProcedure",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-VaccinationProcedure"
                        ]
                    }
                ]
            },
            {
                "id": "Immunization.identifier.assigner",
                "path": "Immunization.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "Immunization.status",
                "path": "Immunization.status",
                "constraint":  [
                    {
                        "key": "ukcore-imm-1",
                        "severity": "error",
                        "human": "If the immunization was not given then Immunization.status value MUST = 'not-done', and the Immunization.statusReason MUST be populated",
                        "expression": "status != 'not-done' or (status = 'not-done' and statusReason.exists())",
                        "source": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Immunization"
                    }
                ]
            },
            {
                "id": "Immunization.statusReason",
                "path": "Immunization.statusReason",
                "constraint":  [
                    {
                        "key": "ukcore-imm-1",
                        "severity": "error",
                        "human": "If the immunization was not given then Immunization.status value MUST = 'not-done', and the Immunization.statusReason MUST be populated",
                        "expression": "status != 'not-done' or (status = 'not-done' and statusReason.exists())",
                        "source": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Immunization"
                    }
                ],
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-ReasonImmunizationNotAdministered"
                }
            },
            {
                "id": "Immunization.vaccineCode",
                "path": "Immunization.vaccineCode",
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-VaccineCode"
                }
            },
            {
                "id": "Immunization.patient",
                "path": "Immunization.patient",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient"
                        ]
                    }
                ]
            },
            {
                "id": "Immunization.patient.type",
                "path": "Immunization.patient.type",
                "binding": {
                    "strength": "extensible",
                    "description": "A resource (or, for logical models, the URI of the logical model)."
                }
            },
            {
                "id": "Immunization.patient.identifier.assigner",
                "path": "Immunization.patient.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "Immunization.encounter",
                "path": "Immunization.encounter",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter"
                        ]
                    }
                ]
            },
            {
                "id": "Immunization.encounter.type",
                "path": "Immunization.encounter.type",
                "binding": {
                    "strength": "extensible",
                    "description": "A resource (or, for logical models, the URI of the logical model)."
                }
            },
            {
                "id": "Immunization.encounter.identifier.assigner",
                "path": "Immunization.encounter.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "Immunization.location",
                "path": "Immunization.location",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Location"
                        ]
                    }
                ]
            },
            {
                "id": "Immunization.location.type",
                "path": "Immunization.location.type",
                "binding": {
                    "strength": "extensible",
                    "description": "A resource (or, for logical models, the URI of the logical model)."
                }
            },
            {
                "id": "Immunization.location.identifier.assigner",
                "path": "Immunization.location.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "Immunization.manufacturer",
                "path": "Immunization.manufacturer",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "Immunization.manufacturer.type",
                "path": "Immunization.manufacturer.type",
                "binding": {
                    "strength": "extensible",
                    "description": "A resource (or, for logical models, the URI of the logical model)."
                }
            },
            {
                "id": "Immunization.manufacturer.identifier.assigner",
                "path": "Immunization.manufacturer.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "Immunization.site",
                "path": "Immunization.site",
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-ImmunizationAdministrationBodySite"
                }
            },
            {
                "id": "Immunization.route",
                "path": "Immunization.route",
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-SubstanceOrProductAdministrationRoute"
                }
            },
            {
                "id": "Immunization.performer.actor",
                "path": "Immunization.performer.actor",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "Immunization.note.author[x]",
                "path": "Immunization.note.author[x]",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    },
                    {
                        "code": "string"
                    }
                ]
            },
            {
                "id": "Immunization.reasonCode",
                "path": "Immunization.reasonCode",
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-ImmunizationExplanationReason"
                }
            },
            {
                "id": "Immunization.reasonReference",
                "path": "Immunization.reasonReference",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Condition",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-DiagnosticReport"
                        ]
                    }
                ]
            },
            {
                "id": "Immunization.reasonReference.type",
                "path": "Immunization.reasonReference.type",
                "binding": {
                    "strength": "extensible",
                    "description": "A resource (or, for logical models, the URI of the logical model)."
                }
            },
            {
                "id": "Immunization.reasonReference.identifier.assigner",
                "path": "Immunization.reasonReference.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "Immunization.reaction.detail",
                "path": "Immunization.reaction.detail",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation"
                        ]
                    }
                ]
            },
            {
                "id": "Immunization.reaction.detail.type",
                "path": "Immunization.reaction.detail.type",
                "binding": {
                    "strength": "extensible",
                    "description": "A resource (or, for logical models, the URI of the logical model)."
                }
            },
            {
                "id": "Immunization.reaction.detail.identifier.assigner",
                "path": "Immunization.reaction.detail.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied.authority",
                "path": "Immunization.protocolApplied.authority",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "Immunization.protocolApplied.authority.type",
                "path": "Immunization.protocolApplied.authority.type",
                "binding": {
                    "strength": "extensible",
                    "description": "A resource (or, for logical models, the URI of the logical model)."
                }
            },
            {
                "id": "Immunization.protocolApplied.authority.identifier.assigner",
                "path": "Immunization.protocolApplied.authority.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            }
        ]
    }
}

