{
  "resourceType": "Immunization",
  "id": "4890c87a-e6f2-4037-9905-aeaff944a3cb",
  "meta": {
    "profile": [
      "https://fhir.kbv.de/StructureDefinition/KBV_PR_MIO_Vaccination_Record_Addendum|1.1.0"
    ]
  },
  "extension": [
    {
      "url": "https://fhir.kbv.de/StructureDefinition/KBV_EX_MIO_Vaccination_Entry_Type",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "https://fhir.kbv.de/CodeSystem/KBV_CS_MIO_Vaccination_Technical_Entry_Type",
            "code": "End",
            "display": "Eintrag nur digital"
          }
        ]
      }
    },
    {
      "extension": [
        {
          "url": "mode",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://hl7.org/fhir/composition-attestation-mode",
                "code": "legal"
              }
            ]
          }
        },
        {
          "url": "party",
          "valueReference": {
            "reference": "urn:uuid:0d38b9ea-6125-43d8-a8d5-0ec03fe91996"
          }
        }
      ],
      "url": "https://fhir.kbv.de/StructureDefinition/KBV_EX_MIO_Vaccination_Attester_Addendum"
    },
    {
      "extension": [
        {
          "url": "mode",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                "code": "ENT"
              }
            ]
          }
        },
        {
          "url": "party",
          "valueReference": {
            "reference": "urn:uuid:ebefcfca-7168-40e5-8918-7af38c7f10c9"
          }
        }
      ],
      "url": "https://fhir.kbv.de/StructureDefinition/KBV_EX_MIO_Vaccination_Enterer"
    }
  ],
  "status": "completed",
  "vaccineCode": {
    "text": "Pockenimpfstoff"
  },
  "patient": {
    "reference": "urn:uuid:7eb1aef1-a24e-42e0-926d-904470d044dc"
  },
  "occurrenceDateTime": "2019-12-23",
  "primarySource": false,
  "reportOrigin": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/immunization-origin",
        "code": "recall"
      }
    ],
    "text": "Eltern/Patienten Erinnerung"
  },
  "protocolApplied": [
    {
      "targetDisease": [
        {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "version": "http://snomed.info/sct/900000000000207008/version/20210131",
              "code": "67924001",
              "display": "Smallpox (disorder)",
              "_display": {
                "extension": [
                  {
                    "extension": [
                      {
                        "url": "content",
                        "valueString": "Pocken"
                      }
                    ],
                    "url": "https://fhir.kbv.de/StructureDefinition/KBV_EX_Base_Terminology_German"
                  }
                ]
              }
            }
          ]
        }
      ],
      "_doseNumberString": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
            "valueCode": "unknown"
          }
        ]
      }
    }
  ]
}