Australian Digital Health Agency FHIR
1.2.0-ci-build - draft Australia flag

Australian Digital Health Agency FHIR, published by Australian Digital Health Agency. This guide is not an authorized publication; it is the continuous build for version 1.2.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/AuDigitalHealth/mcv/ and changes regularly. See the Directory of published versions

Resource Profile: ADHAImmunizationAIR - Detailed Descriptions

Active as of 2024-09-16

Definitions for the dh-immunization-air-1 resource profile.

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

0. Immunization
Definition

Describes the event of a patient being administered a vaccine or a record of an immunization as held on the Australian Immunisation Register

ShortRecord of immunisation event held on the Australian Immunisation Register
2. Immunization.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..?
4. Immunization.status
Fixed Valuecompleted
6. Immunization.vaccineCode
8. Immunization.vaccineCode.coding
Control1..?
10. Immunization.occurrence[x]
TypedateTime, string
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
12. Immunization.primarySource
Control1..?
Must Supporttrue
Fixed Valuetrue
14. Immunization.lotNumber
ShortBatch number
Must Supporttrue
16. Immunization.protocolApplied
Control1..?
18. Immunization.protocolApplied.targetDisease
ShortAntigen
Control1..?

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

0. Immunization
Definition

Describes the event of a patient being administered a vaccine or a record of an immunization as held on the Australian Immunisation Register


Describes the event of a patient being administered a vaccine or a record of an immunization as reported by a patient, a clinician or another party.

ShortRecord of immunisation event held on the Australian Immunisation RegisterImmunization event information
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. Immunization.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. Immunization.extension:vaccine-serial-number
Slice Namevaccine-serial-number
Definition

Serial number for the vial of vaccine used in an administration.

ShortVaccine vial serial number
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(Vaccine Vial Serial Number) (Extension Type: string)
Is Modifierfalse
Must Supporttrue
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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Immunization.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())
8. Immunization.identifier
Definition

A unique identifier assigned to this immunization record.

ShortBusiness identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control10..*
TypeIdentifier
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Immunization.status
Definition

Indicates the current status of the immunization event.

Shortcompleted | entered-in-error | not-done
Comments

Will generally be set to show that the immunization has been completed or not done. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Control1..1
BindingThe codes SHALL be taken from ImmunizationStatusCodeshttp://hl7.org/fhir/ValueSet/immunization-status|4.0.1
(required to http://hl7.org/fhir/ValueSet/immunization-status|4.0.1)

A set of codes indicating the current status of an Immunization.

Typecode
Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains statuses entered-in-error and not-done which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Obligations
    ObligationsActor
    SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
    SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
    Summarytrue
    Fixed Valuecompleted
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. Immunization.statusReason
    Definition

    Indicates the reason the immunization event was not performed.

    ShortReason not done
    Comments

    This is generally only used for the status of "not-done". The reason for performing the immunization event is captured in reasonCode, not here.

    Control0..1
    BindingThe codes SHOULD be taken from For example codes, see Reason Vaccine Not Administered .http://hl7.org/fhir/ValueSet/immunization-status-reason
    (preferred to https://healthterminologies.gov.au/fhir/ValueSet/reason-vaccine-not-administered-3)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. Immunization.vaccineCode
    Definition

    Vaccine that was administered or was to be administered.

    ShortVaccine product administered
    Control1..1
    BindingFor example codes, see VaccineAdministeredValueSethttp://hl7.org/fhir/ValueSet/vaccine-code
    (example to http://hl7.org/fhir/ValueSet/vaccine-code)
    Additional BindingsPurposeDocumentation
    Australian Medicines Terminology Vaccine .Preferred

    This value set is for use when AMT (Australian Medicines Terminology) codes are preferred.

    Australian Immunisation Register Vaccine .Preferred

    This value set is for use when AIR (Australian Immunisation Register) codes are preferred.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Obligations
      ObligationsActor
      SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
      SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. Immunization.vaccineCode.coding
      Definition

      A reference to a code defined by a terminology system.

      ShortCode defined by a terminology system
      Comments

      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

      Control10..*
      TypeCoding
      Is Modifierfalse
      Summarytrue
      Requirements

      Allows for alternative encodings within a code system, and translations to other code systems.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on Immunization.vaccineCode.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • pattern @ $this
      • 18. Immunization.vaccineCode.coding:amtVaccineCode
        Slice NameamtVaccineCode
        Definition

        A reference to a code defined by a terminology system.

