2026 US Quality Core Implementation Guide
0.5.0 - cibuild US

2026 US Quality Core Implementation Guide, published by Office of the National Coordinator for Health Information Technology (ONC). This guide is not an authorized publication; it is the continuous build for version 0.5.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/FHIR/us-quality-core/ and changes regularly. See the Directory of published versions

## Resource Profile: US Quality Core ImmunizationRecommendation

Official URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-immunizationrecommendation | Version: 0.5.0
Active as of 2026-05-15 | Computable Name: USQualityCoreImmunizationRecommendation

Profile of ImmunizationRecommendation for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

Usage

See the patterns page for implementation and usage patterns.

### Examples

Example of immunizationrecommendation using a vaccine code

Usages:

- Refer to this Profile: US Quality Core DiagnosticReport Profile for Laboratory Results Reporting and US Quality Core Encounter
- Examples for this Profile: ImmunizationRecommendation/example

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.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ImmunizationRecommendation |  | 0..* | ImmunizationRecommendation | Guidance or advice relating to an immunization
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
patient | Σ | 1..1 | Reference(US Quality Core Patient) | Who this profile is for
date | Σ | 1..1 | dateTime | Date recommendation(s) created
authority |  | 0..1 | Reference(US Quality Core Organization) | Who is responsible for protocol
recommendation | Σ C | 1..* | BackboneElement | Vaccine administration recommendations Constraints: imr-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
vaccineCode | Σ | 0..* | CodeableConcept | Vaccine or vaccine group recommendation applies to Binding: CVX Vaccines Administered Vaccine Set (extensible): CVX Vaccines Administered Vaccine Set
forecastStatus | ?!Σ | 1..1 | CodeableConcept | Vaccine recommendation status Binding: ImmunizationRecommendationStatusCodes (example): The patient's status with respect to a vaccination protocol.
doseNumber[x] | Σ | 0..1 |  | Recommended dose number within series
doseNumberPositiveInt |  |  | positiveInt |
doseNumberString |  |  | string |
supportingImmunization |  | 0..* | Reference(US Quality Core Immunization | US Quality Core ImmunizationEvaluation) | Past immunizations supporting recommendation
supportingPatientInformation |  | 0..* | Reference(US Quality Core Simple Observation | US Quality Core AllergyIntolerance) | Patient observations supporting recommendation
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
ImmunizationRecommendation.​recommendation.vaccineCode | Base | extensible | CVX Vaccines Administered Vaccine Set | 📦20230715 | VSAC v0.18
ImmunizationRecommendation.​recommendation.forecastStatus | Base | example | Immunization Recommendation Status Codes | 📍4.0.1 | 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().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 | 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: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ImmunizationRecommendation |  | 0..* | ImmunizationRecommendation | Guidance or advice relating to an immunization
patient |  | 1..1 | Reference(US Quality Core Patient) | Who this profile is for
authority |  | 0..1 | Reference(US Quality Core Organization) | Who is responsible for protocol
recommendation |  | 1..* | BackboneElement | Vaccine administration recommendations
vaccineCode |  | 0..* | CodeableConcept | Vaccine or vaccine group recommendation applies to Binding: CVX Vaccines Administered Vaccine Set (extensible): CVX Vaccines Administered Vaccine Set
doseNumber[x] |  | 0..1 | positiveInt, string | Recommended dose number within series
supportingImmunization |  | 0..* | Reference(US Quality Core Immunization | US Quality Core ImmunizationEvaluation) | Past immunizations supporting recommendation
supportingPatientInformation |  | 0..* | Reference(US Quality Core Simple Observation | US Quality Core AllergyIntolerance) | Patient observations supporting recommendation
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
ImmunizationRecommendation.​recommendation.vaccineCode | Base | extensible | CVX Vaccines Administered Vaccine Set | 📦20230715 | VSAC v0.18

