Vaccination CDS Implementation Guide
0.1.0 - ci-build
Vaccination CDS Implementation Guide, published by Euvabeco. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/EUVABECO/VCDS/ and changes regularly. See the Directory of published versions
Draft as of 2024-10-25 |
Definitions for the ImmunizationRecommendation resource profile.
Guidance on how to interpret the contents of this table can be found here
0. ImmunizationRecommendation | |
2. ImmunizationRecommendation.extension | |
Control | 1..? |
Slicing | This element introduces a set of slices on ImmunizationRecommendation.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
4. ImmunizationRecommendation.extension:rulesetVersion | |
Slice Name | rulesetVersion |
Control | 1..1 |
Type | Extension(Version of the VCDS ruleset) (Extension Type: string) |
6. ImmunizationRecommendation.recommendation | |
8. ImmunizationRecommendation.recommendation.vaccineCode | |
Binding | The codes SHALL be taken from NUVA codes (required to https://euvabeco.net/vcds-ig/ValueSet/NUVA ) |
10. ImmunizationRecommendation.recommendation.forecastStatus | |
Binding | The codes SHALL be taken from Forecast Statuses (required to https://euvabeco.net/vcds-ig/ValueSet/ForecastStatus ) |
12. ImmunizationRecommendation.recommendation.forecastReason | |
Binding | The codes SHALL be taken from Forecast reasons (required to https://euvabeco.net/vcds-ig/ValueSet/ForecastReasons ) |
Guidance on how to interpret the contents of this table can be found here
0. ImmunizationRecommendation | |
Definition | A patient's point-in-time set of recommendations (i.e. forecasting) according to a published schedule with optional supporting justification. |
Short | Guidance or advice relating to an immunization |
Control | 0..* |
Is Modifier | false |
Must Support | false |
Summary | false |
Invariants | dom-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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists()) |
2. ImmunizationRecommendation.implicitRules | |
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. |
Short | A 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 its narrative along with other profiles, value sets, etc. |
Control | 0..1 |
Type | uri |
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
4. ImmunizationRecommendation.contained | |
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning. |
Short | Contained, 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. |
Control | 0..* This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5 |
Type | Resource |
Is Modifier | false |
Must Support | false |
Summary | false |
Alternate Names | inline resources, anonymous resources, contained resources |
6. ImmunizationRecommendation.extension | |
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, 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. |
Short | ExtensionAdditional 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. |
Control | 10..* |
Type | Extension |
Is Modifier | false |
Must Support | false |
Summary | false |
Alternate Names | extensions, user content |
Invariants | ele-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()) |
Slicing | This element introduces a set of slices on ImmunizationRecommendation.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
8. ImmunizationRecommendation.extension:rulesetVersion | |
Slice Name | rulesetVersion |
Definition | The version of the VCDS ruletset that was used to elaborate this recommendation. |
Short | Version of the VCDS ruleset |
Control | 1..1 |
Type | Extension(Version of the VCDS ruleset) (Extension Type: string) |
Is Modifier | false |
Must Support | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
10. ImmunizationRecommendation.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, 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). |
Short | Extensions 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. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them |
Must Support | false |
Summary | true |
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 Names | extensions, user content |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
12. ImmunizationRecommendation.patient | |
Definition | The patient the recommendation(s) are for. |
Short | Who this profile is for |
Control | 1..1 |
Type | Reference(Patient) |
Is Modifier | false |
Must Support | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
14. ImmunizationRecommendation.date | |
Definition | The date the immunization recommendation(s) were created. |
Short | Date recommendation(s) created |
Control | 1..1 |
Type | dateTime |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
16. ImmunizationRecommendation.recommendation | |
Definition | Vaccine administration recommendations. |
Short | Vaccine administration recommendations |
Comments | A given instance of the .recommendation backbone element should correspond to a single recommended administration. |
Control | 1..* |
Type | BackboneElement |
Is Modifier | false |
Must Support | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) imr-1: One of vaccineCode or targetDisease SHALL be present (vaccineCode.exists() or targetDisease.exists()) |
18. ImmunizationRecommendation.recommendation.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, 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). |
Short | Extensions 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. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
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 Names | extensions, user content, modifiers |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
