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
Resource Profile: ImmunizationRecommendation
| Official URL: https://euvabeco.net/vcds-ig/StructureDefinition/ImmunizationRecommendation | Version: 0.1.0 | |||
| Draft as of 2026-10-22 | Computable Name: ImmunizationRecommendation | |||
The ImmunizationRecommendation resource returns a recommendation based upon the individual patient situation exposed by the questionnaire response and the immunization history.
The VCDS provides detailed and contextualized justification texts for each recommendation. They will be exposed as properties of the forecastReason attribute. Several justifications can be presented for a same recommendation, it belongs to the initiating system to present them according to their presentation classes and its own screen layout rules.
Usages:
- Examples for this Profile: ImmunizationRecommendation/example-recommendation
You can also check for usages in the FHIR IG Statistics
Formal Views of Profile Content
Description of Profiles, Differentials, Snapshots and how the different presentations work.
| Name | Flags | Card. | Type | Description & Constraints Filter:  |
|---|---|---|---|---|
  ImmunizationRecommendation |
0..* | ImmunizationRecommendation | Guidance or advice relating to an immunization | |
  implicitRules |
0..1 | uri | A set of rules under which this content was created | |
| contained |
0..* | Resource | Contained, inline Resources | |
  Slices for extension |
1..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
   extension:rulesetVersion |
1..1 | string | Version of the VCDS ruleset URL: https://euvabeco.net/vcds-ig/StructureDefinition/RulesetVersion | |
 modifierExtension |
0..* | Extension | Extensions that cannot be ignored | |
 patient |
1..1 | Reference(Patient) | Who this profile is for | |
| date |
1..1 | dateTime | Date recommendation(s) created | |
  recommendation |
C | 1..* | BackboneElement | Vaccine administration recommendations Constraints: imr-1 |
 modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| vaccineCode |
C | 0..* | CodeableConcept | Vaccine or vaccine group recommendation applies to Binding: NUVA codes (required) |
| forecastStatus |
1..1 | CodeableConcept | Vaccine recommendation status Binding: Forecast Statuses (required) | |
 forecastReason |
0..* | CodeableConcept | Vaccine administration status reason Binding: Forecast reasons for a recommendation (required) | |
| Documentation for this format | ||||
Terminology Bindings
| Path | Status | Usage | ValueSet | Version | Source |
| ImmunizationRecommendation.recommendation.vaccineCode | Base | required | NUVA codes | 📦0.1.0 | This IG |
| ImmunizationRecommendation.recommendation.forecastStatus | Base | required | Forecast Statuses | 📦0.1.0 | This IG |
| ImmunizationRecommendation.recommendation.forecastReason | Base | required | Forecast reasons for a recommendation | 📦0.1.0 | This IG |
Constraints
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | ImmunizationRecommendation | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | ImmunizationRecommendation | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource |
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().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 | error | ImmunizationRecommendation | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated |
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
|
| dom-5 | error | ImmunizationRecommendation | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | ImmunizationRecommendation | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
| imr-1 | error | ImmunizationRecommendation.recommendation | One of vaccineCode or targetDisease SHALL be present |
vaccineCode.exists() or targetDisease.exists()
|
This structure is derived from ImmunizationRecommendation
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| ImmunizationRecommendation |
0..* | ImmunizationRecommendation | Guidance or advice relating to an immunization | |
| Slices for extension |
1..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| extension:rulesetVersion |
1..1 | string | Version of the VCDS ruleset URL: https://euvabeco.net/vcds-ig/StructureDefinition/RulesetVersion | |
 recommendation |
||||
| vaccineCode |
0..* | CodeableConcept | Vaccine or vaccine group recommendation applies to Binding: NUVA codes (required) | |
| forecastStatus |
1..1 | CodeableConcept | Vaccine recommendation status Binding: Forecast Statuses (required) | |
| forecastReason |
0..* | CodeableConcept | Vaccine administration status reason Binding: Forecast reasons for a recommendation (required) | |
| Documentation for this format | ||||
Terminology Bindings (Differential)
| Path | Status | Usage | ValueSet | Version | Source |