Examples

Influenza virus vaccine - An example to illustrate a Influenza virus vaccine.

Example UKCore-Immunization-Procedure

Example Usage Scenarios

The following are example usage scenarios for the UK Core Immunization profile:

  • Query and retrieve an individual’s immunisations (vaccinations)
  • Record or update an individual’s immunisations (vaccinations).

Profile specific implementation guidance:

extension: parentPresent

Extension UKCore-ParentPresent which indicates if a parent was present at an immunisation.


extension: vaccinationProcedure

Extension UKCore-VaccinationProcedure to hold an immunization procedure code.

Where status=completed this is Mandatory. This relates to the vaccine that was administered (procedure) and is a SNOMED CT from ValueSet UKCoreVaccinationProcedure


identifier

A unique identifier assigned to this immunization record.

identifier.system

A URI for the system that has allocated the vaccination identifier. Note, this must be unique within a given Supplier system or instance of Supplier system.

e.g.

  1. Example of a “single instance for all customers” Supplier system https://supplierABC/identifiers/vacc.

  2. Example of “per customer instance” Supplier system https://supplierABC/ODSCode/NKO41/identifiers/vacc.

identifier.value

A unique identifier for the vaccination record, that is consistent between any subsequent update or delete records.

Ideally this would be a GUID / UUID.

Value in combination with UNIQUE_ID_URI must be globally unique. In other words, a combination of identifier.value and identifier.system act as composite primary key to allow lookup of any Adverse Reactions records from the corresponding Adverse Reaction data file.

  1. UUID example: e045626e-4dc5-4df3-bc35-da25263f901e

  2. Example of a “single instance for all customers” Supplier system ACME-vacc123456.

  3. Example of “per customer instance” Supplier system ACME-CUSTOMER1-vacc123456 ACME-CUSTOMER2-vacc123456.


status

Indicates the current status of the immunization event.

For a vaccination that has been administered, the status will be completed. This status does not indicate a vaccination course has been completed. When the vaccination has not been administered, the status will be not-done and a statusReason should be supplied.


statusReason

Indicates the reason the immunization event was not performed using a code from the ValueSet UKCoreReasonImmunizationNotAdministered.


vaccineCode

Vaccine that was administered or was to be administered.

Where status is completed this is Mandatory. This indicates vaccine product administered. This should be a SNOMED CT code from ValueSet UKCoreVaccineCode AMPP codes should not be used.


XML

<vaccineCode>
    <coding>
        <system value="http://snomed.info/sct" />
        <code value="39114911000001105" />
        <display value="COVID-19 Vaccine AstraZeneca (ChAdOx1 S [recombinant]) 5x10,000,000,000 viral particles/0.5ml dose solution for injection multidose vials (AstraZeneca)" />
    </coding>
</vaccineCode>

JSON

{
"vaccineCode": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "39114911000001105",
                "display": "COVID-19 Vaccine AstraZeneca (ChAdOx1 S [recombinant]) 5x10,000,000,000 viral particles/0.5ml dose solution for injection multidose vials (AstraZeneca)"
            }
        ]
    },
}


For EU/international purposes, a vaccination type code can be also be included. The SNOMED CT concept should be from Vaccines (GPS) - IPS and EU SNOMED CT Vaccine List (COVID-19).