        ShortCode defined by a terminology system
        Comments

        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

        Control0..1*
        BindingThe codes SHALL be taken from For codes, see Australian Medicines Terminology Vaccine .
        (required to https://healthterminologies.gov.au/fhir/ValueSet/amt-vaccine-1)
        TypeCoding
        Is Modifierfalse
        Must Supporttrue
        Obligations
          ObligationsActor
          SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
          SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
          Summarytrue
          Requirements

          Allows for alternative encodings within a code system, and translations to other code systems.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          20. Immunization.vaccineCode.coding:airVaccineCode
          Slice NameairVaccineCode
          Definition

          A reference to a code defined by a terminology system.

          ShortCode defined by a terminology system
          Comments

          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

          Control0..1*
          BindingThe codes SHALL be taken from For codes, see Australian Immunisation Register Vaccine .
          (required to https://healthterminologies.gov.au/fhir/ValueSet/australian-immunisation-register-vaccine-1)
          TypeCoding
          Is Modifierfalse
          Must Supporttrue
          Obligations
            ObligationsActor
            SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
            SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
            Summarytrue
            Requirements

            Allows for alternative encodings within a code system, and translations to other code systems.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            22. Immunization.patient
            Definition

            The patient who either received or did not receive the immunization.

            ShortWho was immunized
            Control1..1
            This element is affected by the following invariants: inv-dh-imm-01
            TypeReference(ADHA Core Patient, Patient)
            Is Modifierfalse
            Must Supporttrue
            Obligations
              ObligationsActor
              SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
              SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              inv-dh-imm-01: At least reference or a valid identifier shall be present (reference.exists() or identifier.where(system.count() + value.count() >1).exists())
              24. Immunization.encounter
              Definition

              The visit or admission or other contact between patient and health care provider the immunization was performed as part of.

              ShortEncounter immunization was part of
              Control0..1
              TypeReference(ADHA Core Encounter, Encounter)
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              26. Immunization.occurrence[x]
              Definition

              Date vaccine administered or was to be administered.

              ShortVaccine administration date
              Comments

              When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given. An exact date is always preferable, but the use of the String data type is acceptable when an exact date is not known. A small number of vaccines (e.g. live oral typhoid vaccine) are given as a series of patient self-administered dose over a span of time. In cases like this, often, only the first dose (typically a provider supervised dose) is recorded with the occurrence indicating the date/time of the first dose.

              Control1..1
              TypedateTime, string
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Obligations
                ObligationsActor
                SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                28. Immunization.primarySource
                Definition

                An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded.

                ShortIndicates context the data was recorded in
                Comments

                Reflects the “reliability” of the content.

                Control10..1
                Typeboolean
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Obligations
                  ObligationsActor
                  SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                  SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                  Summarytrue
                  Fixed Valuetrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  30. Immunization.lotNumber
                  Definition

                  Lot number of the vaccine product.

                  ShortBatch numberVaccine lot number
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  32. Immunization.performer
                  Definition

                  Indicates who performed the immunization event.

                  ShortWho performed event
                  Control0..*
                  TypeBackboneElement
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  SlicingThis element introduces a set of slices on Immunization.performer. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • pattern @ function
                  • 34. Immunization.performer.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. Immunization.performer.function
                    Definition

                    Describes the type of performance (e.g. ordering provider, administering provider, etc.).

                    ShortWhat type of performance was done
                    Control0..1
                    BindingUnless not suitable, these codes SHALL be taken from hl7VS-providerRole - AU Extendedhttp://hl7.org/fhir/ValueSet/immunization-function
                    (extensible to http://terminology.hl7.org.au/ValueSet/v2-0443-extended)
                    TypeCodeableConcept
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    38. Immunization.performer.actor
                    Definition

                    The practitioner or organization who performed the action.

                    ShortIndividual or organization who was performing
                    Comments

                    When the individual practitioner who performed the action is known, it is best to send.

