De-Identified, Anonymized FHIR Profiles Library
0.1.0 - STU1 Release 1 - Standard for Trial-Use

De-Identified, Anonymized FHIR Profiles Library, published by HL7 International / Cross Group Projects. 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/HL7/fhir-dapl/ and changes regularly. See the Directory of published versions

## Resource Profile: De-Identified UDS Plus Immunization

Official URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-immunization | Version: 0.1.0
Standards status: Trial-use | Maturity Level: 1 | Computable Name: UDSPlusImmunization

The UDS+ profile is based on the Immunization resource and establishes the core elements, extensions, vocabularies and value sets for representing immunizations for UDS+ program.

All canonical (Official) URLs will be changed in the future and are not available currently on the web.

### Introduction

This profile is used to represent de-identified Immunization information. The de-identification process has to remove all data elements not explicitly identified as "SUPPORTED" in the profile.

The HHS De-identification Guidance is to be followed to ensure appropriate level of de-identification is performed.

According to the HHS guidance, dates should not have a precision of more than the year. This means month and day cannot be included. This includes Immunization.occurenceDateTime.

In FHIR Resources, text elements and reference.display elements which provide human readable information to the providers may be generated using programs and tools from the data present within the resource. For e.g a Immunization resource text element may contain information such as the Immunization date, patient information. This type of information will enable identification of the individuals. In order to avoid inadvertent revealing of PII/PHI, text elements cannot be included in the De-identified FHIR resource and the submission will be rejected when text elements are present by the validation process.

Ids and References

The original Immunization resource id should not be included in the De-identified Immunization instance. Instead a new id should be created and provided as part of the FHIR resource. The Data Submitter should be capable of using the generated id to relink the data to the original Immunization. All resource references to the Immunization submitted as part of the UDS+ report should refer to newly generated id.

Resource references cannot contain text element as it may contain PHI/PII. The text element for following references are not allowed

- patient

Date Truncation

The Data Submitter has to truncate the following dates to only have a precision of year

- occurence[x]
- recorded

Usages:

- Examples for this Profile: Immunization/de-identified-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
--- | --- | --- | --- | ---
Immunization |  | 0..* | Immunization | De-Identified UDS Plus Immunization
id | S Σ | 0..1 | id | The de-identified Immunization identifier created by the health center to send data to UDS+ Data Receiver
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ | 1..1 | code | completed | entered-in-error | not-done Binding: ImmunizationStatusCodes (required): A set of codes indicating the current status of an Immunization.
statusReason | S | 0..1 | CodeableConcept | Reason not done Binding: ImmunizationStatusReasonCodes (example): The reason why a vaccine was not administered.
vaccineCode | S Σ | 1..1 | CodeableConcept | Vaccine product administered Binding: VaccineAdministeredValueSet (example): The code for vaccine product administered.
patient | S Σ | 1..1 | Reference(De-Identified UDS Plus Patient) | Who was immunized
occurrence[x] | S Σ | 1..1 | dateTime | Vaccine administration date
recorded | S | 0..1 | dateTime | When the immunization was first captured in the subject's record
primarySource | S Σ | 1..1 | boolean | Indicates context the data was recorded in
isSubpotent | ?!Σ | 0..1 | boolean | Dose potency
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Immunization.status | Base | required | Immunization Status Codes | 📍4.0.1 | FHIR Std.
Immunization.statusReason | Base | example | Immunization Status Reason Codes | 📍4.0.1 | FHIR Std.
Immunization.vaccineCode | Base | example | Vaccine Administered Value Set | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Immunization | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Immunization | 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 | Immunization | 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 | Immunization | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Immunization | 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()`

