<status value="draft" /> <date value="2024-02-01T19:39:15.322061+00:00" /> <publisher value="Ontario Health" /> <description value="This profile defines a set of constraints to the FHIR Immunization resource for use in Ontario Patient Summaries (PS-ON). It refines constraints applied to the Immunization resource by the PS-CA project to represent a record of immunization in the patient summary. It is informed by the constraints of the [Immunization-UV-IPS profile](http://hl7.org/fhir/uv/ips/StructureDefinition-Immunization-uv-ips.html) and the [Canadian Baseline Profile](http://build.fhir.org/ig/HL7-Canada/ca-baseline/branches/master/StructureDefinition-profile-immunization.html) to allow for cross-border and cross-jurisdiction sharing of Medication Summary information. It describes the event of a patient being administered a vaccination or a record of a vaccination as reported by a patient, a clinician or another party." /> <fhirVersion value="4.0.1" /> <kind value="resource" /> <abstract value="false" /> <type value="Immunization" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Immunization" /> <derivation value="constraint" /> <differential> <element id="Immunization.meta"> <path value="Immunization.meta" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Immunization.meta.profile"> <path value="Immunization.meta.profile" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Immunization.status"> <path value="Immunization.status" /> <mustSupport value="true" /> </element> <element id="Immunization.vaccineCode"> <path value="Immunization.vaccineCode" /> <short value="Vaccine that was administered or was to be administered. IPS-UV Note: Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent/unknown code. Other coded information can be provided as well as: the Pharmaceutical and medicinal product identifiers, when available, or equivalent coded concepts; the WHO ATC codes; or any other kind of code that that identifies, classifies or cluster the administered product." /> <definition value="Vaccine that was administered or was to be administered." /> <comment value="PS-CA Note: Work is underway to define the pan-Canadian terminology that will be preferred and/or socialized for vaccine.code. IPS-UV Note: Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunized is provided; or the known absent/unknown. Other coded information can be provided as well as: 1. The IDMP Pharmaceutical Product Identifier (PhPID), Level 1, [Substance(s)]. Example: Amoxicillin and Clavulanate Potassium; or any other equivalent coded concept. 1. The IDMP Pharmaceutical Product Identifier (PhPID), Level 2 [Substance(s) + Strength + reference strength]. Example: Amoxicillin 875 mg and Clavulanate Potassium 125 mg; or any other equivalent coded concept. 1. The IDMP Pharmaceutical Product Identifier (PhPID), Level 3 [Substance(s) + administrable dose form]. Example: Amoxicillin and Clavulanate Potassium, Oral Tablet; or any other equivalent coded concept. 1. The IDMP Pharmaceutical Product Identifier (PhPID), Level 4 [Substance(s) + strength + reference strength + administrable dose form]. Example: Amoxicillin 875 mg and clavulanate potassium 125 mg, oral tablet; or any other equivalent coded concept. 1. The IDMP Medicinal Product Identifier (MPID) or any equivalent Medicinal Product Identifier. IDMP MPID uniquely identifies a Medicinal Product, reflecting (but not replacing) any other authorization numbers allocated by a regulator. MPID implies one (set of) PhPID. The MPID shall use a common segment pattern related to a Medicinal Product, which, when each segment is valued shall define a specific MPID concept. 1. The IDMP Packaged Medicinal Product Identifier (PCID) or any equivalent Packaged Medicinal Product Identifier. Uniquely identifies a Medicinal Product based on its packaging. This implies one MPID can be associated with more than one PCID, if the same Medicinal Product has more than one type of package. 1. Any other kind of code that that identifies, classifies or clusters the administered product (e.g. the medicinal product or the product class). The value sets used for the PhPID, MPID and PCID identifiers are provisional and include only few equivalent concepts used for exemplification purposes, they will be updated with real IDMP identifiers when they will become available." /> <min value="1" /> <max value="1" /> <type> <code value="CodeableConcept" /> <profile value="http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-codeableconcept" /> </type> <mustSupport value="true" /> <binding> <strength value="preferred" /> <description value="Codes from the Canadian Vaccine Catalogue Generic Value Set. Use of Tradename Value Set is equivalently preferred" /> <valueSet value="http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-Generic" /> </binding> </element> <element id="Immunization.vaccineCode.coding"> <path