                    Control1..1
                    This element is affected by the following invariants: inv-dh-imm-01
                    TypeReference(ADHA Authoring PractitionerRole, ADHA Core Organization, Practitioner, PractitionerRole, Organization)
                    Is Modifierfalse
                    Must Supporttrue
                    Must Support TypesNo must-support rules about the choice of types/profiles
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    inv-dh-imm-02: At least reference or a valid identifier shall be present (reference.exists() or identifier.where(system.count() + value.count() >1).exists())
                    40. Immunization.performer:administeredBy
                    Slice NameadministeredBy
                    Definition

                    Indicates who performed the immunization event.

                    ShortImmunisation Administered ByWho performed event
                    Control0..1*
                    TypeBackboneElement
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    42. Immunization.performer:administeredBy.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())
                    44. Immunization.performer:administeredBy.function
                    Definition

                    Describes the type of performance (e.g. ordering provider, administering provider, etc.).

                    ShortAdministering roleWhat type of performance was done
                    Control10..1
                    BindingUnless not suitable, these codes SHALL be taken from ImmunizationFunctionCodeshttp://hl7.org/fhir/ValueSet/immunization-function
                    (extensible to http://hl7.org/fhir/ValueSet/immunization-function)

                    The role a practitioner or organization plays in the immunization event.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summarytrue
                    Pattern Value{
                      "coding" : [{
                        "system" : "http://terminology.hl7.org/CodeSystem/v2-0443",
                        "code" : "AP"
                      }]
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    46. Immunization.performer:administeredBy.actor
                    Definition

                    The practitioner or organization who performed the action.

                    ShortAdministering performerIndividual or organization who was performing
                    Comments

                    When the individual practitioner who performed the action is known, it is best to send.

                    Control1..1
                    TypeReference(Practitioner, PractitionerRole, Organization)
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    48. Immunization.performer:approvedBy
                    Slice NameapprovedBy
                    Definition

                    Indicates who performed the immunization event.

                    ShortImmunisation Approved ByWho performed event
                    Control0..1*
                    TypeBackboneElement
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    50. Immunization.performer:approvedBy.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())
                    52. Immunization.performer:approvedBy.function
                    Definition

                    Describes the type of performance (e.g. ordering provider, administering provider, etc.).

                    ShortApprover roleWhat type of performance was done
                    Control10..1
                    BindingUnless not suitable, these codes SHALL be taken from ImmunizationFunctionCodeshttp://hl7.org/fhir/ValueSet/immunization-function
                    (extensible to http://hl7.org/fhir/ValueSet/immunization-function)

                    The role a practitioner or organization plays in the immunization event.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summarytrue
                    Pattern Value{
                      "coding" : [{
                        "system" : "http://terminology.hl7.org/CodeSystem/v2-0443",
                        "code" : "OP"
                      }]
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    54. Immunization.performer:approvedBy.actor
                    Definition

                    The practitioner or organization who performed the action.

                    ShortApproverIndividual or organization who was performing
                    Comments

                    When the individual practitioner who performed the action is known, it is best to send.

                    Control1..1
                    TypeReference(Practitioner, PractitionerRole, Organization)
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    56. Immunization.note
                    Definition

                    Extra information about the immunization that is not conveyed by the other attributes.

                    ShortAdditional immunization notes
                    Control0..*
                    TypeAnnotation
                    Is Modifierfalse
                    Must Supporttrue
                    Obligations
                      ObligationsActor
                      SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                      SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      58. Immunization.reasonCode
                      Definition

                      Reasons why the vaccine was administered.

                      ShortWhy immunization occurred
                      Control0..*
                      BindingThe codes SHOULD be taken from For example codes, see Reason Vaccine Administered .http://hl7.org/fhir/ValueSet/immunization-reason
                      (preferred to https://healthterminologies.gov.au/fhir/ValueSet/reason-vaccine-administered-1)
                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      60. Immunization.isSubpotent
                      Definition

                      Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent.

                      ShortDose potency
                      Comments

                      Typically, the recognition of the dose being sub-potent is retrospective, after the administration (ex. notification of a manufacturer recall after administration). However, in the case of a partial administration (the patient moves unexpectedly and only some of the dose is actually administered), subpotency may be recognized immediately, but it is still important to record the event.

