<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="ImmunizationRecommendation" />
  <meta>
    <lastUpdated value="2021-01-02T08:58:31.578+11:00" />
  </meta>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-category">
    <valueString value="Clinical.Medications" />
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="trial-use" />
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="1" />
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category">
    <valueCode value="patient" />
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="pher" />
  </extension>
  <extension url="http://hl7.org/fhir/build/StructureDefinition/entered-in-error-status">
    <valueCode value="Immunization recommendations are generated on &quot;just in time&quot; and typically are not retained by the system generating them so there isn't an expected workflow where a previous recommendation would be re-evaluated and found to be &quot;in error&quot;." />
  </extension>
  <url value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation" />
  <version value="4.6.0" />
  <name value="ImmunizationRecommendation" />
  <status value="draft" />
  <date value="2021-01-02T08:58:31+11:00" />
  <publisher value="Health Level Seven International (Public Health and Emergency Response)" />
  <contact>
    <telecom>
      <system value="url" />
      <value value="http://hl7.org/fhir" />
    </telecom>
  </contact>
  <contact>
    <telecom>
      <system value="url" />
      <value value="http://www.hl7.org/Special/committees/pher/index.cfm" />
    </telecom>
  </contact>
  <description value="A patient's point-in-time set of recommendations (i.e. forecasting) according to a published schedule with optional supporting justification." />
  <fhirVersion value="4.6.0" />
  <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>
  <kind value="resource" />
  <abstract value="false" />
  <type value="ImmunizationRecommendation" />
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
  <derivation value="specialization" />
  <differential>
    <element id="ImmunizationRecommendation">
      <extension url="http://hl7.org/fhir/build/StructureDefinition/svg">
        <valueCode value="0,0" />
      </extension>
      <path value="ImmunizationRecommendation" />
      <short value="Guidance or advice relating to an immunization" />
      <definition value="A patient's point-in-time set of recommendations (i.e. forecasting) according to a published schedule with optional supporting justification." />
      <min value="0" />
      <max value="*" />
      <mapping>
        <identity value="workflow" />
        <map value="Request" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="VXU_V04" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="SubstanceAdministration[moodCode=RMD]" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="clinical.medication" />
      </mapping>
    </element>
    <element id="ImmunizationRecommendation.identifier">
      <path value="ImmunizationRecommendation.identifier" />
      <short value="Business identifier" />
      <definition value="A unique identifier assigned to this particular recommendation record." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="Identifier" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="workflow" />
        <map value="Request.identifier" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.identifier" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".id" />
      </mapping>
    </element>
    <element id="ImmunizationRecommendation.instantiatesCanonical">
      <extension url="http://hl7.org/fhir/build/StructureDefinition/committee-notes">
        <valueString value="Added - Jira 27016." />
      </extension>
      <path value="ImmunizationRecommendation.instantiatesCanonical" />
      <short value="Instantiates FHIR protocol or definition for the immunization recommendation" />
      <definition value="The URL pointing to a FHIR-defined protocol, guideline or other definition that is adhered to in whole or in part by this ImmunizationRecommendation." />
      <min value="0" />
      <max value="*" />
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-pattern">
          <valueCanonical value="http://hl7.org/fhir/StructureDefinition/Definition" />
        </extension>
        <code value="canonical" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ActivityDefinition" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/EventDefinition" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/EvidenceVariable" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Measure" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/OperationDefinition" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PlanDefinition" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Questionnaire" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/SubscriptionTopic" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="workflow" />
        <map value="Request.instantiatesCanonical" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=DEFN].target" />
      </mapping>
    </element>
    <element id="ImmunizationRecommendation.instantiatesUri">
      <extension url="http://hl7.org/fhir/build/StructureDefinition/committee-notes">
        <valueString value="Added - Jira 27016." />
      </extension>