This structure is derived from Immunization

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Immunization |  | 0..* | Immunization | De-Identified UDS Plus Immunization
id | S | 0..1 | id | The de-identified Immunization identifier created by the health center to send data to UDS+ Data Receiver
text |  | 0..0 |  | Cannot include any text in the resource as part of the de-identified data.
contained |  | 0..0 |  | Cannot include any contained resources in the resource as part of the de-identified data.
status | S | 1..1 | code | completed | entered-in-error | not-done
statusReason | S | 0..1 | CodeableConcept | Reason not done
vaccineCode | S | 1..1 | CodeableConcept | Vaccine product administered
patient | S | 1..1 | Reference(De-Identified UDS Plus Patient) | Who was immunized
occurrence[x] | S | 1..1 | dateTime | Vaccine administration date
recorded | S | 0..1 | dateTime | When the immunization was first captured in the subject's record
primarySource | S | 1..1 | boolean | Indicates context the data was recorded in
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Immunization |  | 0..* | Immunization | De-Identified UDS Plus Immunization
id | S Σ | 0..1 | id | The de-identified Immunization identifier created by the health center to send data to UDS+ Data Receiver
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
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | Business identifier
status | ?!S Σ | 1..1 | code | completed | entered-in-error | not-done Binding: ImmunizationStatusCodes (required): A set of codes indicating the current status of an Immunization.
statusReason | S | 0..1 | CodeableConcept | Reason not done Binding: ImmunizationStatusReasonCodes (example): The reason why a vaccine was not administered.
vaccineCode | S Σ | 1..1 | CodeableConcept | Vaccine product administered Binding: VaccineAdministeredValueSet (example): The code for vaccine product administered.
patient | S Σ | 1..1 | Reference(De-Identified UDS Plus Patient) | Who was immunized
encounter |  | 0..1 | Reference(Encounter) | Encounter immunization was part of
occurrence[x] | S Σ | 1..1 | dateTime | Vaccine administration date
recorded | S | 0..1 | dateTime | When the immunization was first captured in the subject's record
primarySource | S Σ | 1..1 | boolean | Indicates context the data was recorded in
reportOrigin |  | 0..1 | CodeableConcept | Indicates the source of a secondarily reported record Binding: ImmunizationOriginCodes (example): The source of the data for a record which is not from a primary source.
location |  | 0..1 | Reference(Location) | Where immunization occurred
manufacturer |  | 0..1 | Reference(Organization) | Vaccine manufacturer
lotNumber |  | 0..1 | string | Vaccine lot number
expirationDate |  | 0..1 | date | Vaccine expiration date
site |  | 0..1 | CodeableConcept | Body site vaccine was administered Binding: CodesForImmunizationSiteOfAdministration (example): The site at which the vaccine was administered.
route |  | 0..1 | CodeableConcept | How vaccine entered body Binding: ImmunizationRouteCodes (example): The route by which the vaccine was administered.
doseQuantity |  | 0..1 | SimpleQuantity(4.0.1) | Amount of vaccine administered
performer | Σ | 0..* | BackboneElement | Who performed event
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
function | Σ | 0..1 | CodeableConcept | What type of performance was done Binding: ImmunizationFunctionCodes (extensible): The role a practitioner or organization plays in the immunization event.
actor | Σ | 1..1 | Reference(Practitioner | PractitionerRole | Organization) | Individual or organization who was performing
note | Σ | 0..* | Annotation | Additional immunization notes
reasonCode |  | 0..* | CodeableConcept | Why immunization occurred Binding: ImmunizationReasonCodes (example): The reason why a vaccine was administered.
reasonReference |  | 0..* | Reference(Condition | Observation | DiagnosticReport) | Why immunization occurred
isSubpotent | ?!Σ | 0..1 | boolean | Dose potency
subpotentReason |  | 0..* | CodeableConcept | Reason for being subpotent Binding: ImmunizationSubpotentReason (example): The reason why a dose is considered to be subpotent.
education | C | 0..* | BackboneElement | Educational material presented to patient Constraints: imm-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
documentType |  | 0..1 | string | Educational material document identifier
reference |  | 0..1 | uri | Educational material reference pointer
publicationDate |  | 0..1 | dateTime | Educational material publication date
presentationDate |  | 0..1 | dateTime | Educational material presentation date
programEligibility |  | 0..* | CodeableConcept | Patient eligibility for a vaccination program Binding: ImmunizationProgramEligibility (example): The patient's eligibility for a vaccation program.
fundingSource |  | 0..1 | CodeableConcept | Funding source for the vaccine Binding: ImmunizationFundingSource (example): The source of funding used to purchase the vaccine administered.
reaction |  | 0..* | BackboneElement | Details of a reaction that follows 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
date |  | 0..1 | dateTime | When reaction started
detail |  | 0..1 | Reference(Observation) | Additional information on reaction
reported |  | 0..1 | boolean | Indicates self-reported reaction
protocolApplied |  | 0..* | BackboneElement | Protocol followed by the provider
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
series |  | 0..1 | string | Name of vaccine series
authority |  | 0..1 | Reference(Organization) | Who is responsible for publishing the recommendations
targetDisease |  | 0..* | CodeableConcept | Vaccine preventatable disease being targetted Binding: ImmunizationTargetDiseaseCodes (example): The vaccine preventable disease the dose is being administered for.
doseNumber[x] |  | 1..1 |  | Dose number within series
doseNumberPositiveInt |  |  | positiveInt |
doseNumberString |  |  | string |
seriesDoses[x] |  | 0..1 |  | Recommended number of doses for immunity
seriesDosesPositiveInt |  |  | positiveInt |
seriesDosesString |  |  | string |
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Immunization.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Immunization.status | Base | required | Immunization Status Codes | 📍4.0.1 | FHIR Std.
Immunization.statusReason | Base | example | Immunization Status Reason Codes | 📍4.0.1 | FHIR Std.
Immunization.vaccineCode | Base | example | Vaccine Administered Value Set | 📍4.0.1 | FHIR Std.
Immunization.reportOrigin | Base | example | Immunization Origin Codes | 📍4.0.1 | FHIR Std.
Immunization.site | Base | example | Codes for Immunization Site of Administration | 📍4.0.1 | FHIR Std.
Immunization.route | Base | example | Immunization Route Codes | 📍4.0.1 | FHIR Std.
Immunization.performer.​function | Base | extensible | Immunization Function Codes | 📍4.0.1 | FHIR Std.
Immunization.reasonCode | Base | example | Immunization Reason Codes | 📍4.0.1 | FHIR Std.
Immunization.subpotentReason | Base | example | Immunization Subpotent Reason | 📍4.0.1 | FHIR Std.
Immunization.programEligibility | Base | example | Immunization Program Eligibility | 📍4.0.1 | FHIR Std.
Immunization.fundingSource | Base | example | Immunization Funding Source | 📍4.0.1 | FHIR Std.
Immunization.protocolApplied.​targetDisease | Base | example | Immunization Target Disease Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Immunization | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Immunization | 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 | Immunization | 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 | Immunization | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Immunization | 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()`
imm-1 | error | Immunization.education | One of documentType or reference SHALL be present | `documentType.exists() or reference.exists()`