                      Control0..1
                      Typeboolean
                      Is Modifiertrue because This element is labeled as a modifier because an immunization event with a subpotent vaccine doesn't protect the patient the same way as a potent dose.
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Meaning if MissingBy default, a dose should be considered to be potent.
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      62. Immunization.protocolApplied
                      Definition

                      The protocol (set of recommendations) being followed by the provider who administered the dose.

                      ShortProtocol followed by the provider
                      Control10..*
                      TypeBackboneElement
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      64. Immunization.protocolApplied.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())
                      66. Immunization.protocolApplied.series
                      Definition

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

                      ShortName of vaccine series
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      68. Immunization.protocolApplied.targetDisease
                      Definition

                      The vaccine preventable disease the dose is being administered against.

                      ShortAntigenVaccine preventatable disease being targetted
                      Control10..*
                      BindingThe codes SHOULD be taken from For example codes, see Vaccination Target Disease .http://hl7.org/fhir/ValueSet/immunization-target-disease
                      (preferred to https://healthterminologies.gov.au/fhir/ValueSet/vaccination-target-disease-1)
                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      70. Immunization.protocolApplied.doseNumber[x]
                      Definition

                      Nominal position in a series.

                      ShortDose number within series
                      Comments

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

                      Control1..1
                      TypeChoice of: positiveInt, string
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Must Support TypesNo must-support rules about the choice of types/profiles
                      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. Immunization
                      Definition

                      Describes the event of a patient being administered a vaccine or a record of an immunization as held on the Australian Immunisation Register

                      ShortRecord of immunisation event held on the Australian Immunisation Register
                      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. Immunization.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. Immunization.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. Immunization.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. Immunization.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)

                      A human language.

                      Additional BindingsPurpose
                      AllLanguagesMax Binding
                      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. Immunization.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. Immunization.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.

                      ShortContained, 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..*
                      TypeResource
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesinline resources, anonymous resources, contained resources
                      14. Immunization.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 Immunization.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 16. Immunization.extension:vaccine-serial-number
                        Slice Namevaccine-serial-number
                        Definition

                        Serial number for the vial of vaccine used in an administration.

                        ShortVaccine vial serial number
                        Control0..1
                        This element is affected by the following invariants: ele-1
                        TypeExtension(Vaccine Vial Serial Number) (Extension Type: string)
                        Is Modifierfalse
                        Must Supporttrue
                        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. Immunization.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. Immunization.identifier
                        Definition

                        A unique identifier assigned to this immunization record.

                        ShortBusiness identifier
                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control1..*
                        TypeIdentifier
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        22. Immunization.status
                        Definition

                        Indicates the current status of the immunization event.

                        Shortcompleted | entered-in-error | not-done
                        Comments

                        Will generally be set to show that the immunization has been completed or not done. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                        Control1..1
                        BindingThe codes SHALL be taken from ImmunizationStatusCodes
                        (required to http://hl7.org/fhir/ValueSet/immunization-status|4.0.1)

                        A set of codes indicating the current status of an Immunization.

                        Typecode
                        Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains statuses entered-in-error and not-done which means that the resource should not be treated as valid
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Obligations
                          ObligationsActor
                          SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                          SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                          Summarytrue
                          Fixed Valuecompleted
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          24. Immunization.statusReason
                          Definition

                          Indicates the reason the immunization event was not performed.

                          ShortReason not done
                          Comments

                          This is generally only used for the status of "not-done". The reason for performing the immunization event is captured in reasonCode, not here.

                          Control0..1
                          BindingThe codes SHOULD be taken from Reason Vaccine Not Administered .
                          (preferred to https://healthterminologies.gov.au/fhir/ValueSet/reason-vaccine-not-administered-3)
                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          26. Immunization.vaccineCode
                          Definition

                          Vaccine that was administered or was to be administered.

                          ShortVaccine product administered
                          Control1..1
                          BindingFor example codes, see VaccineAdministeredValueSet
                          (example to http://hl7.org/fhir/ValueSet/vaccine-code)
                          Additional BindingsPurposeDocumentation
                          Australian Medicines Terminology Vaccine .Preferred

                          This value set is for use when AMT (Australian Medicines Terminology) codes are preferred.

