Immunization Decision Support Forecast (ImmDS) Implementation Guide, published by HL7 International / Public Health. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/ImmunizationFHIRDS/ and changes regularly. See the Directory of published versions

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Resource Profile: ImmDS Immunization Recommendation

The set of immunization recommendations for the patient.

Usages:

• Examples for this Profile: ImmunizationRecommendation/immunizationrecommendation-forecast-example

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ImmunizationRecommendation		0..*	ImmunizationRecommendation	Guidance or advice relating to an immunization
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
patient	Σ	1..1	Reference(ImmDS Patient)	Who this profile is for
date	Σ	1..1	dateTime	Date recommendation(s) created
recommendation	ΣC	1..*	BackboneElement	Vaccine administration recommendations Constraints: imr-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
vaccineCode	Σ	0..*	CodeableConcept	Vaccine or vaccine group recommendation applies to Binding: US Core Vaccine Administered Value Set (CVX) (extensible)
targetDisease	Σ	0..1	CodeableConcept	Disease to be immunized against Binding: Vaccine Target Disease Value Set (extensible)
contraindicatedVaccineCode	Σ	0..*	CodeableConcept	Vaccine which is contraindicated to fulfill the recommendation Binding: US Core Vaccine Administered Value Set (CVX) (extensible)
forecastStatus	?!Σ	1..1	CodeableConcept	Vaccine recommendation status Binding: Forecast Status Value Set (preferred)
forecastReason	Σ	0..*	CodeableConcept	Vaccine administration status reason Binding: Forecast Reason Value Set (example)
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
ImmunizationRecommendation.​recommendation.vaccineCode	Base	extensible	US Core Vaccine Administered Value Set (CVX)	📦3.1.0	US Core v3.1
ImmunizationRecommendation.​recommendation.targetDisease	Base	extensible	Vaccine Target Disease Value Set	📦2.0.0	This IG
ImmunizationRecommendation.​recommendation.contraindicatedVaccineCode	Base	extensible	US Core Vaccine Administered Value Set (CVX)	📦3.1.0	US Core v3.1
ImmunizationRecommendation.​recommendation.forecastStatus	Base	preferred	Forecast Status Value Set	📦2.0.0	This IG
ImmunizationRecommendation.​recommendation.forecastReason	Base	example	Forecast Reason Value Set	📦2.0.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	ImmunizationRecommendation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	ImmunizationRecommendation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	ImmunizationRecommendation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	ImmunizationRecommendation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	ImmunizationRecommendation	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
imr-1	error	ImmunizationRecommendation.recommendation	One of vaccineCode or targetDisease SHALL be present	vaccineCode.exists() or targetDisease.exists()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ImmunizationRecommendation		0..*	ImmunizationRecommendation	Guidance or advice relating to an immunization
patient		1..1	Reference(ImmDS Patient)	Who this profile is for
recommendation
vaccineCode		0..*	CodeableConcept	Vaccine or vaccine group recommendation applies to Binding: US Core Vaccine Administered Value Set (CVX) (extensible)
targetDisease		0..1	CodeableConcept	Disease to be immunized against Binding: Vaccine Target Disease Value Set (extensible)
contraindicatedVaccineCode		0..*	CodeableConcept	Vaccine which is contraindicated to fulfill the recommendation Binding: US Core Vaccine Administered Value Set (CVX) (extensible)
forecastStatus		1..1	CodeableConcept	Vaccine recommendation status Binding: Forecast Status Value Set (preferred)
forecastReason		0..*	CodeableConcept	Vaccine administration status reason Binding: Forecast Reason Value Set (example)
dateCriterion
code		1..1	CodeableConcept	Type of date Binding: ImmunizationRecommendationDateCriterionCodes (extensible)
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
ImmunizationRecommendation.​recommendation.vaccineCode	Base	extensible	US Core Vaccine Administered Value Set (CVX)	📦3.1.0	US Core v3.1
ImmunizationRecommendation.​recommendation.targetDisease	Base	extensible	Vaccine Target Disease Value Set	📦2.0.0	This IG
ImmunizationRecommendation.​recommendation.contraindicatedVaccineCode	Base	extensible	US Core Vaccine Administered Value Set (CVX)	📦3.1.0	US Core v3.1
ImmunizationRecommendation.​recommendation.forecastStatus	Base	preferred	Forecast Status Value Set	📦2.0.0	This IG
ImmunizationRecommendation.​recommendation.forecastReason	Base	example	Forecast Reason Value Set	📦2.0.0	This IG
ImmunizationRecommendation.​recommendation.dateCriterion.​code	Base	extensible	Immunization Recommendation Date Criterion Codes	📦4.0.1	FHIR Std.