value="Immunization.vaccineCode.coding" /> <slicing> <discriminator> <type value="pattern" /> <path value="$this" /> </discriminator> <description value="Discriminated by bound value set" /> <rules value="open" /> </slicing> <type> <code value="Coding" /> <profile value="http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-coding" /> </type> <mustSupport value="true" /> </element> <element id="Immunization.vaccineCode.coding:vaccineIPSCode"> <path value="Immunization.vaccineCode.coding" /> <sliceName value="vaccineIPSCode" /> <short value="Optional slice for representing the code for vaccine from the SNOMED CT IPS code set" /> <definition value="Code for a vaccine that is selected from the SNOMED CT IPS code set." /> <max value="1" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="vaccineIPS" /> </extension> <strength value="required" /> <valueSet value="http://hl7.org/fhir/uv/ips/ValueSet/vaccines-uv-ips" /> </binding> </element> <element id="Immunization.vaccineCode.coding:atcClass"> <path value="Immunization.vaccineCode.coding" /> <sliceName value="atcClass" /> <short value="Optional slice for representing the vaccine code from the WHO ATC classification" /> <definition value="WHO ATC classification" /> <comment value="The IPS-UV considers this slice MS in STU1, however the impacts of applying MS on terminology slices have been brought forward to the IPS-UV FHIR authors and removal of the MS flag on optional slices is currently being discussed." /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="WHO ATC" /> </extension> <strength value="required" /> <valueSet value="http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips" /> </binding> </element> <element id="Immunization.vaccineCode.coding:Generic"> <path value="Immunization.vaccineCode.coding" /> <sliceName value="CVCGeneric" /> <definition value="Generic Immunizing Agent" /> <comment value="Generic Immunizing Agents subset contains generically described vaccines and passive immunizing agents used in Canada. It is an extension of the Pan-Canadian Immunization Reference Sets Vaccine Historical Name Code and Passive Historical Immunizing Agent Code subset developed by Canada Health Infoway. **Please note** that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: [https://cvc.canimmunize.ca/en/explore#/](https://cvc.canimmunize.ca/en/explore#/)" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="CVCGeneric" /> </extension> <strength value="required" /> <valueSet value="http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-Generic" /> </binding> </element> <element id="Immunization.vaccineCode.coding:Tradename"> <path value="Immunization.vaccineCode.coding" /> <sliceName value="CVCTradename" /> <definition value="Tradename Immunizing Agent" /> <comment value="Tradename Immunizing Agents subset contains tradenames of vaccines and passive immunizing agents used in Canada. It is an extension of the Pan-Canadian Immunization Reference Sets Vaccine Administered Trade Name Code and Immunioglobulin Code subset developed by Canada Health Infoway. **Please note** that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: [https://cvc.canimmunize.ca/en/explore#/](https://cvc.canimmunize.ca/en/explore#/)" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="CVCTradename" /> </extension> <strength value="required" /> <valueSet value="http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-Tradename" /> </binding> </element> <element id="Immunization.vaccineCode.coding:absentOrUnknownImmunization"> <path value="Immunization.vaccineCode.coding" /> <sliceName value="absentOrUnknownImmunization" /> <short value="Optional slice for representing the codes for an Absent or Unknown Immunization" /> <definition value="A reference to a code indicating that there there are no known immunizations or that this information is unknown." /> <comment value="This slice is kept as must support to ensure that systems proving conformance can show that they can produce a value indicating that an immunization is absent or unknown (similar to approach with keeping must support flags on data absent reason extensions)" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Absent Unknown Immunization" /> </extension> <strength value="required" /> <valueSet value="http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-immunizations-uv-ips" /> </binding> </element> <element id="Immunization.patient"> <path value="Immunization.patient" /> <type> <code value="Reference" /> <targetProfile value="http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-patient" /> </type> <mustSupport value="true" /> </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]" /> <min value="1" /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Immunization.occurrence[x].extension"> <path value="Immunization.occurrence[x].extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> </element> <element