20. ImmunizationRecommendation.recommendation.vaccineCode | |
Definition | Vaccine(s) or vaccine group that pertain to the recommendation. |
Short | Vaccine or vaccine group recommendation applies to |
Control | 0..* This element is affected by the following invariants: imr-1 |
Binding | The codes SHALL be taken from For example codes, see NUVA codeshttp://hl7.org/fhir/ValueSet/vaccine-code (required to https://euvabeco.net/vcds-ig/ValueSet/NUVA ) |
Type | CodeableConcept |
Is Modifier | false |
Must Support | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
22. ImmunizationRecommendation.recommendation.forecastStatus | |
Definition | Indicates the patient status with respect to the path to immunity for the target disease. |
Short | Vaccine recommendation status |
Control | 1..1 |
Binding | The codes SHALL be taken from For example codes, see Forecast Statuseshttp://hl7.org/fhir/ValueSet/immunization-recommendation-status (required to https://euvabeco.net/vcds-ig/ValueSet/ForecastStatus ) |
Type | CodeableConcept |
Is Modifier | true because This element is labeled as a modifier because the forecastStatus indicates whether a patient needs additional doses (due, overdue, etc.) or not (contraindicated, complete, etc.). |
Must Support | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
24. ImmunizationRecommendation.recommendation.forecastReason | |
Definition | The reason for the assigned forecast status. |
Short | Vaccine administration status reason |
Control | 0..* |
Binding | The codes SHALL be taken from For example codes, see Forecast reasonshttp://hl7.org/fhir/ValueSet/immunization-recommendation-reason (required to https://euvabeco.net/vcds-ig/ValueSet/ForecastReasons ) |
Type | CodeableConcept |
Is Modifier | false |
Must Support | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Guidance on how to interpret the contents of this table can be found here
0. ImmunizationRecommendation | |
Definition | A patient's point-in-time set of recommendations (i.e. forecasting) according to a published schedule with optional supporting justification. |
Short | Guidance or advice relating to an immunization |
Control | 0..* |
Is Modifier | false |
Must Support | false |
Summary | false |
Invariants | dom-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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty() )dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated ( contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() )dom-5: If a resource is contained in another resource, it SHALL NOT have a security label ( contained.meta.security.empty() )dom-6: A resource should have narrative for robust management ( text.`div`.exists() ) |
2. ImmunizationRecommendation.id | |
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. |
Short | Logical id of this artifact |
Comments | Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case. |
Control | 0..1 |
Type | id |
Is Modifier | false |
Must Support | false |
Summary | true |
4. ImmunizationRecommendation.meta | |
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. |
Short | Metadata about the resource |
Control | 0..1 |
Type | Meta |
Is Modifier | false |
Must Support | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
6. ImmunizationRecommendation.implicitRules | |
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. |
Short | A 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 its narrative along with other profiles, value sets, etc. |
Control | 0..1 |
Type | uri |
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
8. ImmunizationRecommendation.language | |
Definition | The base language in which the resource is written. |
Short | Language 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). |
Control | 0..1 |
Binding | The codes SHALL be taken from AllLanguages (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0 )IETF language tag for a human language |
Type | code |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | false |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
10. ImmunizationRecommendation.text | |
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. |
Short | Text summary of the resource, for human interpretation |
Comments | Contained resources do not have a 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. |
Control | 0..1 This element is affected by the following invariants: dom-6 |
Type | Narrative |
Is Modifier | false |
Must Support | false |
Summary | false |
Alternate Names | narrative, html, xhtml, display |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
12. ImmunizationRecommendation.contained | |
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning. |
Short | Contained, 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. |
Control | 0..* This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5 |
Type | Resource |
Is Modifier | false |
Must Support | false |
Summary | false |
Alternate Names | inline resources, anonymous resources, contained resources |
14. ImmunizationRecommendation.extension | |
Definition | An Extension |
Short | Extension |
Control | 1..* |
Type | Extension |
Is Modifier | false |
Must Support | false |
Summary | false |
Invariants | ele-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() ) |
Slicing | This element introduces a set of slices on ImmunizationRecommendation.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
16. ImmunizationRecommendation.extension:rulesetVersion | |
Slice Name | rulesetVersion |
Definition | The version of the VCDS ruletset that was used to elaborate this recommendation. |