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ImmunizationRecommendation		0..*	ImmunizationRecommendation	Guidance or advice relating to an immunization
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business identifier
patient	Σ	1..1	Reference(ImmDS Patient)	Who this profile is for
date	Σ	1..1	dateTime	Date recommendation(s) created
authority		0..1	Reference(Organization)	Who is responsible for protocol
recommendation	ΣC	1..*	BackboneElement	Vaccine administration recommendations Constraints: imr-1
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
vaccineCode	Σ	0..*	CodeableConcept	Vaccine or vaccine group recommendation applies to Binding: US Core Vaccine Administered Value Set (CVX) (extensible)
targetDisease	Σ	0..1	CodeableConcept	Disease to be immunized against Binding: Vaccine Target Disease Value Set (extensible)
contraindicatedVaccineCode	Σ	0..*	CodeableConcept	Vaccine which is contraindicated to fulfill the recommendation Binding: US Core Vaccine Administered Value Set (CVX) (extensible)
forecastStatus	?!Σ	1..1	CodeableConcept	Vaccine recommendation status Binding: Forecast Status Value Set (preferred)
forecastReason	Σ	0..*	CodeableConcept	Vaccine administration status reason Binding: Forecast Reason Value Set (example)
dateCriterion		0..*	BackboneElement	Dates governing proposed immunization
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	CodeableConcept	Type of date Binding: ImmunizationRecommendationDateCriterionCodes (extensible)
value		1..1	dateTime	Recommended date
description		0..1	string	Protocol details
series		0..1	string	Name of vaccination series
doseNumber[x]	Σ	0..1		Recommended dose number within series
doseNumberPositiveInt			positiveInt
doseNumberString			string
seriesDoses[x]		0..1		Recommended number of doses for immunity
seriesDosesPositiveInt			positiveInt
seriesDosesString			string
supportingImmunization		0..*	Reference(Immunization | ImmunizationEvaluation)	Past immunizations supporting recommendation
supportingPatientInformation		0..*	Reference(Resource)	Patient observations supporting recommendation
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
ImmunizationRecommendation.​language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
ImmunizationRecommendation.​recommendation.vaccineCode	Base	extensible	US Core Vaccine Administered Value Set (CVX)	📦3.1.0	US Core v3.1
ImmunizationRecommendation.​recommendation.targetDisease	Base	extensible	Vaccine Target Disease Value Set	📦2.0.0	This IG
ImmunizationRecommendation.​recommendation.contraindicatedVaccineCode	Base	extensible	US Core Vaccine Administered Value Set (CVX)	📦3.1.0	US Core v3.1
ImmunizationRecommendation.​recommendation.forecastStatus	Base	preferred	Forecast Status Value Set	📦2.0.0	This IG
ImmunizationRecommendation.​recommendation.forecastReason	Base	example	Forecast Reason Value Set	📦2.0.0	This IG
ImmunizationRecommendation.​recommendation.dateCriterion.​code	Base	extensible	Immunization Recommendation Date Criterion Codes	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	ImmunizationRecommendation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	ImmunizationRecommendation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	ImmunizationRecommendation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	ImmunizationRecommendation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	ImmunizationRecommendation	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
imr-1	error	ImmunizationRecommendation.recommendation	One of vaccineCode or targetDisease SHALL be present	vaccineCode.exists() or targetDisease.exists()

