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 - XML Representation

Page standards status: Trial-use

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    <ConceptMap xmlns="http://hl7.org/fhir">
      <id value="FC-ImmunizationRefusal"/>
      <text>
        <status value="generated"/>
        <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>
      </text>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
        <valueCode value="cgp"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="trial-use">
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
            <valueCanonical
                            value="http://hl7.org/fhir/us/ccda/ImplementationGuide/hl7.fhir.us.ccda"/>
          </extension>
        </valueCode>
      </extension>
      <url value="http://hl7.org/fhir/us/ccda/ConceptMap/FC-ImmunizationRefusal"/>
      <version value="2.0.0-ballot"/>
      <name value="FHIRtoCCDAImmunizationRefusal"/>
      <title
             value="FHIR Immunization Status Reason to C-CDA Immunization Refusal"/>
      <status value="active"/>
      <experimental value="false"/>
      <date value="2025-07-31T21:42:42+00:00"/>
      <publisher value="HL7 International / Cross-Group Projects"/>
      <contact>
        <name value="HL7 International / Cross-Group Projects"/>
        <telecom>
          <system value="url"/>
          <value value="http://www.hl7.org/Special/committees/cgp"/>
        </telecom>
      </contact>
      <description
                   value="FHIR Immunization Status Reason to C-CDA Immunization Refusal"/>
      <jurisdiction>
        <coding>
          <system value="urn:iso:std:iso:3166"/>
          <code value="US"/>
        </coding>
      </jurisdiction>
      <sourceUri value="http://hl7.org/fhir/ValueSet/immunization-status-reason"/>
      <targetUri
                 value="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.1.11.19717"/>
      <group>
        <source value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
        <target value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
        <element>
          <code value="IMMUNE"/>
          <display value="immunity"/>
          <target>
            <code value="IMMUNE"/>
            <display value="immunity"/>
            <equivalence value="equivalent"/>
          </target>
        </element>
        <element>
          <code value="MEDPREC"/>
          <display value="medical precaution"/>
          <target>
            <code value="MEDPREC"/>
            <display value="medical precaution"/>
            <equivalence value="equivalent"/>
          </target>
        </element>
        <element>
          <code value="OSTOCK"/>
          <display value="product out of stock"/>
          <target>
            <code value="OSTOCK"/>
            <display value="product out of stock"/>
            <equivalence value="equivalent"/>
          </target>
        </element>
        <element>
          <code value="PATOBJ"/>
          <display value="patient objection"/>
          <target>
            <code value="PATOBJ"/>
            <display value="patient objection"/>
            <equivalence value="equivalent"/>
          </target>
        </element>
      </group>
      <group>
        <source value="http://snomed.info/sct"/>
        <target value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
        <element>
          <code value="171257003"/>
          <display value="No consent - Tetanus/low dose diphtheria vaccine"/>
          <target>
            <code value="PATOBJ"/>
            <display value="patient objection"/>
            <equivalence value="wider"/>
          </target>
        </element>
        <element>
          <code value="171265000"/>
          <display value="Pertussis vaccine refused"/>
          <target>
            <code value="PATOBJ"/>
            <display value="patient objection"/>
            <equivalence value="wider"/>
          </target>
        </element>
        <element>
          <code value="171266004"/>
          <display value="No consent - diphtheria immunization"/>
          <target>
            <code value="PATOBJ"/>
            <display value="patient objection"/>
            <equivalence value="wider"/>
          </target>
        </element>
        <element>
          <code value="171267008"/>
          <display value="No consent - tetanus immunization"/>
          <target>
            <code value="PATOBJ"/>
            <display value="patient objection"/>
            <equivalence value="wider"/>
          </target>
        </element>
        <element>
          <code value="171268003"/>
          <display value="Polio immunization refused"/>
          <target>
            <code value="PATOBJ"/>
            <display value="patient objection"/>
            <equivalence value="wider"/>
          </target>
        </element>
        <element>
          <code value="171269006"/>
          <display value="No consent - measles immunization"/>
          <target>
            <code value="PATOBJ"/>
            <display value="patient objection"/>
            <equivalence value="wider"/>
          </target>
        </element>
        <element>
          <code value="171270007"/>