Short | Version of the VCDS ruleset |
Control | 1..1 |
Type | Extension(Version of the VCDS ruleset) (Extension Type: string) |
Is Modifier | false |
Must Support | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) |
18. ImmunizationRecommendation.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, 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). |
Short | Extensions 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. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them |
Must Support | false |
Summary | true |
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 Names | extensions, user content |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) |
20. ImmunizationRecommendation.identifier | |
Definition | A unique identifier assigned to this particular recommendation record. |
Short | Business identifier |
Note | This is a business identifier, not a resource identifier (see discussion) |
Control | 0..* |
Type | Identifier |
Is Modifier | false |
Must Support | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
22. ImmunizationRecommendation.patient | |
Definition | The patient the recommendation(s) are for. |
Short | Who this profile is for |
Control | 1..1 |
Type | Reference(Patient) |
Is Modifier | false |
Must Support | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
24. ImmunizationRecommendation.date | |
Definition | The date the immunization recommendation(s) were created. |
Short | Date recommendation(s) created |
Control | 1..1 |
Type | dateTime |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
26. ImmunizationRecommendation.authority | |
Definition | Indicates the authority who published the protocol (e.g. ACIP). |
Short | Who is responsible for protocol |
Control | 0..1 |
Type | Reference(Organization) |
Is Modifier | false |
Must Support | false |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
28. ImmunizationRecommendation.recommendation | |
Definition | Vaccine administration recommendations. |
Short | Vaccine administration recommendations |
Comments | A given instance of the .recommendation backbone element should correspond to a single recommended administration. |
Control | 1..* |
Type | BackboneElement |
Is Modifier | false |
Must Support | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )imr-1: One of vaccineCode or targetDisease SHALL be present ( vaccineCode.exists() or targetDisease.exists() ) |
30. ImmunizationRecommendation.recommendation.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Short | Unique id for inter-element referencing |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | string |
Is Modifier | false |
XML Format | In the XML format, this property is represented as an attribute. |
Summary | false |
32. ImmunizationRecommendation.recommendation.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. |
Short | Additional 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. |
Control | 0..* |
Type | Extension |
Is Modifier | false |
Summary | false |
Alternate Names | extensions, user content |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) |
34. ImmunizationRecommendation.recommendation.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, 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). |
Short | Extensions 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. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
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 Names | extensions, user content, modifiers |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) |
36. ImmunizationRecommendation.recommendation.vaccineCode | |
Definition | Vaccine(s) or vaccine group that pertain to the recommendation. |
Short | Vaccine or vaccine group recommendation applies to |
Control | 0..* This element is affected by the following invariants: imr-1 |
Binding | The codes SHALL be taken from NUVA codes (required to https://euvabeco.net/vcds-ig/ValueSet/NUVA ) |
Type | CodeableConcept |
Is Modifier | false |
Must Support | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
38. ImmunizationRecommendation.recommendation.targetDisease | |
Definition | The targeted disease for the recommendation. |
Short | Disease to be immunized against |
Comments | A given instance of the .recommendation backbone element should correspond to a single recommended administration but sometimes that administration (e.g. MMR) will encompass multiple diseases, thus the targetDisease element is allowed to repeat. |
Control | 0..* This element is affected by the following invariants: imr-1 |
Binding | For example codes, see ImmunizationTargetDiseaseCodes (example to http://hl7.org/fhir/ValueSet/immunization-target-disease )The disease that the recommended vaccination targets. |
Type | CodeableConcept |
Is Modifier | false |
Must Support | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
40. ImmunizationRecommendation.recommendation.contraindicatedVaccineCode | |
Definition | Vaccine(s) which should not be used to fulfill the recommendation. |
Short | Vaccine which is contraindicated to fulfill the recommendation |
Control | 0..* |
Binding | For example codes, see VaccineAdministeredValueSet (example to http://hl7.org/fhir/ValueSet/vaccine-code )The type of vaccine administered. |
Type | CodeableConcept |
Is Modifier | false |
Must Support | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
42. ImmunizationRecommendation.recommendation.forecastStatus | |
Definition | Indicates the patient status with respect to the path to immunity for the target disease. |
Short | Vaccine recommendation status |
Control | 1..1 |