| ImmunizationRecommendation.recommendation.vaccineCode | Base | required | NUVA codes | 📦0.1.0 | This IG |
| ImmunizationRecommendation.recommendation.forecastStatus | Base | required | Forecast Statuses | 📦0.1.0 | This IG |
| ImmunizationRecommendation.recommendation.forecastReason | Base | required | Forecast reasons for a recommendation | 📦0.1.0 | This IG |
| Name | Flags | Card. | Type | Description & Constraints Filter: | ||||
|---|---|---|---|---|---|---|---|---|
| ImmunizationRecommendation |
0..* | ImmunizationRecommendation | Guidance or advice relating to an immunization | |||||
| id |
0..1 | id | Logical id of this artifact | |||||
| meta |
0..1 | Meta | Metadata about the resource | |||||
| implicitRules |
0..1 | uri | A set of rules under which this content was created | |||||
| language |
0..1 | code | Language of the resource content Binding: AllLanguages (required): IETF language tag for a human language
| |||||
| text |
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
| Slices for extension |
1..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| extension:rulesetVersion |
1..1 | string | Version of the VCDS ruleset URL: https://euvabeco.net/vcds-ig/StructureDefinition/RulesetVersion | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored | |||||
| identifier |
0..* | Identifier | Business identifier | |||||
| patient |
1..1 | Reference(Patient) | Who this profile is for | |||||
| date |
1..1 | dateTime | Date recommendation(s) created | |||||
| authority |
0..1 | Reference(Organization) | Who is responsible for protocol | |||||
| recommendation |
C | 1..* | BackboneElement | Vaccine administration recommendations Constraints: imr-1 | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| vaccineCode |
C | 0..* | CodeableConcept | Vaccine or vaccine group recommendation applies to Binding: NUVA codes (required) | ||||
| targetDisease |
C | 0..* | CodeableConcept | Disease to be immunized against Binding: ImmunizationTargetDiseaseCodes (example): The disease that the recommended vaccination targets. | ||||
| contraindicatedVaccineCode |
0..* | CodeableConcept | Vaccine which is contraindicated to fulfill the recommendation Binding: VaccineAdministeredValueSet (example): The type of vaccine administered. | |||||
| forecastStatus |
1..1 | CodeableConcept | Vaccine recommendation status Binding: Forecast Statuses (required) | |||||
| forecastReason |
0..* | CodeableConcept | Vaccine administration status reason Binding: Forecast reasons for a recommendation (required) | |||||
| dateCriterion |
0..* | BackboneElement | Dates governing proposed immunization | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| code |
1..1 | CodeableConcept | Type of date Binding: ImmunizationRecommendationDateCriterionCodes (example): Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.). | |||||
| value |
1..1 | dateTime | Recommended date | |||||
| description |
0..1 | markdown | Protocol details | |||||
| series |
0..1 | string | Name of vaccination series | |||||
| doseNumber |
0..1 | string | Recommended dose number within series | |||||
| seriesDoses |
0..1 | string | Recommended number of doses for immunity | |||||
| supportingImmunization |
0..* | Reference(Immunization | ImmunizationEvaluation) | Past immunizations supporting recommendation | |||||
| supportingPatientInformation |
0..* | Reference(Resource) | Patient observations supporting recommendation | |||||
| Documentation for this format | ||||||||
Terminology Bindings
| Path | Status | Usage | ValueSet | Version | Source |
| ImmunizationRecommendation.language | Base | required | All Languages | 📍5.0.0 | FHIR Std. |
| ImmunizationRecommendation.recommendation.vaccineCode | Base | required | NUVA codes | 📦0.1.0 | This IG |
| ImmunizationRecommendation.recommendation.targetDisease | Base | example | Immunization Target Disease Codes | 📍5.0.0 | FHIR Std. |
| ImmunizationRecommendation.recommendation.contraindicatedVaccineCode | Base | example | Vaccine Administered Value Set | 📍5.0.0 | FHIR Std. |
| ImmunizationRecommendation.recommendation.forecastStatus | Base | required | Forecast Statuses | 📦0.1.0 | This IG |
| ImmunizationRecommendation.recommendation.forecastReason | Base | required | Forecast reasons for a recommendation | 📦0.1.0 | This IG |
| ImmunizationRecommendation.recommendation.dateCriterion.code | Base | example | Immunization Recommendation Date Criterion Codes | 📍5.0.0 | FHIR Std. |
Constraints
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | ImmunizationRecommendation | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | ImmunizationRecommendation | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource |
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().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 | error | ImmunizationRecommendation | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated |
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
|
| dom-5 | error | ImmunizationRecommendation | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | ImmunizationRecommendation | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
| imr-1 | error | ImmunizationRecommendation.recommendation | One of vaccineCode or targetDisease SHALL be present |
vaccineCode.exists() or targetDisease.exists()
|
This structure is derived from ImmunizationRecommendation
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| ImmunizationRecommendation |
0..* | ImmunizationRecommendation | Guidance or advice relating to an immunization | |
| implicitRules |
0..1 | uri | A set of rules under which this content was created | |
| contained |
0..* | Resource | Contained, inline Resources | |
| Slices for extension |
1..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| extension:rulesetVersion |
1..1 | string | Version of the VCDS ruleset URL: https://euvabeco.net/vcds-ig/StructureDefinition/RulesetVersion | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored | |
| patient |
1..1 | Reference(Patient) | Who this profile is for | |
| date |
1..1 | dateTime | Date recommendation(s) created | |
| recommendation |
C | 1..* | BackboneElement | Vaccine administration recommendations Constraints: imr-1 |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| vaccineCode |
C | 0..* | CodeableConcept | Vaccine or vaccine group recommendation applies to Binding: NUVA codes (required) |
| forecastStatus |
1..1 | CodeableConcept | Vaccine recommendation status Binding: Forecast Statuses (required) | |
| forecastReason |
0..* | CodeableConcept | Vaccine administration status reason Binding: Forecast reasons for a recommendation (required) | |
| Documentation for this format | ||||
Terminology Bindings
| Path | Status | Usage | ValueSet | Version | Source |
| ImmunizationRecommendation.recommendation.vaccineCode | Base | required | NUVA codes | 📦0.1.0 | This IG |
| ImmunizationRecommendation.recommendation.forecastStatus | Base | required | Forecast Statuses | 📦0.1.0 | This IG |
| ImmunizationRecommendation.recommendation.forecastReason | Base | required | Forecast reasons for a recommendation | 📦0.1.0 | This IG |
Constraints
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | ImmunizationRecommendation | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | ImmunizationRecommendation | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource |
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().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 | error | ImmunizationRecommendation | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated |
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
|
| dom-5 | error | ImmunizationRecommendation | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | ImmunizationRecommendation | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
| imr-1 | error | ImmunizationRecommendation.recommendation | One of vaccineCode or targetDisease SHALL be present |
vaccineCode.exists() or targetDisease.exists()
|
Differential View
This structure is derived from ImmunizationRecommendation
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| ImmunizationRecommendation |
0..* | ImmunizationRecommendation | Guidance or advice relating to an immunization | |
| Slices for extension |
1..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| extension:rulesetVersion |
1..1 | string | Version of the VCDS ruleset URL: https://euvabeco.net/vcds-ig/StructureDefinition/RulesetVersion | |
| recommendation |
||||
| vaccineCode |
0..* | CodeableConcept | Vaccine or vaccine group recommendation applies to Binding: NUVA codes (required) | |
| forecastStatus |
1..1 | CodeableConcept | Vaccine recommendation status Binding: Forecast Statuses (required) | |
| forecastReason |
0..* | CodeableConcept | Vaccine administration status reason Binding: Forecast reasons for a recommendation (required) | |
| Documentation for this format | ||||
Terminology Bindings (Differential)
| Path | Status | Usage | ValueSet | Version | Source |
| ImmunizationRecommendation.recommendation.vaccineCode | Base | required | NUVA codes | 📦0.1.0 | This IG |
| ImmunizationRecommendation.recommendation.forecastStatus | Base | required | Forecast Statuses | 📦0.1.0 | This IG |
| ImmunizationRecommendation.recommendation.forecastReason | Base | required | Forecast reasons for a recommendation | 📦0.1.0 | This IG |
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints Filter: | ||||
|---|---|---|---|---|---|---|---|---|
| ImmunizationRecommendation |
0..* | ImmunizationRecommendation | Guidance or advice relating to an immunization | |||||
| id |
