{
  "resourceType": "StructureDefinition",
  "id": "Immunization",
  "meta": {
    "lastUpdated": "2021-01-01T21:58:31.578+00:00"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-category",
      "valueString": "Clinical.Medications"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode": "trial-use"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger": 3
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category",
      "valueCode": "patient"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "pher"
    },
    {
      "url": "http://hl7.org/fhir/build/StructureDefinition/entered-in-error-status",
      "valueCode": ".status = entered-in-error"
    }
  ],
  "url": "http://hl7.org/fhir/StructureDefinition/Immunization",
  "version": "4.6.0",
  "name": "Immunization",
  "status": "draft",
  "date": "2021-01-01T21:58:31+00:00",
  "publisher": "Health Level Seven International (Public Health and Emergency Response)",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://hl7.org/fhir"
        }
      ]
    },
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/pher/index.cfm"
        }
      ]
    }
  ],
  "description": "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.",
  "fhirVersion": "4.6.0",
  "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/DomainResource",
  "derivation": "specialization",
  "differential": {
    "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": "*",
        "mapping": [
          {
            "identity": "workflow",
            "map": "Event"
          },
          {
            "identity": "v2",
            "map": "VXU_V04"
          },
          {
            "identity": "rim",
            "map": "SubstanceAdministration"
          },
          {
            "identity": "w5",
            "map": "clinical.medication"
          }
        ]
      },
      {
        "id": "Immunization.identifier",
        "path": "Immunization.identifier",
        "short": "Business identifier",
        "definition": "A unique identifier assigned to this immunization record.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Identifier"
          }
        ],
        "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.instantiatesCanonical",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "Added - Jira 27016."
          }
        ],
        "path": "Immunization.instantiatesCanonical",
        "short": "Instantiates FHIR protocol or definition for the immunization event",
        "definition": "The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Immunization.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-pattern",
                "valueCanonical": "http://hl7.org/fhir/StructureDefinition/Definition"
              }
            ],
            "code": "canonical",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/ActivityDefinition",
              "http://hl7.org/fhir/StructureDefinition/EventDefinition",
              "http://hl7.org/fhir/StructureDefinition/EvidenceVariable",
              "http://hl7.org/fhir/StructureDefinition/Measure",
              "http://hl7.org/fhir/StructureDefinition/OperationDefinition",
              "http://hl7.org/fhir/StructureDefinition/PlanDefinition",
              "http://hl7.org/fhir/StructureDefinition/Questionnaire",
              "http://hl7.org/fhir/StructureDefinition/SubscriptionTopic"
            ]
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "workflow",
            "map": "Event.instantiatesCanonical"
          },
          {
            "identity": "rim",
            "map": ".outboundRelationship[typeCode=DEFN].target"
          }
        ]
      },
      {
        "id": "Immunization.instantiatesUri",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "Added - Jira 27016."
          }
        ],
        "path": "Immunization.instantiatesUri",
        "short": "Instantiates external protocol or definition for the immunization event",
        "definition": "The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Immunization.",
        "comment": "This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "uri"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "workflow",
            "map": "Event.instantiatesUri"
          },
          {
            "identity": "rim",
            "map": ".outboundRelationship[typeCode=DEFN].target"
          }
        ]
      },
      {
        "id": "Immunization.basedOn",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "Added - Jira 27015."
          }
        ],
        "path": "Immunization.basedOn",
        "short": "Authority that the immunization event is based on",
        "definition": "A plan, order or recommendation fulfilled in whole or in part by this immunization.",
        "comment": "Allows tracing of an authorization for the Immunization.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/CarePlan",
              "http://hl7.org/fhir/StructureDefinition/MedicationRequest",
              "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
            ]
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "workflow",
            "map": "Event.basedOn"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Immunization.status",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "#7867."
          }
        ],
        "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",
        "type": [
          {
            "code": "code"
          }
        ],
        "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"
            },
            {
              "url": "http://hl7.org/fhir/build/StructureDefinition/definition",
              "valueString": "A set of codes indicating the current status of an Immunization."
            }
          ],
          "strength": "required",
          "description": "x",
          "valueSet": "http://hl7.org/fhir/ValueSet/immunization-status"
        },
        "mapping": [
          {
            "identity": "workflow",
            "map": "Event.status"
          },
          {
            "identity": "w5",
            "map": "FiveWs.status"
          },
          {
            "identity": "rim",
            "map": "statusCode"
          }
        ]
      },
      {
        "id": "Immunization.statusReason",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "#14377, #17811, #17763 (updates to the value set)."