Binding | The codes SHALL be taken from Forecast Statuses (required to https://euvabeco.net/vcds-ig/ValueSet/ForecastStatus ) |
Type | CodeableConcept |
Is Modifier | true because This element is labeled as a modifier because the forecastStatus indicates whether a patient needs additional doses (due, overdue, etc.) or not (contraindicated, complete, etc.). |
Must Support | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
44. ImmunizationRecommendation.recommendation.forecastReason | |
Definition | The reason for the assigned forecast status. |
Short | Vaccine administration status reason |
Control | 0..* |
Binding | The codes SHALL be taken from Forecast reasons (required to https://euvabeco.net/vcds-ig/ValueSet/ForecastReasons ) |
Type | CodeableConcept |
Is Modifier | false |
Must Support | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
46. ImmunizationRecommendation.recommendation.dateCriterion | |
Definition | Vaccine date recommendations. For example, earliest date to administer, latest date to administer, etc. |
Short | Dates governing proposed immunization |
Control | 0..* |
Type | BackboneElement |
Is Modifier | false |
Must Support | false |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
48. ImmunizationRecommendation.recommendation.dateCriterion.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Short | Unique id for inter-element referencing |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | string |
Is Modifier | false |
XML Format | In the XML format, this property is represented as an attribute. |
Summary | false |
50. ImmunizationRecommendation.recommendation.dateCriterion.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. |
Short | Additional 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. |
Control | 0..* |
Type | Extension |
Is Modifier | false |
Summary | false |
Alternate Names | extensions, user content |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) |
52. ImmunizationRecommendation.recommendation.dateCriterion.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, 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). |
Short | Extensions 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. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
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 Names | extensions, user content, modifiers |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) |
54. ImmunizationRecommendation.recommendation.dateCriterion.code | |
Definition | Date classification of recommendation. For example, earliest date to give, latest date to give, etc. |
Short | Type of date |
Control | 1..1 |
Binding | For example codes, see ImmunizationRecommendationDateCriterionCodes (example to http://hl7.org/fhir/ValueSet/immunization-recommendation-date-criterion )Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.). |
Type | CodeableConcept |
Is Modifier | false |
Must Support | false |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
56. ImmunizationRecommendation.recommendation.dateCriterion.value | |
Definition | The date whose meaning is specified by dateCriterion.code. |
Short | Recommended date |
Control | 1..1 |
Type | dateTime |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | false |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
58. ImmunizationRecommendation.recommendation.description | |
Definition | Contains the description about the protocol under which the vaccine was administered. |
Short | Protocol details |
Control | 0..1 |
Type | markdown |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | false |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
60. ImmunizationRecommendation.recommendation.series | |
Definition | One possible path to achieve presumed immunity against a disease - within the context of an authority. |
Short | Name of vaccination series |
Control | 0..1 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | false |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
62. ImmunizationRecommendation.recommendation.doseNumber | |
Definition | Nominal position of the recommended dose in a series as determined by the evaluation and forecasting process (e.g. dose 2 is the next recommended dose). |
Short | Recommended dose 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). |
Control | 0..1 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
64. ImmunizationRecommendation.recommendation.seriesDoses | |
Definition | The recommended number of doses to achieve immunity as determined by the evaluation and forecasting process. |
Short | Recommended number of doses for immunity |
Comments | The use of an integer is preferred if known. |
Control | 0..1 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | false |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
66. ImmunizationRecommendation.recommendation.supportingImmunization | |
Definition | Immunization event history and/or evaluation that supports the status and recommendation. |
Short | Past immunizations supporting recommendation |
Control | 0..* |
Type | Reference(Immunization, ImmunizationEvaluation) |
Is Modifier | false |
Must Support | false |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
68. ImmunizationRecommendation.recommendation.supportingPatientInformation | |
Definition | Patient Information that supports the status and recommendation. This includes patient observations, adverse reactions and allergy/intolerance information. |
Short | Patient observations supporting recommendation |
Control | 0..* |
Type | Reference(Resource) |
Is Modifier | false |
Must Support | false |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |