Implementation Guide CH VACD
5.0.0-ci-build - ci-build Switzerland flag

Implementation Guide CH VACD, published by HL7 Switzerland. This guide is not an authorized publication; it is the continuous build for version 5.0.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7ch/ch-vacd/ and changes regularly. See the Directory of published versions

Resource Profile: CHVACDImmunizationRecommendation - Detailed Descriptions

Active as of 2024-02-15

Definitions for the ch-vacd-immunization-recommendation resource profile.

Guidance on how to interpret the contents of this table can be found here

0. ImmunizationRecommendation
ShortCH VACD Immunization Recommendation
2. ImmunizationRecommendation.contained
ShortImmunizationRecommendation inline resource
Control0..1
4. ImmunizationRecommendation.extension
SlicingThis element introduces a set of slices on ImmunizationRecommendation.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
6. ImmunizationRecommendation.extension:relatesTo
Slice NamerelatesTo
Definition

The definition of a relation of this immunization entry in this document to an immunization entry in an other document.

Control0..1
TypeExtension(Entry Resource Cross References) (Complex Extension)
8. ImmunizationRecommendation.identifier
ShortImmunization Recommendation item ID
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..?
10. ImmunizationRecommendation.patient
ShortPatient
TypeReference(CH Core Patient)
12. ImmunizationRecommendation.authority
TypeReference(CH Core Organization)
14. ImmunizationRecommendation.recommendation
16. ImmunizationRecommendation.recommendation.vaccineCode
ShortImmunization Recommendation Vaccine Code
BindingUnless not suitable, these codes SHALL be taken from Swiss Vaccination Plan Immunizations
(extensible to http://fhir.ch/ig/ch-vacd/ValueSet/ch-vacd-ch-vaccination-plan-immunizations-vs
18. ImmunizationRecommendation.recommendation.targetDisease
Control1..?
BindingUnless not suitable, these codes SHALL be taken from Target disease and illnesses undergone for immunization
(extensible to http://fhir.ch/ig/ch-vacd/ValueSet/ch-vacd-targetdiseasesandillnessesundergoneforimmunization-vs
Must Supporttrue
20. ImmunizationRecommendation.recommendation.forecastReason
Control1..?
BindingUnless not suitable, these codes SHALL be taken from Recommendation-Categories for Immunizations
(extensible to http://fhir.ch/ig/ch-vacd/ValueSet/ch-vacd-recommendation-categories-vs
Must Supporttrue
22. ImmunizationRecommendation.recommendation.dateCriterion
Control1..?
Must Supporttrue

Guidance on how to interpret the contents of this table can be found here

0. ImmunizationRecommendation
Definition

A patient's point-in-time set of recommendations (i.e. forecasting) according to a published schedule with optional supporting justification.

ShortCH VACD Immunization RecommendationGuidance or advice relating to an immunization
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. ImmunizationRecommendation.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. ImmunizationRecommendation.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

ShortImmunizationRecommendation inline resourceContained, inline Resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Control0..1*
TypeResource
Is Modifierfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
6. ImmunizationRecommendation.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ImmunizationRecommendation.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
8. ImmunizationRecommendation.extension:relatesTo
Slice NamerelatesTo
Definition

The definition of a relation of this immunization entry in this document to an immunization entry in an other document.

ShortEntry Resource Cross References
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(Entry Resource Cross References) (Complex Extension)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. ImmunizationRecommendation.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
12. ImmunizationRecommendation.identifier
Definition

A unique identifier assigned to this particular recommendation record.

ShortImmunization Recommendation item IDBusiness identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control10..*
TypeIdentifier
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. ImmunizationRecommendation.patient
Definition

The patient the recommendation(s) are for.

ShortPatientWho this profile is for
Control1..1
TypeReference(CH Core Patient, Patient)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. ImmunizationRecommendation.date
Definition

The date the immunization recommendation(s) were created.

ShortDate recommendation(s) created
Control1..1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. ImmunizationRecommendation.authority
Definition

Indicates the authority who published the protocol (e.g. ACIP).

ShortWho is responsible for protocol
Control0..1
TypeReference(CH Core Organization, Organization)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. ImmunizationRecommendation.recommendation
Definition

Vaccine administration recommendations.

ShortVaccine administration recommendations
Control1..*
TypeBackboneElement
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
imr-1: One of vaccineCode or targetDisease SHALL be present (vaccineCode.exists() or targetDisease.exists())
imr-1: One of vaccineCode or targetDisease SHALL be present (vaccineCode.exists() or targetDisease.exists())
22. ImmunizationRecommendation.recommendation.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
24. ImmunizationRecommendation.recommendation.vaccineCode
Definition

Vaccine(s) or vaccine group that pertain to the recommendation.

