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11.7 Resource ImmunizationRecommendation - Content

Public Health and Emergency Response Work GroupMaturity Level: 1 Trial UseCompartments: Patient

A patient's point-in-time immunization and recommendation (i.e. forecasting a patient's immunization eligibility according to a published schedule) with optional supporting justification.

The ImmunizationRecommendation resource is intended to cover communication of a specified patient's immunization recommendations and status across all healthcare disciplines in all care settings and all regions.

Additionally, the ImmunizationRecommendation resource is expected to cover key concepts related to the querying of a patient's immunization recommendations and status. This resource - through consultation with the PHER work group - is believed to meet key use cases and information requirements as defined in the existing HL7 v3 POIZ domain and Immunization Domain Analysis Model.

This resource references the following resources:

  • Allergy/Intolerance
  • Patient
  • Organization
  • Immunization
  • Observation

One of the considerations for this resource is if it is better for this resource to be a profile of the CarePlan resource, or if it is more appropriate for this to be a separate resource due to the number of immunization profile-specific data elements.

This resource is referenced by DiagnosticReport and Observation

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. ImmunizationRecommendation DomainResourceGuidance or advice relating to an immunization
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierBusiness identifier
... patient Σ1..1Reference(Patient)Who this profile is for
... recommendation ΣI1..*BackboneElementVaccine administration recommendations
+ One of vaccineCode or targetDisease SHALL be present
.... date Σ1..1dateTimeDate recommendation created
.... vaccineCode Σ0..1CodeableConceptVaccine recommendation applies to
Vaccine Administered Value Set (Example)
.... targetDisease Σ0..1CodeableConceptDisease to be immunized against
Immunization Recommendation Target Disease Codes (Example)
.... doseNumber Σ0..1positiveIntRecommended dose number
.... forecastStatus Σ1..1CodeableConceptVaccine administration status
Immunization Recommendation Status Codes (Example)
.... dateCriterion 0..*BackboneElementDates governing proposed immunization
..... code 1..1CodeableConceptType of date
Immunization Recommendation Date Criterion Codes (Example)
..... value 1..1dateTimeRecommended date
.... protocol 0..1BackboneElementProtocol used by recommendation
..... doseSequence 0..1positiveIntDose number within sequence
..... description 0..1stringProtocol details
..... authority 0..1Reference(Organization)Who is responsible for protocol
..... series 0..1stringName of vaccination series
.... supportingImmunization 0..*Reference(Immunization)Past immunizations supporting recommendation
.... supportingPatientInformation 0..*Reference(Observation | AllergyIntolerance)Patient observations supporting recommendation

doco Documentation for this format

UML Diagram (Legend)

ImmunizationRecommendation (DomainResource)A unique identifier assigned to this particular recommendation recordidentifier : Identifier [0..*]The patient the recommendations are forpatient : Reference [1..1] « Patient »RecommendationThe date the immunization recommendation was createddate : dateTime [1..1]Vaccine that pertains to the recommendationvaccineCode : CodeableConcept [0..1] « The type of vaccine administered (Strength=Example)Vaccine Administered Value Set?? »The targeted disease for the recommendationtargetDisease : CodeableConcept [0..1] « The disease that the recommended vaccination targets (Strength=Example)Immunization Recommendation T...?? »The next recommended dose number (e.g. dose 2 is the next recommended dose)doseNumber : positiveInt [0..1]Vaccine administration statusforecastStatus : CodeableConcept [1..1] « The patient's status with respect to a vaccination protocol (Strength=Example)Immunization Recommendation S...?? »Immunization event history that supports the status and recommendationsupportingImmunization : Reference [0..*] « Immunization »Patient Information that supports the status and recommendation. This includes patient observations, adverse reactions and allergy/intolerance informationsupportingPatientInformation : Reference [0..*] « Observation| AllergyIntolerance »DateCriterionDate classification of recommendation. For example, earliest date to give, latest date to give, etccode : CodeableConcept [1..1] « Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.) (Strength=Example)Immunization Recommendation D...?? »The date whose meaning is specified by dateCriterion.codevalue : dateTime [1..1]ProtocolIndicates the nominal position in a series of the next dose. This is the recommended dose number as per a specified protocoldoseSequence : positiveInt [0..1]Contains the description about the protocol under which the vaccine was administereddescription : string [0..1]Indicates the authority who published the protocol. For example, ACIPauthority : Reference [0..1] « Organization »One possible path to achieve presumed immunity against a disease - within the context of an authorityseries : string [0..1]Vaccine date recommendations. For example, earliest date to administer, latest date to administer, etcdateCriterion[0..*]Contains information about the protocol under which the vaccine was administeredprotocol[0..1]Vaccine administration recommendationsrecommendation[1..*]