                          Australian Immunisation Register Vaccine .Preferred

                          This value set is for use when AIR (Australian Immunisation Register) codes are preferred.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supporttrue
                          Obligations
                            ObligationsActor
                            SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                            SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            28. Immunization.vaccineCode.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
                            30. Immunization.vaccineCode.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())
                            SlicingThis element introduces a set of slices on Immunization.vaccineCode.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 32. Immunization.vaccineCode.coding
                              Definition

                              A reference to a code defined by a terminology system.

                              ShortCode defined by a terminology system
                              Comments

                              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                              Control1..*
                              TypeCoding
                              Is Modifierfalse
                              Summarytrue
                              Requirements

                              Allows for alternative encodings within a code system, and translations to other code systems.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              SlicingThis element introduces a set of slices on Immunization.vaccineCode.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • pattern @ $this
                              • 34. Immunization.vaccineCode.coding:amtVaccineCode
                                Slice NameamtVaccineCode
                                Definition

                                A reference to a code defined by a terminology system.

                                ShortCode defined by a terminology system
                                Comments

                                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                Control0..1
                                BindingThe codes SHALL be taken from Australian Medicines Terminology Vaccine .
                                (required to https://healthterminologies.gov.au/fhir/ValueSet/amt-vaccine-1)
                                TypeCoding
                                Is Modifierfalse
                                Must Supporttrue
                                Obligations
                                  ObligationsActor
                                  SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                                  SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                                  Summarytrue
                                  Requirements

                                  Allows for alternative encodings within a code system, and translations to other code systems.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  36. Immunization.vaccineCode.coding:airVaccineCode
                                  Slice NameairVaccineCode
                                  Definition

                                  A reference to a code defined by a terminology system.

                                  ShortCode defined by a terminology system
                                  Comments

                                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                  Control0..1
                                  BindingThe codes SHALL be taken from Australian Immunisation Register Vaccine .
                                  (required to https://healthterminologies.gov.au/fhir/ValueSet/australian-immunisation-register-vaccine-1)
                                  TypeCoding
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Obligations
                                    ObligationsActor
                                    SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                                    SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                                    Summarytrue
                                    Requirements

                                    Allows for alternative encodings within a code system, and translations to other code systems.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    38. Immunization.vaccineCode.text
                                    Definition

                                    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                    ShortPlain text representation of the concept
                                    Comments

                                    Very often the text is the same as a displayName of one of the codings.

                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Requirements

                                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    40. Immunization.patient
                                    Definition

                                    The patient who either received or did not receive the immunization.

                                    ShortWho was immunized
                                    Control1..1
                                    This element is affected by the following invariants: inv-dh-imm-01
                                    TypeReference(ADHA Core Patient)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Obligations
                                      ObligationsActor
                                      SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                                      SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      inv-dh-imm-01: At least reference or a valid identifier shall be present (reference.exists() or identifier.where(system.count() + value.count() >1).exists())
                                      42. Immunization.encounter
                                      Definition

                                      The visit or admission or other contact between patient and health care provider the immunization was performed as part of.

                                      ShortEncounter immunization was part of
                                      Control0..1
                                      TypeReference(ADHA Core Encounter)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      44. Immunization.occurrence[x]
                                      Definition

                                      Date vaccine administered or was to be administered.

                                      ShortVaccine administration date
                                      Comments

                                      When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given. An exact date is always preferable, but the use of the String data type is acceptable when an exact date is not known. A small number of vaccines (e.g. live oral typhoid vaccine) are given as a series of patient self-administered dose over a span of time. In cases like this, often, only the first dose (typically a provider supervised dose) is recorded with the occurrence indicating the date/time of the first dose.

                                      Control1..1
                                      TypedateTime
                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Obligations
                                        ObligationsActor
                                        SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                                        SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        46. Immunization.recorded
                                        Definition

                                        The date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event.

                                        ShortWhen the immunization was first captured in the subject's record
                                        Control0..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()))
                                        48. Immunization.primarySource
                                        Definition

                                        An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded.

                                        ShortIndicates context the data was recorded in
                                        Comments

                                        Reflects the “reliability” of the content.

                                        Control1..1
                                        Typeboolean
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Obligations
                                          ObligationsActor
                                          SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                                          SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                                          Summarytrue
                                          Fixed Valuetrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          50. Immunization.reportOrigin
                                          Definition

                                          The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.

                                          ShortIndicates the source of a secondarily reported record
                                          Comments

                                          Should not be populated if primarySource = True, not required even if primarySource = False.

                                          Control0..1
                                          BindingFor example codes, see ImmunizationOriginCodes
                                          (example to http://hl7.org/fhir/ValueSet/immunization-origin)

                                          The source of the data for a record which is not from a primary source.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          52. Immunization.location
                                          Definition

                                          The service delivery location where the vaccine administration occurred.

                                          ShortWhere immunization occurred
                                          Control0..1
                                          TypeReference(Location)
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          54. Immunization.manufacturer
                                          Definition

                                          Physical vaccine product manufacturer.

                                          ShortVaccine manufacturer
                                          Control0..1
                                          TypeReference(Organization)
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          56. Immunization.lotNumber
                                          Definition

                                          Lot number of the vaccine product.

                                          ShortBatch number
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          58. Immunization.expirationDate
                                          Definition

                                          Date vaccine batch expires.

                                          ShortVaccine expiration date
                                          Control0..1
                                          Typedate
                                          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. Immunization.site
                                          Definition

                                          Body site where vaccine was administered.

                                          ShortBody site vaccine was administered
                                          Control0..1
                                          BindingThe codes SHOULD be taken from Immunisation Anatomical Site .
                                          (preferred to https://healthterminologies.gov.au/fhir/ValueSet/immunisation-anatomical-site-1)
                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          62. Immunization.route
                                          Definition

                                          The path by which the vaccine product is taken into the body.

                                          ShortHow vaccine entered body
                                          Control0..1
                                          BindingThe codes SHOULD be taken from Immunisation Route of Administration .
                                          (preferred to https://healthterminologies.gov.au/fhir/ValueSet/immunisation-route-of-administration-1)
                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          64. Immunization.doseQuantity
                                          Definition

                                          The quantity of vaccine product that was administered.

                                          ShortAmount of vaccine administered
                                          Control0..1
                                          TypeQuantity(SimpleQuantity)
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          66. Immunization.performer
                                          Definition

                                          Indicates who performed the immunization event.

                                          ShortWho performed event
                                          Control0..*
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          SlicingThis element introduces a set of slices on Immunization.performer. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • pattern @ function
                                          • 68. Immunization.performer.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
                                            70. Immunization.performer.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())
                                            72. Immunization.performer.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())
                                            74. Immunization.performer.function
                                            Definition

                                            Describes the type of performance (e.g. ordering provider, administering provider, etc.).

                                            ShortWhat type of performance was done
                                            Control0..1
                                            BindingUnless not suitable, these codes SHALL be taken from hl7VS-providerRole - AU Extended
                                            (extensible to http://terminology.hl7.org.au/ValueSet/v2-0443-extended)
                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            76. Immunization.performer.actor
                                            Definition

                                            The practitioner or organization who performed the action.

                                            ShortIndividual or organization who was performing
                                            Comments

                                            When the individual practitioner who performed the action is known, it is best to send.

                                            Control1..1
                                            This element is affected by the following invariants: inv-dh-imm-01
                                            TypeReference(ADHA Authoring PractitionerRole, ADHA Core Organization)
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Must Support TypesNo must-support rules about the choice of types/profiles
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            inv-dh-imm-02: At least reference or a valid identifier shall be present (reference.exists() or identifier.where(system.count() + value.count() >1).exists())
                                            78. Immunization.performer:administeredBy
                                            Slice NameadministeredBy
                                            Definition

                                            Indicates who performed the immunization event.

                                            ShortImmunisation Administered By
                                            Control0..1
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            80. Immunization.performer:administeredBy.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
                                            82. Immunization.performer:administeredBy.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())
                                            84. Immunization.performer:administeredBy.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())
                                            86. Immunization.performer:administeredBy.function
                                            Definition

                                            Describes the type of performance (e.g. ordering provider, administering provider, etc.).

                                            ShortAdministering role
                                            Control1..1
                                            BindingUnless not suitable, these codes SHALL be taken from ImmunizationFunctionCodes
                                            (extensible to http://hl7.org/fhir/ValueSet/immunization-function)

                                            The role a practitioner or organization plays in the immunization event.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summarytrue
                                            Pattern Value{
                                              "coding" : [{
                                                "system" : "http://terminology.hl7.org/CodeSystem/v2-0443",
                                                "code" : "AP"
                                              }]
                                            }
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            88. Immunization.performer:administeredBy.actor
                                            Definition

                                            The practitioner or organization who performed the action.