XML

 <vaccineCode>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="39114911000001105" />
            <display value="COVID-19 Vaccine AstraZeneca (ChAdOx1 S [recombinant]) 5x10,000,000,000 viral particles/0.5ml dose solution for injection multidose vials (AstraZeneca)" />
        </coding>
		<coding>
		     <system value="http://snomed.info/sct" />
            <code value="1119305005" />
            <display value="SARS-CoV-2 antigen vaccine" />
		</coding>
 </vaccineCode> 

JSON

{
    "vaccineCode": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "39114911000001105",
                "display": "COVID-19 Vaccine AstraZeneca (ChAdOx1 S [recombinant]) 5x10,000,000,000 viral particles/0.5ml dose solution for injection multidose vials (AstraZeneca)"
            },
            {
                "system": "http://snomed.info/sct",
                "code": "1119305005",
                "display": "SARS-CoV-2 antigen vaccine"
            }
        ]
    },
}


patient

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

Only traced NHS/CHI/HSCNI Numbers SHOULD be used.

JSON

{
"patient": {
                    "reference": "urn:uuid:edea022a-2d81-11eb-adc1-0242ac120002",
                    "type": "Patient",
                    "identifier": {
                        "system": "https://fhir.nhs.uk/Id/nhs-number",
                        "value": "9912003888"
                    }
                },
}

Provider Systems

Provider systems MUST provide a reference and/or identifier MUST be provided that allows the consumer system to query another API if they need to access the complete UKCore-Patient resource.

Consumer Systems

Consumer systems MUST consume this data.


encounter

Implementation guidance is pending further analysis for the potential use of this element.


occurrence

Date vaccine administered or was to be administered.


recorded

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


primarySource

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.

Set as true when the content of the record is based on information from the person performing the vaccine or who has clinical responsibility for the vaccination, and the system can be considered a primary source of the vaccination event. Set as false when the information has NOT come directly from people performing the vaccine (e.g. a patient or patient’s carer), and the system should not be treated as a primary source for this record. This is used to help identify and eliminate duplicate records held centrally.


reportOrgin

The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.

Should not be populated if primarySource = true, not required even if primarySource = false.

XML

<reportOrigin>
    <text value="RR8 - LEEDS TEACHING HOSPITALS NHS TRUST"/>
</reportOrign>

JSON

{
"reportOrigin": {
        "text": "RR8 - LEEDS TEACHING HOSPITALS NHS TRUST"
    },
}


location

The service delivery location where the vaccine administration occurred.


manufacturer

Name of vaccine manufacturer.

XML

<manufacturer>
    <display value="DREAMLAND Pharmaceuticals Ltd"/>
</manufacturer>


JSON

{
"manufacturer": {
        "display": "DREAMLAND Pharmaceuticals Ltd"
    },
}


lotNumber

Lot number of the vaccine product.

Where status=completed this SHOULD be present.

This should be captured at source ideally via use of automated scanning technology (GS1 GTIN / NTIN standard).

XML

<lotNumber value="R04X"/>

JSON

{
   "lotNumber": "R04X",
   }


expirationDate

Date vaccine batch expires.


site

Body site where vaccine was administered.

Body site vaccine was administered into. A SNOMED Concept ID value from UK published reference set “Vaccine body site of administration simple reference set” (1127941000000100) should be used ValueSet UKCoreBodySite.

XML

<site>
    <coding>
        <system value="http://snomed.info/sct"/>
        <code value="368208006"/>
        <display value="Left upper arm structure (body structure)"/>
    </coding>
 </site>   

JSON


{
    "site": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "368208006",
                "display": "Left upper arm structure (body structure)"
            }
        ]
    },
}


route

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

A SNOMED concept ID value from either of the following should be used:
UK “ePrescribing route of administration simple reference set (foundation metadata concept)” (999000051000001100)
Or:
UK published reference set “Vaccine route of administration simple reference set” (115231000001104).