ShortImmunization Recommendation Vaccine CodeVaccine or vaccine group recommendation applies to
Control0..*
BindingUnless not suitable, these codes SHALL be taken from For example codes, see Swiss Vaccination Plan Immunizationshttp://hl7.org/fhir/ValueSet/vaccine-code
(extensible to http://fhir.ch/ig/ch-vacd/ValueSet/ch-vacd-ch-vaccination-plan-immunizations-vs
TypeCodeableConcept
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. ImmunizationRecommendation.recommendation.targetDisease
Definition

The targeted disease for the recommendation.

ShortDisease to be immunized against
Control10..1
BindingUnless not suitable, these codes SHALL be taken from For example codes, see Target disease and illnesses undergone for immunizationhttp://hl7.org/fhir/ValueSet/immunization-recommendation-target-disease
(extensible to http://fhir.ch/ig/ch-vacd/ValueSet/ch-vacd-targetdiseasesandillnessesundergoneforimmunization-vs
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. ImmunizationRecommendation.recommendation.forecastStatus
Definition

Indicates the patient status with respect to the path to immunity for the target disease.

ShortVaccine recommendation status
Control1..1
BindingFor example codes, see ImmunizationRecommendationStatusCodeshttp://hl7.org/fhir/ValueSet/immunization-recommendation-status
(example to http://hl7.org/fhir/ValueSet/immunization-recommendation-status
TypeCodeableConcept
Is Modifiertrue because 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).
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. ImmunizationRecommendation.recommendation.forecastReason
Definition

The reason for the assigned forecast status.

ShortVaccine administration status reason
Control10..*
BindingUnless not suitable, these codes SHALL be taken from For example codes, see Recommendation-Categories for Immunizationshttp://hl7.org/fhir/ValueSet/immunization-recommendation-reason
(extensible to http://fhir.ch/ig/ch-vacd/ValueSet/ch-vacd-recommendation-categories-vs
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. ImmunizationRecommendation.recommendation.dateCriterion
Definition

Vaccine date recommendations. For example, earliest date to administer, latest date to administer, etc.

ShortDates governing proposed immunization
Control10..*
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. ImmunizationRecommendation.recommendation.dateCriterion.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
36. ImmunizationRecommendation.recommendation.dateCriterion.code
Definition

Date classification of recommendation. For example, earliest date to give, latest date to give, etc.

ShortType of date
Control1..1
BindingFor example codes, see ImmunizationRecommendationDateCriterionCodeshttp://hl7.org/fhir/ValueSet/immunization-recommendation-date-criterion
(example to http://hl7.org/fhir/ValueSet/immunization-recommendation-date-criterion
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. ImmunizationRecommendation.recommendation.dateCriterion.value
Definition

The date whose meaning is specified by dateCriterion.code.

ShortRecommended date
Control1..1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be found here

0. ImmunizationRecommendation
Definition

A patient's point-in-time set of recommendations (i.e. forecasting) according to a published schedule with optional supporting justification.

ShortCH VACD Immunization Recommendation
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. ImmunizationRecommendation.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortLogical id of this artifact
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control0..1
Typeid
Is Modifierfalse
Summarytrue
4. ImmunizationRecommendation.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

ShortMetadata about the resource
Control0..1
TypeMeta
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. ImmunizationRecommendation.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. ImmunizationRecommendation.language
Definition

The base language in which the resource is written.

ShortLanguage of the resource content
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Control0..1
BindingThe codes SHOULD be taken from CommonLanguages
(preferred to http://hl7.org/fhir/ValueSet/languages
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. ImmunizationRecommendation.text
Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

ShortText summary of the resource, for human interpretation
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Control0..1
TypeNarrative
Is Modifierfalse
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. ImmunizationRecommendation.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

ShortImmunizationRecommendation inline resource
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Control0..1
TypeResource
Is Modifierfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
14. ImmunizationRecommendation.extension
Definition

An Extension

ShortExtension
Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ImmunizationRecommendation.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
16. ImmunizationRecommendation.extension:relatesTo
Slice NamerelatesTo
Definition

The definition of a relation of this immunization entry in this document to an immunization entry in an other document.

ShortEntry Resource Cross References
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(Entry Resource Cross References) (Complex Extension)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. ImmunizationRecommendation.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
20. ImmunizationRecommendation.identifier
Definition

A unique identifier assigned to this particular recommendation record.

ShortImmunization Recommendation item ID
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..*
TypeIdentifier
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. ImmunizationRecommendation.patient
Definition

The patient the recommendation(s) are for.

ShortPatient
Control1..1
TypeReference(CH Core Patient)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. ImmunizationRecommendation.date
Definition

The date the immunization recommendation(s) were created.

ShortDate recommendation(s) created
Control1..1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. ImmunizationRecommendation.authority
Definition

Indicates the authority who published the protocol (e.g. ACIP).

ShortWho is responsible for protocol
Control0..1
TypeReference(CH Core Organization)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. ImmunizationRecommendation.recommendation
Definition

Vaccine administration recommendations.