Summary

Structures

This structure refers to these other structures:

• ImmDS Patient (http://hl7.org/fhir/us/immds/StructureDefinition/immds-patient)

Maturity: 3

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ImmunizationRecommendation		0..*	ImmunizationRecommendation	Guidance or advice relating to an immunization
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
patient	Σ	1..1	Reference(ImmDS Patient)	Who this profile is for
date	Σ	1..1	dateTime	Date recommendation(s) created
recommendation	ΣC	1..*	BackboneElement	Vaccine administration recommendations Constraints: imr-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
vaccineCode	Σ	0..*	CodeableConcept	Vaccine or vaccine group recommendation applies to Binding: US Core Vaccine Administered Value Set (CVX) (extensible)
targetDisease	Σ	0..1	CodeableConcept	Disease to be immunized against Binding: Vaccine Target Disease Value Set (extensible)
contraindicatedVaccineCode	Σ	0..*	CodeableConcept	Vaccine which is contraindicated to fulfill the recommendation Binding: US Core Vaccine Administered Value Set (CVX) (extensible)
forecastStatus	?!Σ	1..1	CodeableConcept	Vaccine recommendation status Binding: Forecast Status Value Set (preferred)
forecastReason	Σ	0..*	CodeableConcept	Vaccine administration status reason Binding: Forecast Reason Value Set (example)
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
ImmunizationRecommendation.​recommendation.vaccineCode	Base	extensible	US Core Vaccine Administered Value Set (CVX)	📦3.1.0	US Core v3.1
ImmunizationRecommendation.​recommendation.targetDisease	Base	extensible	Vaccine Target Disease Value Set	📦2.0.0	This IG
ImmunizationRecommendation.​recommendation.contraindicatedVaccineCode	Base	extensible	US Core Vaccine Administered Value Set (CVX)	📦3.1.0	US Core v3.1
ImmunizationRecommendation.​recommendation.forecastStatus	Base	preferred	Forecast Status Value Set	📦2.0.0	This IG
ImmunizationRecommendation.​recommendation.forecastReason	Base	example	Forecast Reason Value Set	📦2.0.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	ImmunizationRecommendation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	ImmunizationRecommendation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	ImmunizationRecommendation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	ImmunizationRecommendation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	ImmunizationRecommendation	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
imr-1	error	ImmunizationRecommendation.recommendation	One of vaccineCode or targetDisease SHALL be present	vaccineCode.exists() or targetDisease.exists()

Differential View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ImmunizationRecommendation		0..*	ImmunizationRecommendation	Guidance or advice relating to an immunization
patient		1..1	Reference(ImmDS Patient)	Who this profile is for
recommendation
vaccineCode		0..*	CodeableConcept	Vaccine or vaccine group recommendation applies to Binding: US Core Vaccine Administered Value Set (CVX) (extensible)
targetDisease		0..1	CodeableConcept	Disease to be immunized against Binding: Vaccine Target Disease Value Set (extensible)
contraindicatedVaccineCode		0..*	CodeableConcept	Vaccine which is contraindicated to fulfill the recommendation Binding: US Core Vaccine Administered Value Set (CVX) (extensible)
forecastStatus		1..1	CodeableConcept	Vaccine recommendation status Binding: Forecast Status Value Set (preferred)
forecastReason		0..*	CodeableConcept	Vaccine administration status reason Binding: Forecast Reason Value Set (example)
dateCriterion
code		1..1	CodeableConcept	Type of date Binding: ImmunizationRecommendationDateCriterionCodes (extensible)
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
ImmunizationRecommendation.​recommendation.vaccineCode	Base	extensible	US Core Vaccine Administered Value Set (CVX)	📦3.1.0	US Core v3.1
ImmunizationRecommendation.​recommendation.targetDisease	Base	extensible	Vaccine Target Disease Value Set	📦2.0.0	This IG
ImmunizationRecommendation.​recommendation.contraindicatedVaccineCode	Base	extensible	US Core Vaccine Administered Value Set (CVX)	📦3.1.0	US Core v3.1
ImmunizationRecommendation.​recommendation.forecastStatus	Base	preferred	Forecast Status Value Set	📦2.0.0	This IG
ImmunizationRecommendation.​recommendation.forecastReason	Base	example	Forecast Reason Value Set	📦2.0.0	This IG
ImmunizationRecommendation.​recommendation.dateCriterion.​code	Base	extensible	Immunization Recommendation Date Criterion Codes	📦4.0.1	FHIR Std.

