C-CDA on FHIR
2.0.0-ballot - STU 2 Ballot

C-CDA on FHIR, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/ccda-on-fhir/ and changes regularly. See the Directory of published versions

## : FHIR Immunization Status Reason to C-CDA Immunization Refusal - JSON Representation

Page standards status: Trial-use

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    {
      "resourceType" : "ConceptMap",
      "id" : "FC-ImmunizationRefusal",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ConceptMap FC-ImmunizationRefusal</b></p><a name=\"FC-ImmunizationRefusal\"> </a><a name=\"hcFC-ImmunizationRefusal\"> </a><p>Mapping from <a href=\"http://hl7.org/fhir/R4/valueset-immunization-status-reason.html\">Immunization Status Reason Codes</a> to https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.1.11.19717</p><br/><p><b>Group 1 </b>Mapping from <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActReason.html\">ActReason</a> to <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActReason.html\">ActReason</a></p><table class=\"grid\"><tr><td><b>Source Code</b></td><td><b>Relationship</b></td><td><b>Target Code</b></td></tr><tr><td>IMMUNE (immunity)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent\" title=\"equivalent\">is equivalent to</a></td><td>IMMUNE (immunity)</td></tr><tr><td>MEDPREC (medical precaution)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent\" title=\"equivalent\">is equivalent to</a></td><td>MEDPREC (medical precaution)</td></tr><tr><td>OSTOCK (product out of stock)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent\" title=\"equivalent\">is equivalent to</a></td><td>OSTOCK (product out of stock)</td></tr><tr><td>PATOBJ (patient objection)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent\" title=\"equivalent\">is equivalent to</a></td><td>PATOBJ (patient objection)</td></tr></table><hr/><p><b>Group 2 </b>Mapping from <a href=\"http://hl7.org/fhir/R4/codesystem-snomedct.html\">SNOMED CT (all versions)</a> to <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActReason.html\">ActReason</a></p><table class=\"grid\"><tr><td><b>Source Code</b></td><td><b>Relationship</b></td><td><b>Target Code</b></td></tr><tr><td>171257003 (No consent - Tetanus/low dose diphtheria vaccine)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider\" title=\"wider\">maps to wider concept</a></td><td>PATOBJ (patient objection)</td></tr><tr><td>171265000 (Pertussis vaccine refused)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider\" title=\"wider\">maps to wider concept</a></td><td>PATOBJ (patient objection)</td></tr><tr><td>171266004 (No consent - diphtheria immunization)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider\" title=\"wider\">maps to wider concept</a></td><td>PATOBJ (patient objection)</td></tr><tr><td>171267008 (No consent - tetanus immunization)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider\" title=\"wider\">maps to wider concept</a></td><td>PATOBJ (patient objection)</td></tr><tr><td>171268003 (Polio immunization refused)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider\" title=\"wider\">maps to wider concept</a></td><td>PATOBJ (patient objection)</td></tr><tr><td>171269006 (No consent - measles immunization)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider\" title=\"wider\">maps to wider concept</a></td><td>PATOBJ (patient objection)</td></tr><tr><td>171270007 (No consent - rubella immunization)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider\" title=\"wider\">maps to wider concept</a></td><td>PATOBJ (patient objection)</td></tr><tr><td>171271006 (No consent - BCG)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider\" title=\"wider\">maps to wider concept</a></td><td>PATOBJ (patient objection)</td></tr><tr><td>171272004 (No consent - influenza immunization)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider\" title=\"wider\">maps to wider concept</a></td><td>PATOBJ (patient objection)</td></tr><tr><td>171280006 (No consent for MMR)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider\" title=\"wider\">maps to wider concept</a></td><td>PATOBJ (patient objection)</td></tr><tr><td>171283008 (No consent for any primary immunization)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider\" title=\"wider\">maps to wider concept</a></td><td>PATOBJ (patient objection)</td></tr><tr><td>171285001 (No consent - pre-school vaccinations)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider\" title=\"wider\">maps to wider concept</a></td><td>PATOBJ (patient objection)</td></tr><tr><td>171286000 (No consent - school exit vaccinations)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider\" title=\"wider\">maps to wider concept</a></td><td>PATOBJ (patient objection)</td></tr><tr><td>171291004 (No consent - Haemophilus influenzae type B immunization)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider\" title=\"wider\">maps to wider concept</a></td><td>PATOBJ (patient objection)</td></tr><tr><td>171292006 (No consent pneumococcal immunization)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider\" title=\"wider\">maps to wider concept</a></td><td>PATOBJ (patient objection)</td></tr><tr><td>171293001 (No consent for MR - Measles/rubella vaccine)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider\" title=\"wider\">maps to wider concept</a></td><td>PATOBJ (patient objection)</td></tr><tr><td>268559007 (No consent for any immunization)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider\" title=\"wider\">maps to wider concept</a></td><td>PATOBJ (patient objection)</td></tr><tr><td>310839003 (No consent for MMR1)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider\" title=\"wider\">maps to wider concept</a></td><td>PATOBJ (patient objection)</td></tr><tr><td>310840001 (No consent for second measles, mumps and rubella vaccine)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider\" title=\"wider\">maps to wider concept</a></td><td>PATOBJ (patient objection)</td></tr><tr><td>314768003 (No consent diphtheria, tetanus, pertussis immunization)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider\" title=\"wider\">maps to wider concept</a></td><td>PATOBJ (patient objection)</td></tr><tr><td>314769006 (No consent tetanus plus diphtheria immunization)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider\" title=\"wider\">maps to wider concept</a></td><td>PATOBJ (patient objection)</td></tr><tr><td>314936001 (No consent for meningitis C immunization)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider\" title=\"wider\">maps to wider concept</a></td><td>PATOBJ (patient objection)</td></tr><tr><td>407598009 (No consent for 3rd HIB booster)</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider\" title=\"wider\">maps to wider concept</a></td><td>PATOBJ (patient objection)</td></tr></table></div>"