id="Immunization.occurrence[x].extension:data-absent-reason"> <path value="Immunization.occurrence[x].extension" /> <sliceName value="data-absent-reason" /> <short value="occurrence[x] absence reason" /> <definition value="Provides a reason why the occurrence is missing." /> <comment value="**Note to implementers:** Path to this element in the FHIR Artifact is ~Immunization.occurrence[x].extension:data-absent-reason~ although it may be redering incorrectly in Simplifier." /> <max value="1" /> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/data-absent-reason" /> </type> <mustSupport value="true" /> </element> <element id="Immunization.site"> <path value="Immunization.site" /> <comment value="Code for anatomical site from the Canadian Vaccine Catalogue code set. **Please note** that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: [https://cvc.canimmunize.ca/en/explore#/](https://cvc.canimmunize.ca/en/explore#/)" /> <type> <code value="CodeableConcept" /> <profile value="http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-codeableconcept" /> </type> <binding> <strength value="preferred" /> <valueSet value="http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-AnatomicalSite" /> </binding> </element> <element id="Immunization.route"> <path value="Immunization.route" /> <comment value="Code for a route of administration from the Canadian Vaccine Catalogue code set. **Please note** that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: [https://cvc.canimmunize.ca/en/explore#/](https://cvc.canimmunize.ca/en/explore#/)" /> <type> <code value="CodeableConcept" /> <profile value="http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-codeableconcept" /> </type> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ImmunizationRoute" /> </extension> <strength value="preferred" /> <valueSet value="http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-RouteOfAdmin" /> </binding> </element> <element id="Immunization.performer"> <path value="Immunization.performer" /> <comment value="While the IPS-UV specification considers this a MS element, some systems will not have a field directly representing performer, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance" /> <max value="1" /> </element> <element id="Immunization.protocolApplied.targetDisease"> <path value="Immunization.protocolApplied.targetDisease" /> <min value="0" /> <type> <code value="CodeableConcept" /> <profile value="http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-codeableconcept" /> </type> <binding> <strength value="preferred" /> <valueSet value="http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-Disease" /> </binding> </element> <element id="Immunization.protocolApplied.targetDisease.coding"> <path value="Immunization.protocolApplied.targetDisease.coding" /> <slicing> <discriminator> <type value="pattern" /> <path value="$this" /> </discriminator> <description value="Discriminated by bound value set" /> <rules value="open" /> </slicing> <type> <code value="Coding" /> <profile value="http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-coding" /> </type> </element> <element id="Immunization.protocolApplied.targetDisease.coding:targetDiseaseIPSCode"> <path value="Immunization.protocolApplied.targetDisease.coding" /> <sliceName value="targetDiseaseIPSCode" /> <short value="Optional slice for representing the code for a disease the vaccination is against the IPS Value Set" /> <definition value="Code for a disease the vaccination is against from the SNOMED CT code set." /> <comment value="The IPS slice has replaced the GPS slice in this release to support validation tooling." /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="TargetDiseasesUvIps" /> </extension> <strength value="required" /> <valueSet value="http://hl7.org/fhir/uv/ips/ValueSet/targetDiseases-uv-ips" /> </binding> </element> <element id="Immunization.protocolApplied.targetDisease.coding:CVC"> <path value="Immunization.protocolApplied.targetDisease.coding" /> <sliceName value="targetDiseaseCVC" /> <short value="Optional slice for representing the code for a disease the vaccination is against from the Canadian Vaccine Catalogue code set." /> <definition value="Code for a disease the vaccination is against from the Canadian Vaccine Catalogue code set. **Please note** that Canadian Vaccine Catalogue (CVC)-published value set urls are currently not resolvable, but details of the referenced value sets are available in the current version of the CVC accessible here: [https://cvc.canimmunize.ca/en/explore#/](https://cvc.canimmunize.ca/en/explore#/)" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="TargetDiseasesCVC" /> </extension> <strength value="required" /> <valueSet value="http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-Disease" /> </binding> </element> </differential> </StructureDefinition>