                                            ShortAdministering performer
                                            Comments

                                            When the individual practitioner who performed the action is known, it is best to send.

                                            Control1..1
                                            TypeReference(Practitioner, PractitionerRole, Organization)
                                            Is Modifierfalse
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            90. Immunization.performer:approvedBy
                                            Slice NameapprovedBy
                                            Definition

                                            Indicates who performed the immunization event.

                                            ShortImmunisation Approved By
                                            Control0..1
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            92. Immunization.performer:approvedBy.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
                                            94. Immunization.performer:approvedBy.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())
                                            96. Immunization.performer:approvedBy.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())
                                            98. Immunization.performer:approvedBy.function
                                            Definition

                                            Describes the type of performance (e.g. ordering provider, administering provider, etc.).

                                            ShortApprover role
                                            Control1..1
                                            BindingUnless not suitable, these codes SHALL be taken from ImmunizationFunctionCodes
                                            (extensible to http://hl7.org/fhir/ValueSet/immunization-function)

                                            The role a practitioner or organization plays in the immunization event.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summarytrue
                                            Pattern Value{
                                              "coding" : [{
                                                "system" : "http://terminology.hl7.org/CodeSystem/v2-0443",
                                                "code" : "OP"
                                              }]
                                            }
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            100. Immunization.performer:approvedBy.actor
                                            Definition

                                            The practitioner or organization who performed the action.

                                            ShortApprover
                                            Comments

                                            When the individual practitioner who performed the action is known, it is best to send.

                                            Control1..1
                                            TypeReference(Practitioner, PractitionerRole, Organization)
                                            Is Modifierfalse
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            102. Immunization.note
                                            Definition

                                            Extra information about the immunization that is not conveyed by the other attributes.

                                            ShortAdditional immunization notes
                                            Control0..*
                                            TypeAnnotation
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Obligations
                                              ObligationsActor
                                              SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                                              SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              104. Immunization.reasonCode
                                              Definition

                                              Reasons why the vaccine was administered.

                                              ShortWhy immunization occurred
                                              Control0..*
                                              BindingThe codes SHOULD be taken from Reason Vaccine Administered .
                                              (preferred to https://healthterminologies.gov.au/fhir/ValueSet/reason-vaccine-administered-1)
                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              106. Immunization.reasonReference
                                              Definition

                                              Condition, Observation or DiagnosticReport that supports why the immunization was administered.

                                              ShortWhy immunization occurred
                                              Control0..*
                                              TypeReference(Condition, Observation, DiagnosticReport)
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              108. Immunization.isSubpotent
                                              Definition

                                              Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent.

                                              ShortDose potency
                                              Comments

                                              Typically, the recognition of the dose being sub-potent is retrospective, after the administration (ex. notification of a manufacturer recall after administration). However, in the case of a partial administration (the patient moves unexpectedly and only some of the dose is actually administered), subpotency may be recognized immediately, but it is still important to record the event.

                                              Control0..1
                                              Typeboolean
                                              Is Modifiertrue because This element is labeled as a modifier because an immunization event with a subpotent vaccine doesn't protect the patient the same way as a potent dose.
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Meaning if MissingBy default, a dose should be considered to be potent.
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              110. Immunization.subpotentReason
                                              Definition

                                              Reason why a dose is considered to be subpotent.

                                              ShortReason for being subpotent
                                              Control0..*
                                              BindingFor example codes, see ImmunizationSubpotentReason
                                              (example to http://hl7.org/fhir/ValueSet/immunization-subpotent-reason)

                                              The reason why a dose is considered to be subpotent.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              112. Immunization.education
                                              Definition

                                              Educational material presented to the patient (or guardian) at the time of vaccine administration.

                                              ShortEducational material presented to patient
                                              Control0..*
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              imm-1: One of documentType or reference SHALL be present (documentType.exists() or reference.exists())
                                              114. Immunization.education.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
                                              116. Immunization.education.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())
                                              118. Immunization.education.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())
                                              120. Immunization.education.documentType
                                              Definition

                                              Identifier of the material presented to the patient.