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ImmunizationRecommendation |  | 0..* | ImmunizationRecommendation | Guidance or advice relating to an immunization
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
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
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Business identifier
patient | Σ | 1..1 | Reference(US Quality Core Patient) | Who this profile is for
date | Σ | 1..1 | dateTime | Date recommendation(s) created
authority |  | 0..1 | Reference(US Quality Core Organization) | Who is responsible for protocol
recommendation | Σ 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 | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
vaccineCode | Σ | 0..* | CodeableConcept | Vaccine or vaccine group recommendation applies to Binding: CVX Vaccines Administered Vaccine Set (extensible): CVX Vaccines Administered Vaccine Set
targetDisease | Σ | 0..1 | CodeableConcept | Disease to be immunized against Binding: ImmunizationRecommendationTargetDiseaseCodes (example): The disease that the recommended vaccination targets.
contraindicatedVaccineCode | Σ | 0..* | CodeableConcept | Vaccine which is contraindicated to fulfill the recommendation Binding: VaccineAdministeredValueSet (example): The type of vaccine administered.
forecastStatus | ?!Σ | 1..1 | CodeableConcept | Vaccine recommendation status Binding: ImmunizationRecommendationStatusCodes (example): The patient's status with respect to a vaccination protocol.
forecastReason | Σ | 0..* | CodeableConcept | Vaccine administration status reason Binding: ImmunizationRecommendationReasonCodes (example): The reason for the patient's status with respect to a vaccination protocol.
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 | ?!Σ | 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 | string | Protocol details
series |  | 0..1 | string | Name of vaccination series
doseNumber[x] | Σ | 0..1 |  | Recommended dose number within series
doseNumberPositiveInt |  |  | positiveInt |
doseNumberString |  |  | string |
seriesDoses[x] |  | 0..1 |  | Recommended number of doses for immunity
seriesDosesPositiveInt |  |  | positiveInt |
seriesDosesString |  |  | string |
supportingImmunization |  | 0..* | Reference(US Quality Core Immunization | US Quality Core ImmunizationEvaluation) | Past immunizations supporting recommendation
supportingPatientInformation |  | 0..* | Reference(US Quality Core Simple Observation | US Quality Core AllergyIntolerance) | Patient observations supporting recommendation
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
ImmunizationRecommendation.​language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
ImmunizationRecommendation.​recommendation.vaccineCode | Base | extensible | CVX Vaccines Administered Vaccine Set | 📦20230715 | VSAC v0.18
ImmunizationRecommendation.​recommendation.targetDisease | Base | example | Immunization Recommendation Target Disease Codes | 📍4.0.1 | FHIR Std.
ImmunizationRecommendation.​recommendation.contraindicatedVaccineCode | Base | example | Vaccine Administered Value Set | 📍4.0.1 | FHIR Std.
ImmunizationRecommendation.​recommendation.forecastStatus | Base | example | Immunization Recommendation Status Codes | 📍4.0.1 | FHIR Std.
ImmunizationRecommendation.​recommendation.forecastReason | Base | example | Immunization Recommendation Reason Codes | 📍4.0.1 | FHIR Std.
ImmunizationRecommendation.​recommendation.dateCriterion.​code | Base | example | Immunization Recommendation Date Criterion Codes | 📍4.0.1 | 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().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 | 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

Summary

Structures

This structure refers to these other structures:

- US Quality Core Patient (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-patient)
- US Quality Core Organization (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-organization)
- US Quality Core Immunization (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-immunization)
- US Quality Core ImmunizationEvaluation (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-immunizationevaluation)
- US Quality Core Simple Observation (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-simple-observation)
- US Quality Core AllergyIntolerance (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-allergyintolerance)

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ImmunizationRecommendation |  | 0..* | ImmunizationRecommendation | Guidance or advice relating to an immunization
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
patient | Σ | 1..1 | Reference(US Quality Core Patient) | Who this profile is for
date | Σ | 1..1 | dateTime | Date recommendation(s) created
authority |  | 0..1 | Reference(US Quality Core Organization) | Who is responsible for protocol
recommendation | Σ C | 1..* | BackboneElement | Vaccine administration recommendations Constraints: imr-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
vaccineCode | Σ | 0..* | CodeableConcept | Vaccine or vaccine group recommendation applies to Binding: CVX Vaccines Administered Vaccine Set (extensible): CVX Vaccines Administered Vaccine Set
forecastStatus | ?!Σ | 1..1 | CodeableConcept | Vaccine recommendation status Binding: ImmunizationRecommendationStatusCodes (example): The patient's status with respect to a vaccination protocol.
doseNumber[x] | Σ | 0..1 |  | Recommended dose number within series
doseNumberPositiveInt |  |  | positiveInt |
doseNumberString |  |  | string |
supportingImmunization |  | 0..* | Reference(US Quality Core Immunization | US Quality Core ImmunizationEvaluation) | Past immunizations supporting recommendation
supportingPatientInformation |  | 0..* | Reference(US Quality Core Simple Observation | US Quality Core AllergyIntolerance) | Patient observations supporting recommendation
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
ImmunizationRecommendation.​recommendation.vaccineCode | Base | extensible | CVX Vaccines Administered Vaccine Set | 📦20230715 | VSAC v0.18
ImmunizationRecommendation.​recommendation.forecastStatus | Base | example | Immunization Recommendation Status Codes | 📍4.0.1 | 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().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 | 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: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ImmunizationRecommendation |  | 0..* | ImmunizationRecommendation | Guidance or advice relating to an immunization
patient |  | 1..1 | Reference(US Quality Core Patient) | Who this profile is for
authority |  | 0..1 | Reference(US Quality Core Organization) | Who is responsible for protocol
recommendation |  | 1..* | BackboneElement | Vaccine administration recommendations
vaccineCode |  | 0..* | CodeableConcept | Vaccine or vaccine group recommendation applies to Binding: CVX Vaccines Administered Vaccine Set (extensible): CVX Vaccines Administered Vaccine Set
doseNumber[x] |  | 0..1 | positiveInt, string | Recommended dose number within series
supportingImmunization |  | 0..* | Reference(US Quality Core Immunization | US Quality Core ImmunizationEvaluation) | Past immunizations supporting recommendation
supportingPatientInformation |  | 0..* | Reference(US Quality Core Simple Observation | US Quality Core AllergyIntolerance) | Patient observations supporting recommendation
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
ImmunizationRecommendation.​recommendation.vaccineCode | Base | extensible | CVX Vaccines Administered Vaccine Set | 📦20230715 | VSAC v0.18