      <path value="ImmunizationRecommendation.instantiatesUri" />
      <short value="Instantiates external protocol or definition for the immunization recommendation" />
      <definition value="The URL pointing to an externally maintained protocol, guideline or other definition that is adhered to in whole or in part by this ImmunizationRecommendation." />
      <comment value="This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="uri" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="workflow" />
        <map value="Request.instantiatesUri" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=DEFN].target" />
      </mapping>
    </element>
    <element id="ImmunizationRecommendation.patient">
      <extension url="http://hl7.org/fhir/build/StructureDefinition/committee-notes">
        <valueString value="PID, PD1, NK1 | #3706." />
      </extension>
      <path value="ImmunizationRecommendation.patient" />
      <short value="Who this profile is for" />
      <definition value="The patient the recommendation(s) are for." />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="workflow" />
        <map value="Request.subject" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.subject[x]" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="PID-3" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".partipication[typeCode=SUBJ].role" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.subject" />
      </mapping>
    </element>
    <element id="ImmunizationRecommendation.date">
      <path value="ImmunizationRecommendation.date" />
      <short value="Date recommendation(s) created" />
      <definition value="The date the immunization recommendation(s) were created." />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="dateTime" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="workflow" />
        <map value="Request.authoredOn" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="OBX-15" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".partipication[typeCode=AUTH].time" />
      </mapping>
    </element>
    <element id="ImmunizationRecommendation.authority">
      <path value="ImmunizationRecommendation.authority" />
      <short value="Who is responsible for protocol" />
      <definition value="Indicates the authority who published the protocol (e.g. ACIP)." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
      </type>
      <mapping>
        <identity value="v2" />
        <map value="OBX-5 : OBX-3 = 59779-9" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".participation[typeCode=AUT]" />
      </mapping>
    </element>
    <element id="ImmunizationRecommendation.recommendation">
      <extension url="http://hl7.org/fhir/build/StructureDefinition/committee-notes">
        <valueString value="#17773." />
      </extension>
      <extension url="http://hl7.org/fhir/build/StructureDefinition/svg">
        <valueCode value="300,120" />
      </extension>
      <path value="ImmunizationRecommendation.recommendation" />
      <short value="Vaccine administration recommendations" />
      <definition value="Vaccine administration recommendations." />
      <comment value="A given instance of the .recommendation backbone element should correspond to a single recommended administration." />
      <min value="1" />
      <max value="*" />
      <type>
        <code value="BackboneElement" />
      </type>
      <constraint>
        <key value="imr-1" />
        <severity value="error" />
        <human value="One of vaccineCode or targetDisease SHALL be present" />
        <expression value="vaccineCode.exists() or targetDisease.exists()" />
        <xpath value="exists(f:vaccineCode) or exists(f:targetDisease)" />
        <source value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode='COMP'].target[classCode=SBADM, moodCode=RMD]" />
      </mapping>
    </element>
    <element id="ImmunizationRecommendation.recommendation.vaccineCode">
      <extension url="http://hl7.org/fhir/build/StructureDefinition/committee-notes">
        <valueString value="#12484." />
      </extension>
      <path value="ImmunizationRecommendation.recommendation.vaccineCode" />
      <short value="Vaccine  or vaccine group recommendation applies to" />
      <definition value="Vaccine(s) or vaccine group that pertain to the recommendation." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="VaccineCode" />
        </extension>
        <strength value="example" />
        <description value="The type of vaccine administered." />
        <valueSet value="http://hl7.org/fhir/ValueSet/vaccine-code" />
      </binding>
      <mapping>
        <identity value="workflow" />
        <map value="Request.code" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="OBX-5 : OBX-3 = ( 30956-7 | 38890-0 )" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".partipication[typeCode=CSM].role[classCode=ADMM].code" />
      </mapping>
    </element>
    <element id="ImmunizationRecommendation.recommendation.targetDisease">
      <extension url="http://hl7.org/fhir/build/StructureDefinition/committee-notes">
        <valueString value="#12484, #17773." />
      </extension>
      <path value="ImmunizationRecommendation.recommendation.targetDisease" />
      <short value="Disease to be immunized against" />
      <definition value="The targeted disease for the recommendation." />