                                              ShortEducational material document identifier
                                              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()))
                                              122. Immunization.education.reference
                                              Definition

                                              Reference pointer to the educational material given to the patient if the information was on line.

                                              ShortEducational material reference pointer
                                              Control0..1
                                              Typeuri
                                              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()))
                                              124. Immunization.education.publicationDate
                                              Definition

                                              Date the educational material was published.

                                              ShortEducational material publication date
                                              Control0..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()))
                                              126. Immunization.education.presentationDate
                                              Definition

                                              Date the educational material was given to the patient.

                                              ShortEducational material presentation date
                                              Control0..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()))
                                              128. Immunization.programEligibility
                                              Definition

                                              Indicates a patient's eligibility for a funding program.

                                              ShortPatient eligibility for a vaccination program
                                              Control0..*
                                              BindingFor example codes, see ImmunizationProgramEligibility
                                              (example to http://hl7.org/fhir/ValueSet/immunization-program-eligibility)

                                              The patient's eligibility for a vaccation program.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              130. Immunization.fundingSource
                                              Definition

                                              Indicates the source of the vaccine actually administered. This may be different than the patient eligibility (e.g. the patient may be eligible for a publically purchased vaccine but due to inventory issues, vaccine purchased with private funds was actually administered).

                                              ShortFunding source for the vaccine
                                              Control0..1
                                              BindingFor example codes, see ImmunizationFundingSource
                                              (example to http://hl7.org/fhir/ValueSet/immunization-funding-source)

                                              The source of funding used to purchase the vaccine administered.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              132. Immunization.reaction
                                              Definition

                                              Categorical data indicating that an adverse event is associated in time to an immunization.

                                              ShortDetails of a reaction that follows immunization
                                              Comments

                                              A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case, it should be recorded as a new AllergyIntolerance resource instance as most systems will not query against past Immunization.reaction elements.

                                              Control0..*
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              134. Immunization.reaction.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
                                              136. Immunization.reaction.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())
                                              138. Immunization.reaction.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())
                                              140. Immunization.reaction.date
                                              Definition

                                              Date of reaction to the immunization.

                                              ShortWhen reaction started
                                              Control0..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()))
                                              142. Immunization.reaction.detail
                                              Definition

                                              Details of the reaction.

                                              ShortAdditional information on reaction
                                              Control0..1
                                              TypeReference(Observation)
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              144. Immunization.reaction.reported
                                              Definition

                                              Self-reported indicator.

                                              ShortIndicates self-reported reaction
                                              Control0..1
                                              Typeboolean
                                              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()))
                                              146. Immunization.protocolApplied
                                              Definition

                                              The protocol (set of recommendations) being followed by the provider who administered the dose.

                                              ShortProtocol followed by the provider
                                              Control1..*
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              148. Immunization.protocolApplied.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
                                              150. Immunization.protocolApplied.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())
                                              152. Immunization.protocolApplied.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())
                                              154. Immunization.protocolApplied.series
                                              Definition

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

                                              ShortName of vaccine series
                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supporttrue
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              156. Immunization.protocolApplied.authority
                                              Definition

                                              Indicates the authority who published the protocol (e.g. ACIP) that is being followed.

                                              ShortWho is responsible for publishing the recommendations
                                              Control0..1
                                              TypeReference(Organization)
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              158. Immunization.protocolApplied.targetDisease
                                              Definition

                                              The vaccine preventable disease the dose is being administered against.

                                              ShortAntigen
                                              Control1..*
                                              BindingThe codes SHOULD be taken from Vaccination Target Disease .
                                              (preferred to https://healthterminologies.gov.au/fhir/ValueSet/vaccination-target-disease-1)
                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              160. Immunization.protocolApplied.doseNumber[x]
                                              Definition

                                              Nominal position in a series.

                                              ShortDose number within series
                                              Comments

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

                                              Control1..1
                                              TypeChoice of: positiveInt, string
                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supporttrue
                                              Must Support TypesNo must-support rules about the choice of types/profiles
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              162. Immunization.protocolApplied.seriesDoses[x]
                                              Definition

                                              The recommended number of doses to achieve immunity.

                                              ShortRecommended number of doses for immunity
                                              Comments

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

                                              Control0..1
                                              TypeChoice of: positiveInt, string
                                              [x] NoteSeeChoice of Data Typesfor 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()))