      },
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
          "valueCode" : "cgp"
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
          "valueCode" : "trial-use",
          "_valueCode" : {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
                "valueCanonical" : "http://hl7.org/fhir/us/ccda/ImplementationGuide/hl7.fhir.us.ccda"
              }
            ]
          }
        }
      ],
      "url" : "http://hl7.org/fhir/us/ccda/ConceptMap/FC-ImmunizationRefusal",
      "version" : "2.0.0-ballot",
      "name" : "FHIRtoCCDAImmunizationRefusal",
      "title" : "FHIR Immunization Status Reason to C-CDA Immunization Refusal",
      "status" : "active",
      "experimental" : false,
      "date" : "2025-07-31T21:42:42+00:00",
      "publisher" : "HL7 International / Cross-Group Projects",
      "contact" : [
        {
          "name" : "HL7 International / Cross-Group Projects",
          "telecom" : [
            {
              "system" : "url",
              "value" : "http://www.hl7.org/Special/committees/cgp"
            }
          ]
        }
      ],
      "description" : "FHIR Immunization Status Reason to C-CDA Immunization Refusal",
      "jurisdiction" : [
        {
          "coding" : [
            {
              "system" : "urn:iso:std:iso:3166",
              "code" : "US"
            }
          ]
        }
      ],
      "sourceUri" : "http://hl7.org/fhir/ValueSet/immunization-status-reason",
      "targetUri" : "https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.1.11.19717",
      "group" : [
        {
          "source" : "http://terminology.hl7.org/CodeSystem/v3-ActReason",
          "target" : "http://terminology.hl7.org/CodeSystem/v3-ActReason",
          "element" : [
            {
              "code" : "IMMUNE",
              "display" : "immunity",
              "target" : [
                {
                  "code" : "IMMUNE",
                  "display" : "immunity",
                  "equivalence" : "equivalent"
                }
              ]
            },
            {
              "code" : "MEDPREC",
              "display" : "medical precaution",
              "target" : [
                {
                  "code" : "MEDPREC",
                  "display" : "medical precaution",
                  "equivalence" : "equivalent"
                }
              ]
            },
            {
              "code" : "OSTOCK",
              "display" : "product out of stock",
              "target" : [
                {
                  "code" : "OSTOCK",
                  "display" : "product out of stock",
                  "equivalence" : "equivalent"
                }
              ]
            },
            {
              "code" : "PATOBJ",
              "display" : "patient objection",
              "target" : [
                {
                  "code" : "PATOBJ",
                  "display" : "patient objection",
                  "equivalence" : "equivalent"
                }
              ]
            }
          ]
        },
        {
          "source" : "http://snomed.info/sct",
          "target" : "http://terminology.hl7.org/CodeSystem/v3-ActReason",
          "element" : [
            {
              "code" : "171257003",
              "display" : "No consent - Tetanus/low dose diphtheria vaccine",
              "target" : [
                {
                  "code" : "PATOBJ",
                  "display" : "patient objection",
                  "equivalence" : "wider"
                }
              ]
            },
            {
              "code" : "171265000",
              "display" : "Pertussis vaccine refused",
              "target" : [
                {
                  "code" : "PATOBJ",
                  "display" : "patient objection",
                  "equivalence" : "wider"
                }
              ]
            },
            {
              "code" : "171266004",
              "display" : "No consent - diphtheria immunization",
              "target" : [
                {
                  "code" : "PATOBJ",
                  "display" : "patient objection",
                  "equivalence" : "wider"
                }
              ]
            },
            {
              "code" : "171267008",
              "display" : "No consent - tetanus immunization",
              "target" : [
                {
                  "code" : "PATOBJ",
                  "display" : "patient objection",
                  "equivalence" : "wider"
                }
              ]
            },
            {
              "code" : "171268003",
              "display" : "Polio immunization refused",
              "target" : [
                {
                  "code" : "PATOBJ",
                  "display" : "patient objection",
                  "equivalence" : "wider"
                }
              ]
            },
            {
              "code" : "171269006",
              "display" : "No consent - measles immunization",
              "target" : [
                {
                  "code" : "PATOBJ",