XML

<route>
    <coding>
        <system value="http://snomed.info/sct"/>
        <code value="78421000"/>
        <display value="Intramuscular route (qualifier value)"/>
    </coding>
</route>    

JSON

{
 "route": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "78421000",
                "display": "Intramuscular route (qualifier value)"
            }
        ]
    },
}


doseQuantity

The quantity of vaccine product that was administered.

A dm+d (SNOMED) Concept ID value representing the Unit of measure used.

For COVID-19 a reference set has been published here: https://dd4c.digital.nhs.uk/dd4c/publishedmetadatas/intid/980?size=10.

XML

<doseQuantity>
        <value value="1"/>
        <unit value=""pre-filled disposable injection"/>
        <system value="http://snomed.info/sct"/>
        <code value="3318611000001100/>
</doseQuanity>

JSON

{
 "doseQuantity": {
        "value": 1,
        "unit": "pre-filled disposable injection",
        "system": "http://snomed.info/sct",
        "code": "3318611000001100"
    },
}


performer

Indicates who performed the immunization event.

XML

<performer>
    <actor>
        <type value="Practitioner"/>
            <identifier>
                <system value="https://fhir.hl7.org.uk/Id/nmc-number"/>
                <value value="5566789"/>
                <display value="HOLDING, Rafferty"/>
            </identifer>
    </actor>            
    <actor>
        <type value="Organization"/>
            <identifier>
                <system value="https://fhir.nhs.uk/Id/ods-organization-code"/>
                <value value="C4B2A"/>
                <display value="ELLAND ROAD STADIUM - COVID VACCINATION CENTRE"/>
            </identifer>
    </actor>
</performer>


JSON

{
"performer":  [
        {
            "actor": {
                "type": "Practitioner",
                "identifier": {
                    "system": "https://fhir.hl7.org.uk/Id/nmc-number",
                    "value": "5566789"
                },
                "display": "HOLDING, Rafferty"
            }
        },
        {
            "actor": {
                "type": "Organization",
                "identifier": {
                    "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                    "value": "C4B2A"
                },
                "display": "ELLAND ROAD STADIUM - COVID VACCINATION CENTRE"
            }
        }
    ],
}


note

An optional element for when the clinical user wishes to provides supporting textual information for the allergy record that cannot be conveyed within other elements of the resource.

Provider Systems

Where a provider system only has the capability to record a note at one level it should populate the AllergyIntolerance.note elements with any notes data captured within the system, irrespective of the data level that the system uses to capture that data.

Where a provider system has the capability to record a note at both the AllergyIntolerance and at the AllergyIntolerance.reaction level it should populate both with the relevant notes applicable to each level.

Consumer Systems

Consumer systems MUST be able to handle both multiple AllergyIntolerance.note and multiple AllergyIntolerance.reaction.note elements.


reasonCode

Reasons why the vaccine was administered.

For SNOMED Concepts for COVID19 and Flu see https://digital.nhs.uk/developer/api-catalogue/vaccination as an example of what has been implemented by NHS Digital.


reasonReference

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


isSubpotent

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


subpotentReason

Reason why a dose is considered to be subpotent.


education

Educational material presented to the patient (or guardian) at the time of vaccine administration.


programEligibility

Indicates a patient's eligibility for a funding program.


fundingSource

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).


reaction

Details about each adverse reaction event linked to exposure to the identified substance.

The AllergyIntolerance.reaction is optional, but where a severity is available in the provider system it MUST be included to convey severity even if no other reaction details are explicitly available. If this is the case the AllergyIntolerance.reaction.manifestation MUST be coded as the nullFlavor NI.

Element: reaction.substance

An optional element to record the specific substance or pharmaceutical product considered to be responsible for event.

Provider Systems

When recording a reaction to a medication substance, the provider system should use a dm+d concept class.