ShortVaccine administration recommendations
Control1..*
TypeBackboneElement
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
imr-1: One of vaccineCode or targetDisease SHALL be present (vaccineCode.exists() or targetDisease.exists())
30. ImmunizationRecommendation.recommendation.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
32. ImmunizationRecommendation.recommendation.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
34. ImmunizationRecommendation.recommendation.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
36. ImmunizationRecommendation.recommendation.vaccineCode
Definition

Vaccine(s) or vaccine group that pertain to the recommendation.

ShortImmunization Recommendation Vaccine Code
Control0..*
BindingUnless not suitable, these codes SHALL be taken from Swiss Vaccination Plan Immunizations
(extensible to http://fhir.ch/ig/ch-vacd/ValueSet/ch-vacd-ch-vaccination-plan-immunizations-vs
TypeCodeableConcept
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. ImmunizationRecommendation.recommendation.targetDisease
Definition

The targeted disease for the recommendation.

ShortDisease to be immunized against
Control1..1
BindingUnless not suitable, these codes SHALL be taken from Target disease and illnesses undergone for immunization
(extensible to http://fhir.ch/ig/ch-vacd/ValueSet/ch-vacd-targetdiseasesandillnessesundergoneforimmunization-vs
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. ImmunizationRecommendation.recommendation.contraindicatedVaccineCode
Definition

Vaccine(s) which should not be used to fulfill the recommendation.

ShortVaccine which is contraindicated to fulfill the recommendation
Control0..*
BindingFor example codes, see VaccineAdministeredValueSet
(example to http://hl7.org/fhir/ValueSet/vaccine-code
TypeCodeableConcept
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. ImmunizationRecommendation.recommendation.forecastStatus
Definition

Indicates the patient status with respect to the path to immunity for the target disease.

ShortVaccine recommendation status
Control1..1
BindingFor example codes, see ImmunizationRecommendationStatusCodes
(example to http://hl7.org/fhir/ValueSet/immunization-recommendation-status
TypeCodeableConcept
Is Modifiertrue because 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).
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. ImmunizationRecommendation.recommendation.forecastReason
Definition

The reason for the assigned forecast status.

ShortVaccine administration status reason
Control1..*
BindingUnless not suitable, these codes SHALL be taken from Recommendation-Categories for Immunizations
(extensible to http://fhir.ch/ig/ch-vacd/ValueSet/ch-vacd-recommendation-categories-vs
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. ImmunizationRecommendation.recommendation.dateCriterion
Definition

Vaccine date recommendations. For example, earliest date to administer, latest date to administer, etc.

ShortDates governing proposed immunization
Control1..*
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. ImmunizationRecommendation.recommendation.dateCriterion.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
50. ImmunizationRecommendation.recommendation.dateCriterion.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
52. ImmunizationRecommendation.recommendation.dateCriterion.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
54. ImmunizationRecommendation.recommendation.dateCriterion.code
Definition

Date classification of recommendation. For example, earliest date to give, latest date to give, etc.

ShortType of date
Control1..1
BindingFor example codes, see ImmunizationRecommendationDateCriterionCodes
(example to http://hl7.org/fhir/ValueSet/immunization-recommendation-date-criterion
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. ImmunizationRecommendation.recommendation.dateCriterion.value
Definition

The date whose meaning is specified by dateCriterion.code.

ShortRecommended date
Control1..1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. ImmunizationRecommendation.recommendation.description
Definition

Contains the description about the protocol under which the vaccine was administered.

ShortProtocol details
Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. ImmunizationRecommendation.recommendation.series
Definition

One possible path to achieve presumed immunity against a disease - within the context of an authority.

ShortName of vaccination series
Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. ImmunizationRecommendation.recommendation.doseNumber[x]
Definition

Nominal position of the recommended dose in a series (e.g. dose 2 is the next recommended dose).

ShortRecommended dose number within series
Comments

The use of an integer is prefered if known. A string should only be used in cases where an interger is not available (such as when documenting a recurring booster dose).

Control0..1
TypeChoice of: positiveInt, string
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. ImmunizationRecommendation.recommendation.seriesDoses[x]
Definition

The recommended number of doses to achieve immunity.

ShortRecommended number of doses for immunity
Comments

The use of an integer is prefered if known. A string should only be used in cases where an interger is not available (such as when documenting a recurring booster dose).

Control0..1
TypeChoice of: positiveInt, string
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
66. ImmunizationRecommendation.recommendation.supportingImmunization
Definition

Immunization event history and/or evaluation that supports the status and recommendation.

ShortPast immunizations supporting recommendation
Control0..*
TypeReference(Immunization, ImmunizationEvaluation)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. ImmunizationRecommendation.recommendation.supportingPatientInformation
Definition

Patient Information that supports the status and recommendation. This includes patient observations, adverse reactions and allergy/intolerance information.

ShortPatient observations supporting recommendation
Control0..*
TypeReference(Resource)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))