Snapshot ViewView

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ImmunizationRecommendation		0..*	ImmunizationRecommendation	Guidance or advice relating to an immunization
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business identifier
patient	Σ	1..1	Reference(ImmDS Patient)	Who this profile is for
date	Σ	1..1	dateTime	Date recommendation(s) created
authority		0..1	Reference(Organization)	Who is responsible for protocol
recommendation	ΣC	1..*	BackboneElement	Vaccine administration recommendations Constraints: imr-1
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
vaccineCode	Σ	0..*	CodeableConcept	Vaccine or vaccine group recommendation applies to Binding: US Core Vaccine Administered Value Set (CVX) (extensible)
targetDisease	Σ	0..1	CodeableConcept	Disease to be immunized against Binding: Vaccine Target Disease Value Set (extensible)
contraindicatedVaccineCode	Σ	0..*	CodeableConcept	Vaccine which is contraindicated to fulfill the recommendation Binding: US Core Vaccine Administered Value Set (CVX) (extensible)
forecastStatus	?!Σ	1..1	CodeableConcept	Vaccine recommendation status Binding: Forecast Status Value Set (preferred)
forecastReason	Σ	0..*	CodeableConcept	Vaccine administration status reason Binding: Forecast Reason Value Set (example)
dateCriterion		0..*	BackboneElement	Dates governing proposed immunization
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	CodeableConcept	Type of date Binding: ImmunizationRecommendationDateCriterionCodes (extensible)
value		1..1	dateTime	Recommended date
description		0..1	string	Protocol details
series		0..1	string	Name of vaccination series
doseNumber[x]	Σ	0..1		Recommended dose number within series
doseNumberPositiveInt			positiveInt
doseNumberString			string
seriesDoses[x]		0..1		Recommended number of doses for immunity
seriesDosesPositiveInt			positiveInt
seriesDosesString			string
supportingImmunization		0..*	Reference(Immunization | ImmunizationEvaluation)	Past immunizations supporting recommendation
supportingPatientInformation		0..*	Reference(Resource)	Patient observations supporting recommendation
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
ImmunizationRecommendation.​language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
ImmunizationRecommendation.​recommendation.vaccineCode	Base	extensible	US Core Vaccine Administered Value Set (CVX)	📦3.1.0	US Core v3.1
ImmunizationRecommendation.​recommendation.targetDisease	Base	extensible	Vaccine Target Disease Value Set	📦2.0.0	This IG
ImmunizationRecommendation.​recommendation.contraindicatedVaccineCode	Base	extensible	US Core Vaccine Administered Value Set (CVX)	📦3.1.0	US Core v3.1
ImmunizationRecommendation.​recommendation.forecastStatus	Base	preferred	Forecast Status Value Set	📦2.0.0	This IG
ImmunizationRecommendation.​recommendation.forecastReason	Base	example	Forecast Reason Value Set	📦2.0.0	This IG
ImmunizationRecommendation.​recommendation.dateCriterion.​code	Base	extensible	Immunization Recommendation Date Criterion Codes	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	ImmunizationRecommendation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	ImmunizationRecommendation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	ImmunizationRecommendation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	ImmunizationRecommendation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	ImmunizationRecommendation	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
imr-1	error	ImmunizationRecommendation.recommendation	One of vaccineCode or targetDisease SHALL be present	vaccineCode.exists() or targetDisease.exists()

Summary

Structures

This structure refers to these other structures:

• ImmDS Patient (http://hl7.org/fhir/us/immds/StructureDefinition/immds-patient)

Maturity: 3

Other representations of profile: CSV, Excel, Schematron