<Immunization xmlns="http://hl7.org/fhir"><id value="notGiven"/><status value="not-done"/><statusReason><coding><system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/><code value="MEDPREC"/><display value="medical precaution"/></coding></statusReason><vaccineCode><coding><system value="http://hl7.org/fhir/sid/cvx"/><code value="01"/><display value="DTP"/></coding></vaccineCode><patient><reference value="Patient/example"/></patient><occurrenceDateTime value="2013-01-10"/><primarySource value="true"/></Immunization>