      <comment value="A given instance of the .recommendation backbone element should correspond to a single recommended administration but sometimes that administration (eg. MMR) will encompass multiple diseases, thus the targetDisease element is allowed to repeat." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="TargetDisease" />
        </extension>
        <strength value="example" />
        <description value="The disease that the recommended vaccination targets." />
        <valueSet value="http://hl7.org/fhir/ValueSet/immunization-target-disease" />
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="OBX-5 : OBX-3 = ( 30956-7 | 38890-0 )" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".partipication[typeCode=CSM].role[classCode=ADMM].code" />
      </mapping>
    </element>
    <element id="ImmunizationRecommendation.recommendation.contraindicatedVaccineCode">
      <path value="ImmunizationRecommendation.recommendation.contraindicatedVaccineCode" />
      <short value="Vaccine which is contraindicated to fulfill the recommendation" />
      <definition value="Vaccine(s) which should not be used to fulfill the recommendation." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="VaccineCode" />
        </extension>
        <strength value="example" />
        <description value="The type of vaccine administered." />
        <valueSet value="http://hl7.org/fhir/ValueSet/vaccine-code" />
      </binding>
    </element>
    <element id="ImmunizationRecommendation.recommendation.forecastStatus">
      <path value="ImmunizationRecommendation.recommendation.forecastStatus" />
      <short value="Vaccine recommendation status" />
      <definition value="Indicates the patient status with respect to the path to immunity for the target disease." />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <isModifier value="true" />
      <isModifierReason value="This element is labeled as a modifier because the forecastStatus indicates whether a patient needs additional doses (due, overdue, etc) or not  (contraindicated, complete, etc)." />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImmunizationRecommendationStatus" />
        </extension>
        <strength value="example" />
        <description value="The patient's status with respect to a vaccination protocol." />
        <valueSet value="http://hl7.org/fhir/ValueSet/immunization-recommendation-status" />
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="OBX-5 : OBX-3 = 59783-1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".inboundRelationship[typeCode=SUBJ] .source[classCode=OBS, moodCode=EVN, code=&quot;Immunization Forecast Status&quot;].value" />
      </mapping>
    </element>
    <element id="ImmunizationRecommendation.recommendation.forecastReason">
      <path value="ImmunizationRecommendation.recommendation.forecastReason" />
      <short value="Vaccine administration status reason" />
      <definition value="The reason for the assigned forecast status." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImmunizationRecommendationReason" />
        </extension>
        <strength value="example" />
        <description value="The reason for the patient's status with respect to a vaccination protocol." />
        <valueSet value="http://hl7.org/fhir/ValueSet/immunization-recommendation-reason" />
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="OBX-5 : OBX-3 = 30982-3" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="ImmunizationRecommendation.recommendation.dateCriterion">
      <extension url="http://hl7.org/fhir/build/StructureDefinition/svg">
        <valueCode value="350,0" />
      </extension>
      <path value="ImmunizationRecommendation.recommendation.dateCriterion" />
      <short value="Dates governing proposed immunization" />
      <definition value="Vaccine date recommendations.  For example, earliest date to administer, latest date to administer, etc." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="BackboneElement" />
      </type>
      <mapping>
        <identity value="workflow" />
        <map value="Request.occurrence[x]" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="OBX-3: 30980-7 = Next dose recommended, 59777-3 = Latest next dose should be given, 59778-1 = Dose is overdue" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode='LIMIT'].target[classCode=OBS, moodCode=EVN, isCriterionInd=true]" />
      </mapping>
    </element>
    <element id="ImmunizationRecommendation.recommendation.dateCriterion.code">
      <path value="ImmunizationRecommendation.recommendation.dateCriterion.code" />
      <short value="Type of date" />
      <definition value="Date classification of recommendation.  For example, earliest date to give, latest date to give, etc." />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ImmunizationRecommendationDateCriterion" />
        </extension>
        <strength value="example" />
        <description value="Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.)." />
        <valueSet value="http://hl7.org/fhir/ValueSet/immunization-recommendation-date-criterion" />
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="OBX-3" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".code" />
      </mapping>
    </element>
    <element id="ImmunizationRecommendation.recommendation.dateCriterion.value">
      <path value="ImmunizationRecommendation.recommendation.dateCriterion.value" />
      <short value="Recommended date" />
      <definition value="The date whose meaning is specified by dateCriterion.code." />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="dateTime" />
      </type>
      <mapping>
        <identity value="v2" />
        <map value="OBX-5" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".value" />
      </mapping>
    </element>
    <element id="ImmunizationRecommendation.recommendation.description">
      <path value="ImmunizationRecommendation.recommendation.description" />
      <short value="Protocol details" />
      <definition value="Contains the description about the protocol under which the vaccine was administered." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="string" />
      </type>
      <mapping>
        <identity value="v2" />
        <map value="OBX-5 : OBX-3 = 30956-7" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".text" />
      </mapping>
    </element>
    <element id="ImmunizationRecommendation.recommendation.series">
      <path value="ImmunizationRecommendation.recommendation.series" />
      <short value="Name of vaccination series" />
      <definition value="One possible path to achieve presumed immunity against a disease - within the context of an authority." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="string" />
      </type>
      <mapping>
        <identity value="v2" />
        <map value="RXA-5-administered code" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".title" />
      </mapping>
    </element>
    <element id="ImmunizationRecommendation.recommendation.doseNumber">
      <extension url="http://hl7.org/fhir/build/StructureDefinition/committee-notes">
        <valueString value="#13185 (add option for string), #25277 (restrict to string data type)." />
      </extension>
      <path value="ImmunizationRecommendation.recommendation.doseNumber" />
      <short value="Recommended dose number within series" />
      <definition value="Nominal position of the recommended dose in a series as determined by the evaluation and forecasting process (e.g. dose 2 is the next recommended dose)." />
      <comment value="The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose)." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="OBX-5 : OBX-3 = 30973-2" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".inboundRelationship[typeCode=COMP, .source[classCode=SBADM, moodCode=INT]].sequenceNumber" />
      </mapping>
    </element>
    <element id="ImmunizationRecommendation.recommendation.seriesDoses">
      <extension url="http://hl7.org/fhir/build/StructureDefinition/committee-notes">
        <valueString value="#13185 (add option for string), #25277 (restrict to string data type)." />
      </extension>
      <path value="ImmunizationRecommendation.recommendation.seriesDoses" />
      <short value="Recommended number of doses for immunity" />
      <definition value="The recommended number of doses to achieve immunity as determined by the evaluation and forecasting process." />
      <comment value="The use of an integer is preferred if known." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="string" />
      </type>
      <mapping>
        <identity value="v2" />
        <map value="OBX-5 : OBX-3 = 59782-3" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".inboundRelationship[typeCode=COMP, .source[classCode=SBADM, moodCode=DEF]].sequenceNumber" />
      </mapping>
    </element>
    <element id="ImmunizationRecommendation.recommendation.supportingImmunization">
      <path value="ImmunizationRecommendation.recommendation.supportingImmunization" />
      <short value="Past immunizations supporting recommendation" />
      <definition value="Immunization event history and/or evaluation that supports the status and recommendation." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Immunization" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImmunizationEvaluation" />
      </type>
      <mapping>
        <identity value="v2" />
        <map value="? No clear way to associate in HL7 v2 or IG" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=RSON].target[classCode=SBADM, moodCode=EVN, code=&quot;immunization&quot;]" />
      </mapping>
    </element>
    <element id="ImmunizationRecommendation.recommendation.supportingPatientInformation">
      <path value="ImmunizationRecommendation.recommendation.supportingPatientInformation" />
      <short value="Patient observations supporting recommendation" />
      <definition value="Patient Information that supports the status and recommendation.  This includes patient observations, adverse reactions and allergy/intolerance information." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
      </type>
      <mapping>
        <identity value="workflow" />
        <map value="Request.supportingInfo" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="OBX If OBX is associated with ( RXA : RXA-5-administered code = '998^No vaccine administered^CVX'), could contain the reason the vaccine was not administered" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=RSON].target[classCode=OBS, moodCode=EVN]" />
      </mapping>
    </element>
  </differential>
</StructureDefinition>