                  "display" : "patient objection",
                  "equivalence" : "wider"
                }
              ]
            },
            {
              "code" : "171270007",
              "display" : "No consent - rubella immunization",
              "target" : [
                {
                  "code" : "PATOBJ",
                  "display" : "patient objection",
                  "equivalence" : "wider"
                }
              ]
            },
            {
              "code" : "171271006",
              "display" : "No consent - BCG",
              "target" : [
                {
                  "code" : "PATOBJ",
                  "display" : "patient objection",
                  "equivalence" : "wider"
                }
              ]
            },
            {
              "code" : "171272004",
              "display" : "No consent - influenza immunization",
              "target" : [
                {
                  "code" : "PATOBJ",
                  "display" : "patient objection",
                  "equivalence" : "wider"
                }
              ]
            },
            {
              "code" : "171280006",
              "display" : "No consent for MMR",
              "target" : [
                {
                  "code" : "PATOBJ",
                  "display" : "patient objection",
                  "equivalence" : "wider"
                }
              ]
            },
            {
              "code" : "171283008",
              "display" : "No consent for any primary immunization",
              "target" : [
                {
                  "code" : "PATOBJ",
                  "display" : "patient objection",
                  "equivalence" : "wider"
                }
              ]
            },
            {
              "code" : "171285001",
              "display" : "No consent - pre-school vaccinations",
              "target" : [
                {
                  "code" : "PATOBJ",
                  "display" : "patient objection",
                  "equivalence" : "wider"
                }
              ]
            },
            {
              "code" : "171286000",
              "display" : "No consent - school exit vaccinations",
              "target" : [
                {
                  "code" : "PATOBJ",
                  "display" : "patient objection",
                  "equivalence" : "wider"
                }
              ]
            },
            {
              "code" : "171291004",
              "display" : "No consent - Haemophilus influenzae type B immunization",
              "target" : [
                {
                  "code" : "PATOBJ",
                  "display" : "patient objection",
                  "equivalence" : "wider"
                }
              ]
            },
            {
              "code" : "171292006",
              "display" : "No consent pneumococcal immunization",
              "target" : [
                {
                  "code" : "PATOBJ",
                  "display" : "patient objection",
                  "equivalence" : "wider"
                }
              ]
            },
            {
              "code" : "171293001",
              "display" : "No consent for MR - Measles/rubella vaccine",
              "target" : [
                {
                  "code" : "PATOBJ",
                  "display" : "patient objection",
                  "equivalence" : "wider"
                }
              ]
            },
            {
              "code" : "268559007",
              "display" : "No consent for any immunization",
              "target" : [
                {
                  "code" : "PATOBJ",
                  "display" : "patient objection",
                  "equivalence" : "wider"
                }
              ]
            },
            {
              "code" : "310839003",
              "display" : "No consent for MMR1",
              "target" : [
                {
                  "code" : "PATOBJ",
                  "display" : "patient objection",
                  "equivalence" : "wider"
                }
              ]
            },
            {
              "code" : "310840001",
              "display" : "No consent for second measles, mumps and rubella vaccine",
              "target" : [
                {
                  "code" : "PATOBJ",
                  "display" : "patient objection",
                  "equivalence" : "wider"
                }
              ]
            },
            {
              "code" : "314768003",
              "display" : "No consent diphtheria, tetanus, pertussis immunization",
              "target" : [
                {
                  "code" : "PATOBJ",
                  "display" : "patient objection",
                  "equivalence" : "wider"
                }
              ]
            },
            {
              "code" : "314769006",
              "display" : "No consent tetanus plus diphtheria immunization",
              "target" : [
                {
                  "code" : "PATOBJ",
                  "display" : "patient objection",
                  "equivalence" : "wider"
                }
              ]
            },
            {
              "code" : "314936001",
              "display" : "No consent for meningitis C immunization",
              "target" : [
                {
                  "code" : "PATOBJ",
                  "display" : "patient objection",
                  "equivalence" : "wider"
                }
              ]
            },
            {
              "code" : "407598009",
              "display" : "No consent for 3rd HIB booster",
              "target" : [
                {
                  "code" : "PATOBJ",
                  "display" : "patient objection",
                  "equivalence" : "wider"
                }
              ]
            }
          ]
        }
      ]
    }