0..1 | id | Logical id of this artifact | |||||
| meta |
0..1 | Meta | Metadata about the resource | |||||
| implicitRules |
0..1 | uri | A set of rules under which this content was created | |||||
| language |
0..1 | code | Language of the resource content Binding: AllLanguages (required): IETF language tag for a human language
| |||||
| text |
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
| Slices for extension |
1..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| extension:rulesetVersion |
1..1 | string | Version of the VCDS ruleset URL: https://euvabeco.net/vcds-ig/StructureDefinition/RulesetVersion | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored | |||||
| identifier |
0..* | Identifier | Business identifier | |||||
| patient |
1..1 | Reference(Patient) | Who this profile is for | |||||
| date |
1..1 | dateTime | Date recommendation(s) created | |||||
| authority |
0..1 | Reference(Organization) | Who is responsible for protocol | |||||
| recommendation |
C | 1..* | BackboneElement | Vaccine administration recommendations Constraints: imr-1 | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| vaccineCode |
C | 0..* | CodeableConcept | Vaccine or vaccine group recommendation applies to Binding: NUVA codes (required) | ||||
| targetDisease |
C | 0..* | CodeableConcept | Disease to be immunized against Binding: ImmunizationTargetDiseaseCodes (example): The disease that the recommended vaccination targets. | ||||
| contraindicatedVaccineCode |
0..* | CodeableConcept | Vaccine which is contraindicated to fulfill the recommendation Binding: VaccineAdministeredValueSet (example): The type of vaccine administered. | |||||
| forecastStatus |
1..1 | CodeableConcept | Vaccine recommendation status Binding: Forecast Statuses (required) | |||||
| forecastReason |
0..* | CodeableConcept | Vaccine administration status reason Binding: Forecast reasons for a recommendation (required) | |||||
| dateCriterion |
0..* | BackboneElement | Dates governing proposed immunization | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| code |
1..1 | CodeableConcept | Type of date Binding: ImmunizationRecommendationDateCriterionCodes (example): Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.). | |||||
| value |
1..1 | dateTime | Recommended date | |||||
| description |
0..1 | markdown | Protocol details | |||||
| series |
0..1 | string | Name of vaccination series | |||||
| doseNumber |
0..1 | string | Recommended dose number within series | |||||
| seriesDoses |
0..1 | string | Recommended number of doses for immunity | |||||
| supportingImmunization |
0..* | Reference(Immunization | ImmunizationEvaluation) | Past immunizations supporting recommendation | |||||
| supportingPatientInformation |
0..* | Reference(Resource) | Patient observations supporting recommendation | |||||
| Documentation for this format | ||||||||
Terminology Bindings
| Path | Status | Usage | ValueSet | Version | Source |
| ImmunizationRecommendation.language | Base | required | All Languages | 📍5.0.0 | FHIR Std. |
| ImmunizationRecommendation.recommendation.vaccineCode | Base | required | NUVA codes | 📦0.1.0 | This IG |
| ImmunizationRecommendation.recommendation.targetDisease | Base | example | Immunization Target Disease Codes | 📍5.0.0 | FHIR Std. |
| ImmunizationRecommendation.recommendation.contraindicatedVaccineCode | Base | example | Vaccine Administered Value Set | 📍5.0.0 | FHIR Std. |
| ImmunizationRecommendation.recommendation.forecastStatus | Base | required | Forecast Statuses | 📦0.1.0 | This IG |
| ImmunizationRecommendation.recommendation.forecastReason | Base | required | Forecast reasons for a recommendation | 📦0.1.0 | This IG |
| ImmunizationRecommendation.recommendation.dateCriterion.code | Base | example | Immunization Recommendation Date Criterion Codes | 📍5.0.0 | FHIR Std. |
Constraints
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | ImmunizationRecommendation | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | ImmunizationRecommendation | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource |
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().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 | error | ImmunizationRecommendation | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated |
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
|
| dom-5 | error | ImmunizationRecommendation | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | ImmunizationRecommendation | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
| imr-1 | error | ImmunizationRecommendation.recommendation | One of vaccineCode or targetDisease SHALL be present |
vaccineCode.exists() or targetDisease.exists()
|
This structure is derived from ImmunizationRecommendation
Other representations of profile: CSV, Excel, Schematron