XML Template

<ImmunizationRecommendation xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business identifier --></identifier>
 <patient><!-- 1..1 Reference(Patient) Who this profile is for --></patient>
 <recommendation>  <!-- 1..* Vaccine administration recommendations -->
  <date value="[dateTime]"/><!-- 1..1 Date recommendation created -->
  <vaccineCode><!-- 0..1 CodeableConcept Vaccine recommendation applies to --></vaccineCode>
  <targetDisease><!-- 0..1 CodeableConcept Disease to be immunized against --></targetDisease>
  <doseNumber value="[positiveInt]"/><!-- 0..1 Recommended dose number -->
  <forecastStatus><!-- 1..1 CodeableConcept Vaccine administration status --></forecastStatus>
  <dateCriterion>  <!-- 0..* Dates governing proposed immunization -->
   <code><!-- 1..1 CodeableConcept Type of date --></code>
   <value value="[dateTime]"/><!-- 1..1 Recommended date -->
  </dateCriterion>
  <protocol>  <!-- 0..1 Protocol used by recommendation -->
   <doseSequence value="[positiveInt]"/><!-- 0..1 Dose number within sequence -->
   <description value="[string]"/><!-- 0..1 Protocol details -->
   <authority><!-- 0..1 Reference(Organization) Who is responsible for protocol --></authority>
   <series value="[string]"/><!-- 0..1 Name of vaccination series -->
  </protocol>
  <supportingImmunization><!-- 0..* Reference(Immunization) Past immunizations supporting recommendation --></supportingImmunization>
  <supportingPatientInformation><!-- 0..* Reference(Observation|
    AllergyIntolerance) Patient observations supporting recommendation --></supportingPatientInformation>
 </recommendation>
</ImmunizationRecommendation>

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:ImmunizationRecommendation;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:ImmunizationRecommendation.identifier [ Identifier ], ... ; # 0..* Business identifier
  fhir:ImmunizationRecommendation.patient [ Reference(Patient) ]; # 1..1 Who this profile is for
  fhir:ImmunizationRecommendation.recommendation [ # 1..* Vaccine administration recommendations
    fhir:ImmunizationRecommendation.recommendation.date [ dateTime ]; # 1..1 Date recommendation created
    fhir:ImmunizationRecommendation.recommendation.vaccineCode [ CodeableConcept ]; # 0..1 Vaccine recommendation applies to
    fhir:ImmunizationRecommendation.recommendation.targetDisease [ CodeableConcept ]; # 0..1 Disease to be immunized against
    fhir:ImmunizationRecommendation.recommendation.doseNumber [ positiveInt ]; # 0..1 Recommended dose number
    fhir:ImmunizationRecommendation.recommendation.forecastStatus [ CodeableConcept ]; # 1..1 Vaccine administration status
    fhir:ImmunizationRecommendation.recommendation.dateCriterion [ # 0..* Dates governing proposed immunization
      fhir:ImmunizationRecommendation.recommendation.dateCriterion.code [ CodeableConcept ]; # 1..1 Type of date
      fhir:ImmunizationRecommendation.recommendation.dateCriterion.value [ dateTime ]; # 1..1 Recommended date
    ], ...;
    fhir:ImmunizationRecommendation.recommendation.protocol [ # 0..1 Protocol used by recommendation
      fhir:ImmunizationRecommendation.recommendation.protocol.doseSequence [ positiveInt ]; # 0..1 Dose number within sequence
      fhir:ImmunizationRecommendation.recommendation.protocol.description [ string ]; # 0..1 Protocol details
      fhir:ImmunizationRecommendation.recommendation.protocol.authority [ Reference(Organization) ]; # 0..1 Who is responsible for protocol
      fhir:ImmunizationRecommendation.recommendation.protocol.series [ string ]; # 0..1 Name of vaccination series
    ];
    fhir:ImmunizationRecommendation.recommendation.supportingImmunization [ Reference(Immunization) ], ... ; # 0..* Past immunizations supporting recommendation
    fhir:ImmunizationRecommendation.recommendation.supportingPatientInformation [ Reference(Observation|AllergyIntolerance) ], ... ; # 0..* Patient observations supporting recommendation
  ], ...;
]

Changes since DSTU2

ImmunizationRecommendation
ImmunizationRecommendation.recommendation.vaccineCode
  • Min Cardinality changed from 1 to 0
ImmunizationRecommendation.recommendation.targetDisease
  • Added Element
ImmunizationRecommendation.recommendation.protocol.doseSequence
  • Type changed from integer to positiveInt

See the Full Difference for further information

This analysis is available as XML or JSON.

See R2 <--> R3 Conversion Maps (status = 1 test that all execute ok. All tests pass round-trip testing and all r3 resources are valid.).

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. ImmunizationRecommendation DomainResourceGuidance or advice relating to an immunization
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierBusiness identifier
... patient Σ1..1Reference(Patient)Who this profile is for
... recommendation ΣI1..*BackboneElementVaccine administration recommendations
+ One of vaccineCode or targetDisease SHALL be present
.... date Σ1..1dateTimeDate recommendation created
.... vaccineCode Σ0..1CodeableConceptVaccine recommendation applies to
Vaccine Administered Value Set (Example)
.... targetDisease Σ0..1CodeableConceptDisease to be immunized against
Immunization Recommendation Target Disease Codes (Example)
.... doseNumber Σ0..1positiveIntRecommended dose number
.... forecastStatus Σ1..1CodeableConceptVaccine administration status
Immunization Recommendation Status Codes (Example)
.... dateCriterion 0..*BackboneElementDates governing proposed immunization
..... code 1..1CodeableConceptType of date
Immunization Recommendation Date Criterion Codes (Example)
..... value 1..1dateTimeRecommended date
.... protocol 0..1BackboneElementProtocol used by recommendation
..... doseSequence 0..1positiveIntDose number within sequence
..... description 0..1stringProtocol details
..... authority 0..1Reference(Organization)Who is responsible for protocol
..... series 0..1stringName of vaccination series
.... supportingImmunization 0..*Reference(Immunization)Past immunizations supporting recommendation
.... supportingPatientInformation 0..*Reference(Observation | AllergyIntolerance)Patient observations supporting recommendation

doco Documentation for this format

UML Diagram (Legend)

ImmunizationRecommendation (DomainResource)A unique identifier assigned to this particular recommendation recordidentifier : Identifier [0..*]The patient the recommendations are forpatient : Reference [1..1] « Patient »RecommendationThe date the immunization recommendation was createddate : dateTime [1..1]Vaccine that pertains to the recommendationvaccineCode : CodeableConcept [0..1] « The type of vaccine administered (Strength=Example)Vaccine Administered Value Set?? »The targeted disease for the recommendationtargetDisease : CodeableConcept [0..1] « The disease that the recommended vaccination targets (Strength=Example)Immunization Recommendation T...?? »The next recommended dose number (e.g. dose 2 is the next recommended dose)doseNumber : positiveInt [0..1]Vaccine administration statusforecastStatus : CodeableConcept [1..1] « The patient's status with respect to a vaccination protocol (Strength=Example)Immunization Recommendation S...?? »Immunization event history that supports the status and recommendationsupportingImmunization : Reference [0..*] « Immunization »Patient Information that supports the status and recommendation. This includes patient observations, adverse reactions and allergy/intolerance informationsupportingPatientInformation : Reference [0..*] « Observation| AllergyIntolerance »DateCriterionDate classification of recommendation. For example, earliest date to give, latest date to give, etccode : CodeableConcept [1..1] « Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.) (Strength=Example)Immunization Recommendation D...?? »The date whose meaning is specified by dateCriterion.codevalue : dateTime [1..1]ProtocolIndicates the nominal position in a series of the next dose. This is the recommended dose number as per a specified protocoldoseSequence : positiveInt [0..1]Contains the description about the protocol under which the vaccine was administereddescription : string [0..1]Indicates the authority who published the protocol. For example, ACIPauthority : Reference [0..1] « Organization »One possible path to achieve presumed immunity against a disease - within the context of an authorityseries : string [0..1]Vaccine date recommendations. For example, earliest date to administer, latest date to administer, etcdateCriterion[0..*]Contains information about the protocol under which the vaccine was administeredprotocol[0..1]Vaccine administration recommendationsrecommendation[1..*]

XML Template

<ImmunizationRecommendation xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business identifier --></identifier>
 <patient><!-- 1..1 Reference(Patient) Who this profile is for --></patient>
 <recommendation>  <!-- 1..* Vaccine administration recommendations -->
  <date value="[dateTime]"/><!-- 1..1 Date recommendation created -->
  <vaccineCode><!-- 0..1 CodeableConcept Vaccine recommendation applies to --></vaccineCode>
  <targetDisease><!-- 0..1 CodeableConcept Disease to be immunized against --></targetDisease>
  <doseNumber value="[positiveInt]"/><!-- 0..1 Recommended dose number -->
  <forecastStatus><!-- 1..1 CodeableConcept Vaccine administration status --></forecastStatus>
  <dateCriterion>  <!-- 0..* Dates governing proposed immunization -->
   <code><!-- 1..1 CodeableConcept Type of date --></code>
   <value value="[dateTime]"/><!-- 1..1 Recommended date -->
  </dateCriterion>
  <protocol>  <!-- 0..1 Protocol used by recommendation -->
   <doseSequence value="[positiveInt]"/><!-- 0..1 Dose number within sequence -->
   <description value="[string]"/><!-- 0..1 Protocol details -->
   <authority><!-- 0..1 Reference(Organization) Who is responsible for protocol --></authority>
   <series value="[string]"/><!-- 0..1 Name of vaccination series -->
  </protocol>
  <supportingImmunization><!-- 0..* Reference(Immunization) Past immunizations supporting recommendation --></supportingImmunization>
  <supportingPatientInformation><!-- 0..* Reference(Observation|
    AllergyIntolerance) Patient observations supporting recommendation --></supportingPatientInformation>
 </recommendation>
</ImmunizationRecommendation>

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:ImmunizationRecommendation;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:ImmunizationRecommendation.identifier [ Identifier ], ... ; # 0..* Business identifier
  fhir:ImmunizationRecommendation.patient [ Reference(Patient) ]; # 1..1 Who this profile is for
  fhir:ImmunizationRecommendation.recommendation [ # 1..* Vaccine administration recommendations
    fhir:ImmunizationRecommendation.recommendation.date [ dateTime ]; # 1..1 Date recommendation created
    fhir:ImmunizationRecommendation.recommendation.vaccineCode [ CodeableConcept ]; # 0..1 Vaccine recommendation applies to
    fhir:ImmunizationRecommendation.recommendation.targetDisease [ CodeableConcept ]; # 0..1 Disease to be immunized against
    fhir:ImmunizationRecommendation.recommendation.doseNumber [ positiveInt ]; # 0..1 Recommended dose number
    fhir:ImmunizationRecommendation.recommendation.forecastStatus [ CodeableConcept ]; # 1..1 Vaccine administration status
    fhir:ImmunizationRecommendation.recommendation.dateCriterion [ # 0..* Dates governing proposed immunization
      fhir:ImmunizationRecommendation.recommendation.dateCriterion.code [ CodeableConcept ]; # 1..1 Type of date
      fhir:ImmunizationRecommendation.recommendation.dateCriterion.value [ dateTime ]; # 1..1 Recommended date
    ], ...;
    fhir:ImmunizationRecommendation.recommendation.protocol [ # 0..1 Protocol used by recommendation
      fhir:ImmunizationRecommendation.recommendation.protocol.doseSequence [ positiveInt ]; # 0..1 Dose number within sequence
      fhir:ImmunizationRecommendation.recommendation.protocol.description [ string ]; # 0..1 Protocol details
      fhir:ImmunizationRecommendation.recommendation.protocol.authority [ Reference(Organization) ]; # 0..1 Who is responsible for protocol
      fhir:ImmunizationRecommendation.recommendation.protocol.series [ string ]; # 0..1 Name of vaccination series
    ];
    fhir:ImmunizationRecommendation.recommendation.supportingImmunization [ Reference(Immunization) ], ... ; # 0..* Past immunizations supporting recommendation
    fhir:ImmunizationRecommendation.recommendation.supportingPatientInformation [ Reference(Observation|AllergyIntolerance) ], ... ; # 0..* Patient observations supporting recommendation
  ], ...;
]

Changes since DSTU2

ImmunizationRecommendation
ImmunizationRecommendation.recommendation.vaccineCode
  • Min Cardinality changed from 1 to 0
ImmunizationRecommendation.recommendation.targetDisease
  • Added Element
ImmunizationRecommendation.recommendation.protocol.doseSequence
  • Type changed from integer to positiveInt

See the Full Difference for further information

This analysis is available as XML or JSON.

See R2 <--> R3 Conversion Maps (status = 1 test that all execute ok. All tests pass round-trip testing and all r3 resources are valid.).

 

Alternate definitions: Master Definition (XML, JSON), XML Schema/Schematron + JSON Schema, ShEx (for Turtle)

PathDefinitionTypeReference
ImmunizationRecommendation.recommendation.vaccineCode The type of vaccine administeredExampleVaccine Administered Value Set
ImmunizationRecommendation.recommendation.targetDisease The disease that the recommended vaccination targetsExampleImmunization Recommendation Target Disease Codes
ImmunizationRecommendation.recommendation.forecastStatus The patient's status with respect to a vaccination protocolExampleImmunization Recommendation Status Codes
ImmunizationRecommendation.recommendation.dateCriterion.code Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.)ExampleImmunization Recommendation Date Criterion Codes

  • imr-1: On ImmunizationRecommendation.recommendation: One of vaccineCode or targetDisease SHALL be present (expression on ImmunizationRecommendation.recommendation: vaccineCode.exists() or targetDisease.exists())

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

NameTypeDescriptionExpressionIn Common
datedateDate recommendation createdImmunizationRecommendation.recommendation.date
dose-numbernumberRecommended dose numberImmunizationRecommendation.recommendation.doseNumber
dose-sequencenumberDose number within sequenceImmunizationRecommendation.recommendation.protocol.doseSequence
identifiertokenBusiness identifierImmunizationRecommendation.identifier
informationreferencePatient observations supporting recommendationImmunizationRecommendation.recommendation.supportingPatientInformation
(AllergyIntolerance, Observation)
patientreferenceWho this profile is forImmunizationRecommendation.patient
(Patient)
statustokenVaccine administration statusImmunizationRecommendation.recommendation.forecastStatus
supportreferencePast immunizations supporting recommendationImmunizationRecommendation.recommendation.supportingImmunization
(Immunization)
target-diseasetokenDisease to be immunized againstImmunizationRecommendation.recommendation.targetDisease
vaccine-typetokenVaccine recommendation applies toImmunizationRecommendation.recommendation.vaccineCode