          <display value="No consent - rubella immunization"/>
          <target>
            <code value="PATOBJ"/>
            <display value="patient objection"/>
            <equivalence value="wider"/>
          </target>
        </element>
        <element>
          <code value="171271006"/>
          <display value="No consent - BCG"/>
          <target>
            <code value="PATOBJ"/>
            <display value="patient objection"/>
            <equivalence value="wider"/>
          </target>
        </element>
        <element>
          <code value="171272004"/>
          <display value="No consent - influenza immunization"/>
          <target>
            <code value="PATOBJ"/>
            <display value="patient objection"/>
            <equivalence value="wider"/>
          </target>
        </element>
        <element>
          <code value="171280006"/>
          <display value="No consent for MMR"/>
          <target>
            <code value="PATOBJ"/>
            <display value="patient objection"/>
            <equivalence value="wider"/>
          </target>
        </element>
        <element>
          <code value="171283008"/>
          <display value="No consent for any primary immunization"/>
          <target>
            <code value="PATOBJ"/>
            <display value="patient objection"/>
            <equivalence value="wider"/>
          </target>
        </element>
        <element>
          <code value="171285001"/>
          <display value="No consent - pre-school vaccinations"/>
          <target>
            <code value="PATOBJ"/>
            <display value="patient objection"/>
            <equivalence value="wider"/>
          </target>
        </element>
        <element>
          <code value="171286000"/>
          <display value="No consent - school exit vaccinations"/>
          <target>
            <code value="PATOBJ"/>
            <display value="patient objection"/>
            <equivalence value="wider"/>
          </target>
        </element>
        <element>
          <code value="171291004"/>
          <display
                   value="No consent - Haemophilus influenzae type B immunization"/>
          <target>
            <code value="PATOBJ"/>
            <display value="patient objection"/>
            <equivalence value="wider"/>
          </target>
        </element>
        <element>
          <code value="171292006"/>
          <display value="No consent pneumococcal immunization"/>
          <target>
            <code value="PATOBJ"/>
            <display value="patient objection"/>
            <equivalence value="wider"/>
          </target>
        </element>
        <element>
          <code value="171293001"/>
          <display value="No consent for MR - Measles/rubella vaccine"/>
          <target>
            <code value="PATOBJ"/>
            <display value="patient objection"/>
            <equivalence value="wider"/>
          </target>
        </element>
        <element>
          <code value="268559007"/>
          <display value="No consent for any immunization"/>
          <target>
            <code value="PATOBJ"/>
            <display value="patient objection"/>
            <equivalence value="wider"/>
          </target>
        </element>
        <element>
          <code value="310839003"/>
          <display value="No consent for MMR1"/>
          <target>
            <code value="PATOBJ"/>
            <display value="patient objection"/>
            <equivalence value="wider"/>
          </target>
        </element>
        <element>
          <code value="310840001"/>
          <display
                   value="No consent for second measles, mumps and rubella vaccine"/>
          <target>
            <code value="PATOBJ"/>
            <display value="patient objection"/>
            <equivalence value="wider"/>
          </target>
        </element>
        <element>
          <code value="314768003"/>
          <display
                   value="No consent diphtheria, tetanus, pertussis immunization"/>
          <target>
            <code value="PATOBJ"/>
            <display value="patient objection"/>
            <equivalence value="wider"/>
          </target>
        </element>
        <element>
          <code value="314769006"/>
          <display value="No consent tetanus plus diphtheria immunization"/>
          <target>
            <code value="PATOBJ"/>
            <display value="patient objection"/>
            <equivalence value="wider"/>
          </target>
        </element>
        <element>
          <code value="314936001"/>
          <display value="No consent for meningitis C immunization"/>
          <target>
            <code value="PATOBJ"/>
            <display value="patient objection"/>
            <equivalence value="wider"/>
          </target>
        </element>
        <element>
          <code value="407598009"/>
          <display value="No consent for 3rd HIB booster"/>
          <target>
            <code value="PATOBJ"/>
            <display value="patient objection"/>
            <equivalence value="wider"/>
          </target>
        </element>
      </group>
    </ConceptMap>