  • National Health Service dictionary of medicines and devices combination drug Virtual Therapeutic Moiety (VTM) – just the drugs, no formulation. May be additional concepts to those in the SNOMED-CT hierarchy.
  • National Health Service dictionary of medicines and devices Virtual Medicinal Product (VMP) - generic drug products and also generic appliance/ device concepts. May be additional concepts to those in the SNOMED-CT hierarchy and will support the recording of allergies to bandages and dressings etc. Device/appliances are concepts that would not be within scope of the SNOMED-CT pharmaceutical/biologic product hierarchy.
  • National Health Service dictionary of medicines and devices Actual Medicinal Product (AMP) – branded drug products and branded appliance/device concepts that would not be within scope of the SNOMED-CT pharmaceutical/ biologic product hierarchy.
  • National Health Service dictionary of medicines and devices ingredient – just the drug ingredients, no formulation. May be additional concepts to those in the SNOMED-CT hierarchy. Important to have this in addition to VTM as some things may be more specific at VTM level for example things only available as combinations where VTM would only be the combination also VTM may not identify the salt but this concept class would support that.

Alternatively, the reaction substance can be recorded using a SNOMED CT code from a union of the following.

Consumer Systems

Consumer systems may consume this data.

Element: reaction.manifestation (Mandatory)

A mandatory element if a reaction is recorded for the clinical symptoms and/or signs that are observed or associated with the adverse reaction event.

Use nullFlavour NI for the case when a reaction.severity needs to be shared but where a manifestation is not known.

Element: reaction.description

An optional text description about the reaction as a whole, including more verbose details of the manifestation if required.

Element: reaction.onset

An optional date or date/time when the manifestation showed.

This FHIR element may be populated if known.

Element: reaction.severity

An optional value from a required terminology binding containing the values;

  • mild
  • moderate
  • severe

Provider Systems

Where a severity is available in the provider system it MUST be included to convey severity even if no other reaction details are explicitly available.

Where the severity is not known, this element should be omitted.

Consumer Systems

Use of this element when populated as severe may be used to express life threatening allergies, used in conjunction with the AllergyIntolerance.criticality element.

An omitted severity will either mean severity date is not available within the provider system or the severity is not known by the provider system.

Element: reaction.exposureRoute

An optional element to identify the route by which the patient was exposed to the substance.

Provider Systems

If this data is available the binding should be to the 999000051000001100 | ePrescribing route of administration simple reference set.

Consumer Systems

Consumer systems are recommended not to include this coded information within automated clinical decision support. This is because it could either mean two quite different things;

  1. The reaction only occurs if the substance enters the body via the specified route, implying the use of other routes is safe.

OR

  1. The reaction was identified when the substance entered the body via the specified route, but could also react when using other routes.

Element: reaction.note

An optional element for when the clinical user wishes to provides supporting textual information for the reaction that cannot be conveyed within other elements of the backbone element.

See the related guidance above for AllergyIntolerance.note.


protocolApplied

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

doseNumberPositiveInt Nominal position in a series of vaccines, N.B. This field will not always be reliable, therefore for Covid vaccinations, the vaccination procedure code or situation code should be used as that includes the dose number.

JSON


{"protocolApplied":  [
        {
            "doseNumberPositiveInt": 1
        }
    ]
}


It is recommended for international/EU interoperability targetDisease is populated. The SNOMED CT concept should be from EU COVID-19 Diseases or Vaccine Target Diseases (GPS) - IPS.

Disease UK SNOMED self
COVID-19 840539006
Others See Vaccine Target Diseases (GPS) - IPS

JSON


  "protocolApplied": [
    {
        "targetDisease": [
            {
                "coding": [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "840539006",
                        "display": "COVID-19"
                    }
                ]
            }
        ],
        "doseNumberPositiveInt": 1
    }
]



SNOMED CT codes relating to COVID-19 Vaccination

A complete list of SNOMED CT Codes relating to this profile can be found here SNOMED CT codes relating to COVID-19 Vaccination.


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