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ImmunizationRecommendation |  | 0..* | ImmunizationRecommendation | Guidance or advice relating to an immunization
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
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
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Business identifier
patient | Σ | 1..1 | Reference(US Quality Core Patient) | Who this profile is for
date | Σ | 1..1 | dateTime | Date recommendation(s) created
authority |  | 0..1 | Reference(US Quality Core Organization) | Who is responsible for protocol
recommendation | Σ 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 | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
vaccineCode | Σ | 0..* | CodeableConcept | Vaccine or vaccine group recommendation applies to Binding: CVX Vaccines Administered Vaccine Set (extensible): CVX Vaccines Administered Vaccine Set
targetDisease | Σ | 0..1 | CodeableConcept | Disease to be immunized against Binding: ImmunizationRecommendationTargetDiseaseCodes (example): The disease that the recommended vaccination targets.
contraindicatedVaccineCode | Σ | 0..* | CodeableConcept | Vaccine which is contraindicated to fulfill the recommendation Binding: VaccineAdministeredValueSet (example): The type of vaccine administered.
forecastStatus | ?!Σ | 1..1 | CodeableConcept | Vaccine recommendation status Binding: ImmunizationRecommendationStatusCodes (example): The patient's status with respect to a vaccination protocol.
forecastReason | Σ | 0..* | CodeableConcept | Vaccine administration status reason Binding: ImmunizationRecommendationReasonCodes (example): The reason for the patient's status with respect to a vaccination protocol.
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 | ?!Σ | 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 | string | Protocol details
series |  | 0..1 | string | Name of vaccination series
doseNumber[x] | Σ | 0..1 |  | Recommended dose number within series
doseNumberPositiveInt |  |  | positiveInt |
doseNumberString |  |  | string |
seriesDoses[x] |  | 0..1 |  | Recommended number of doses for immunity
seriesDosesPositiveInt |  |  | positiveInt |
seriesDosesString |  |  | string |
supportingImmunization |  | 0..* | Reference(US Quality Core Immunization | US Quality Core ImmunizationEvaluation) | Past immunizations supporting recommendation
supportingPatientInformation |  | 0..* | Reference(US Quality Core Simple Observation | US Quality Core AllergyIntolerance) | Patient observations supporting recommendation
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
ImmunizationRecommendation.​language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
ImmunizationRecommendation.​recommendation.vaccineCode | Base | extensible | CVX Vaccines Administered Vaccine Set | 📦20230715 | VSAC v0.18
ImmunizationRecommendation.​recommendation.targetDisease | Base | example | Immunization Recommendation Target Disease Codes | 📍4.0.1 | FHIR Std.
ImmunizationRecommendation.​recommendation.contraindicatedVaccineCode | Base | example | Vaccine Administered Value Set | 📍4.0.1 | FHIR Std.
ImmunizationRecommendation.​recommendation.forecastStatus | Base | example | Immunization Recommendation Status Codes | 📍4.0.1 | FHIR Std.
ImmunizationRecommendation.​recommendation.forecastReason | Base | example | Immunization Recommendation Reason Codes | 📍4.0.1 | FHIR Std.
ImmunizationRecommendation.​recommendation.dateCriterion.​code | Base | example | Immunization Recommendation Date Criterion Codes | 📍4.0.1 | 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().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 | 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

Summary

Structures

This structure refers to these other structures:

- US Quality Core Patient (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-patient)
- US Quality Core Organization (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-organization)
- US Quality Core Immunization (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-immunization)
- US Quality Core ImmunizationEvaluation (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-immunizationevaluation)
- US Quality Core Simple Observation (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-simple-observation)
- US Quality Core AllergyIntolerance (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-allergyintolerance)

Other representations of profile: CSV, Excel, Schematron