          }
        ],
        "path": "Immunization.statusReason",
        "short": "Reason for current status",
        "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",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "ImmunizationStatusReason"
            },
            {
              "url": "http://hl7.org/fhir/build/StructureDefinition/definition",
              "valueString": "The reason why a vaccine was not administered."
            }
          ],
          "strength": "example",
          "description": "x",
          "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"
          }
        ]
      },
      {
        "id": "Immunization.vaccineCode",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "#6128."
          }
        ],
        "path": "Immunization.vaccineCode",
        "short": "Vaccine product administered",
        "definition": "Vaccine that was administered or was to be administered.",
        "comment": "The code for the administered vaccine may be reported at various levels of granularity from a very generic code for a general type of vaccine (e.g. the SNOMED or CVX code for the flu vaccine) to a very discrete code for a specific product including the form and packaging (e.g. an NDC code). Because vaccineCode uses the CodeableConcept data type, multiple codes at different levels of granularity may be reported for a single immunization event provided that all codes are appropriate for the same vaccine. For example, both NDC and CVX codes may be provided for a given immunization event by repeating the coding element within vaccineCode.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "isSummary": true,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "VaccineCode"
            },
            {
              "url": "http://hl7.org/fhir/build/StructureDefinition/definition",
              "valueString": "The code for vaccine product administered."
            }
          ],
          "strength": "example",
          "description": "x",
          "valueSet": "http://hl7.org/fhir/ValueSet/vaccine-code"
        },
        "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"
          }
        ]
      },
      {
        "id": "Immunization.manufacturer",
        "path": "Immunization.manufacturer",
        "short": "Vaccine manufacturer",
        "definition": "Name of vaccine manufacturer.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Organization"
            ]
          }
        ],
        "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",
        "type": [
          {
            "code": "string"
          }
        ],
        "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",
        "type": [
          {
            "code": "date"
          }
        ],
        "mapping": [
          {
            "identity": "v2",
            "map": "RXA-16"
          },
          {
            "identity": "rim",
            "map": ".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime"
          }
        ]
      },
      {
        "id": "Immunization.patient",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "PID, PD1, NK1 | #3705."
          }
        ],
        "path": "Immunization.patient",
        "short": "Who was immunized",
        "definition": "The patient who either received or did not receive the immunization.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Patient"
            ]
          }
        ],
        "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"
          }
        ]
      },
      {
        "id": "Immunization.encounter",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "#3840."
          }
        ],
        "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",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Encounter"
            ]
          }
        ],
        "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]",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "#7887, #16223."
          }
        ],
        "path": "Immunization.occurrence[x]",
        "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",
        "type": [
          {
            "code": "dateTime"
          },
          {
            "code": "string"
          }
        ],
        "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",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "Approved to add 8/9/2018."
          }
        ],
        "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",
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "isSummary": false,
        "mapping": [
          {
            "identity": "w5",
            "map": "FiveWs.recorded"
          },
          {
            "identity": "rim",
            "map": ".participation[typeCode=AUT].time"
          }
        ]
      },
      {
        "id": "Immunization.primarySource",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "gForge #15696 and #20327."
          }
        ],
        "path": "Immunization.primarySource",
        "short": "Indicates context the data was recorded in",
        "definition": "Indicates whether this record was captured as an original primary source-of-truth record rather than a secondary 'reported' record. A value \"true\" means this is a primary record of the immunization.",
        "comment": "Reflects the “reliability” of the content.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "boolean"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "workflow",
            "map": "Event.reportedBoolean"
          },
          {
            "identity": "w5",
            "map": "FiveWs.source"
          },
          {
            "identity": "v2",
            "map": "RXA-9"
          },
          {
            "identity": "rim",
            "map": "immunization.uncertaintycode (if primary source=false, uncertainty=U)"
          }
        ]
      },
      {
        "id": "Immunization.informationSource",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "gForge #15696 and #20327."
          }
        ],
        "path": "Immunization.informationSource",
        "short": "Indicates the source of a  reported record",
        "definition": "Typically 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": "Typically will not be populated if primarySource = True, not required even if primarySource = False.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "CodeableReference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Patient",
              "http://hl7.org/fhir/StructureDefinition/Practitioner",
              "http://hl7.org/fhir/StructureDefinition/PractitionerRole",
              "http://hl7.org/fhir/StructureDefinition/RelatedPerson",
              "http://hl7.org/fhir/StructureDefinition/Organization"
            ]
          }
        ],
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "ImmunizationReportOrigin"
            },
            {
              "url": "http://hl7.org/fhir/build/StructureDefinition/definition",
              "valueString": "The source of the data for a record which is not from a primary source."
            }
          ],
          "strength": "example",
          "description": "x",
          "valueSet": "http://hl7.org/fhir/ValueSet/immunization-origin"
        },
        "mapping": [
          {
            "identity": "workflow",
            "map": "Event.reportedReference"
          },
          {
            "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.location",
        "path": "Immunization.location",
        "short": "Where immunization occurred",
        "definition": "The service delivery location where the vaccine administration occurred.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Location"
            ]
          }
        ],
        "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.site",
        "path": "Immunization.site",
        "short": "Body site vaccine  was administered",
        "definition": "Body site where vaccine was administered.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "ImmunizationSite"
            },
            {
              "url": "http://hl7.org/fhir/build/StructureDefinition/definition",
              "valueString": "The site at which the vaccine was administered."
            }
          ],
          "strength": "example",
          "description": "x",
          "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"
          }
        ]
      },
      {
        "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",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "ImmunizationRoute"
            },
            {
              "url": "http://hl7.org/fhir/build/StructureDefinition/definition",
              "valueString": "The route by which the vaccine was administered."
            }
          ],
          "strength": "example",
          "description": "x",
          "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"
          }
        ]
      },
      {
        "id": "Immunization.doseQuantity",
        "path": "Immunization.doseQuantity",
        "short": "Amount of vaccine administered",
        "definition": "The quantity of vaccine product that was administered.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Quantity",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
            ]
          }
        ],
        "mapping": [
          {
            "identity": "v2",
            "map": "RXA-6 / RXA-7"
          },
          {
            "identity": "rim",
            "map": ".doseQuantity"
          }
        ]
      },
      {
        "id": "Immunization.performer",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "#13290."
          },
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/svg",
            "valueCode": "0,360"
          }
        ],
        "path": "Immunization.performer",
        "short": "Who performed event",
        "definition": "Indicates who performed the immunization event.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "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.function",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "#13290."
          }
        ],
        "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",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "isSummary": true,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "ImmunizationFunction"
            },
            {
              "url": "http://hl7.org/fhir/build/StructureDefinition/definition",
              "valueString": "The role a practitioner or organization plays in the immunization event."
            }
          ],
          "strength": "extensible",
          "description": "x",
          "valueSet": "http://hl7.org/fhir/ValueSet/immunization-function"
        },
        "mapping": [
          {
            "identity": "workflow",
            "map": "Event.performer.function"
          },
          {
            "identity": "rim",
            "map": ".participation.functionCode"
          }
        ]
      },
      {
        "id": "Immunization.performer.actor",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "#13290."
          }
        ],
        "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",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Practitioner",
              "http://hl7.org/fhir/StructureDefinition/PractitionerRole",
              "http://hl7.org/fhir/StructureDefinition/Organization"
            ]
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "workflow",
            "map": "Event.performer.actor"
          },
          {
            "identity": "w5",
            "map": "FiveWs.actor"
          },
          {
            "identity": "rim",
            "map": ".player"
          }
        ]
      },
      {
        "id": "Immunization.note",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "#7866."
          }
        ],
        "path": "Immunization.note",
        "short": "Additional immunization notes",
        "definition": "Extra information about the immunization that is not conveyed by the other attributes.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Annotation"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "workflow",
            "map": "Event.note"
          },
          {
            "identity": "v2",
            "map": "OBX-5 : OBX-3 = 48767-8"
          },
          {
            "identity": "rim",
            "map": "note"
          }
        ]
      },
      {
        "id": "Immunization.reason",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "#17811."
          }
        ],
        "path": "Immunization.reason",
        "short": "Why immunization occurred",
        "definition": "Describes why the immunization occurred in coded or textual form, or Indicates another resource (Condition, Observation or DiagnosticReport) whose existence justifies this immunization.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "CodeableReference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Condition",
              "http://hl7.org/fhir/StructureDefinition/Observation",
              "http://hl7.org/fhir/StructureDefinition/DiagnosticReport"
            ]
          }
        ],
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "ImmunizationReason"
            },
            {
              "url": "http://hl7.org/fhir/build/StructureDefinition/definition",
              "valueString": "The reason why a vaccine was administered."
            }
          ],
          "strength": "example",
          "description": "x",
          "valueSet": "http://hl7.org/fhir/ValueSet/immunization-reason"
        },
        "mapping": [
          {
            "identity": "workflow",
            "map": "Event.reason"
          },
          {
            "identity": "rim",
            "map": "[actionNegationInd=false].reasonCode"
          }
        ]
      },
      {
        "id": "Immunization.isSubpotent",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "#14366; #18867."
          }
        ],
        "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",
        "type": [
          {
            "code": "boolean"
          }
        ],
        "meaningWhenMissing": "By default, a dose should be considered to be potent.",
        "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",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "#14366."
          }
        ],
        "path": "Immunization.subpotentReason",
        "short": "Reason for being subpotent",
        "definition": "Reason why a dose is considered to be subpotent.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "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"
          }
        ]
      },
      {
        "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": "*",
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "constraint": [
          {
            "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)",
            "source": "http://hl7.org/fhir/StructureDefinition/Immunization"
          }
        ],
        "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",
        "type": [
          {
            "code": "string"
          }
        ],
        "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",
        "type": [
          {
            "code": "uri"
          }
        ],
        "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",
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "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",
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "mapping": [
          {
            "identity": "v2",
            "map": "OBX-5 : OBX-3 = 29769-7"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Immunization.programEligibility",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "#5758."
          }
        ],
        "path": "Immunization.programEligibility",
        "short": "Patient eligibility for a vaccination program",
        "definition": "Indicates a patient's eligibility for a funding program.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "ProgramEligibility"
            },
            {
              "url": "http://hl7.org/fhir/build/StructureDefinition/definition",
              "valueString": "The patient's eligibility for a vaccation program."
            }
          ],
          "strength": "example",
          "description": "x",
          "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",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "#5758."
          }
        ],
        "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",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "FundingSource"
            },
            {
              "url": "http://hl7.org/fhir/build/StructureDefinition/definition",
              "valueString": "The source of funding used to purchase the vaccine administered."
            }
          ],
          "strength": "example",
          "description": "x",
          "valueSet": "http://hl7.org/fhir/ValueSet/immunization-funding-source"
        },
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Immunization.reaction",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "Restored for R4 after an initial attempt to migrate to AdverseEvent (see #15124)."
          }
        ],
        "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": "*",
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "mapping": [
          {
            "identity": "v2",
            "map": "OBX-3"
          },
          {
            "identity": "rim",
            "map": "Observation[classCode=obs].code"
          }
        ]
      },
      {
        "id": "Immunization.reaction.date",
        "path": "Immunization.reaction.date",
        "short": "When reaction started",
        "definition": "Date of reaction to the immunization.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "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"
          }
        ]
      },
      {
        "id": "Immunization.reaction.manifestation",
        "path": "Immunization.reaction.manifestation",
        "short": "Additional information on reaction",
        "definition": "Details of the reaction.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "CodeableReference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Observation"
            ]
          }
        ],
        "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",
        "type": [
          {
            "code": "boolean"
          }
        ],
        "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",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "#16520."
          }
        ],
        "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": "*",
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "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",
        "type": [
          {
            "code": "string"
          }
        ],
        "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",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Organization"
            ]
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Immunization.protocolApplied.targetDisease",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "#19487 (cardinality changed), #15972 (changes to the value set)."
          }
        ],
        "path": "Immunization.protocolApplied.targetDisease",
        "short": "Vaccine preventatable disease being targetted",
        "definition": "The vaccine preventable disease the dose is being administered against.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "TargetDisease"
            },
            {
              "url": "http://hl7.org/fhir/build/StructureDefinition/definition",
              "valueString": "The vaccine preventable disease the dose is being administered for."
            }
          ],
          "strength": "example",
          "description": "x",
          "valueSet": "http://hl7.org/fhir/ValueSet/immunization-target-disease"
        },
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Immunization.protocolApplied.doseNumber",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "#25277 (restrict to string data type)."
          }
        ],
        "path": "Immunization.protocolApplied.doseNumber",
        "short": "Dose number within series",
        "definition": "Nominal position in a series as intended by the practitioner administering the dose.",
        "comment": "The use of an integer is preferred if known. Text should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Immunization.protocolApplied.seriesDoses",
        "extension": [
          {
            "url": "http://hl7.org/fhir/build/StructureDefinition/committee-notes",
            "valueString": "#18868, #25277 (restrict to string data type)."
          }
        ],
        "path": "Immunization.protocolApplied.seriesDoses",
        "short": "Recommended number of doses for immunity",
        "definition": "The recommended number of doses to achieve immunity as intended by the practitioner administering the dose.",
        "comment": "The use of an integer is preferred if known.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      }
    ]
  }
}