This structure is derived from Immunization

Summary

Mandatory: 5 elements
Must-Support: 8 elements
Prohibited: 2 elements

Structures

This structure refers to these other structures:

- De-Identified UDS Plus Patient (http://hl7.org/fhir/us/uds-plus/StructureDefinition/de-identified-uds-plus-patient)

Maturity: 1

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Immunization |  | 0..* | Immunization | De-Identified UDS Plus Immunization
id | S Σ | 0..1 | id | The de-identified Immunization identifier created by the health center to send data to UDS+ Data Receiver
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ | 1..1 | code | completed | entered-in-error | not-done Binding: ImmunizationStatusCodes (required): A set of codes indicating the current status of an Immunization.
statusReason | S | 0..1 | CodeableConcept | Reason not done Binding: ImmunizationStatusReasonCodes (example): The reason why a vaccine was not administered.
vaccineCode | S Σ | 1..1 | CodeableConcept | Vaccine product administered Binding: VaccineAdministeredValueSet (example): The code for vaccine product administered.
patient | S Σ | 1..1 | Reference(De-Identified UDS Plus Patient) | Who was immunized
occurrence[x] | S Σ | 1..1 | dateTime | Vaccine administration date
recorded | S | 0..1 | dateTime | When the immunization was first captured in the subject's record
primarySource | S Σ | 1..1 | boolean | Indicates context the data was recorded in
isSubpotent | ?!Σ | 0..1 | boolean | Dose potency
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Immunization.status | Base | required | Immunization Status Codes | 📍4.0.1 | FHIR Std.
Immunization.statusReason | Base | example | Immunization Status Reason Codes | 📍4.0.1 | FHIR Std.
Immunization.vaccineCode | Base | example | Vaccine Administered Value Set | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Immunization | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Immunization | 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 | Immunization | 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 | Immunization | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Immunization | 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()`

Differential View

This structure is derived from Immunization

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Immunization |  | 0..* | Immunization | De-Identified UDS Plus Immunization
id | S | 0..1 | id | The de-identified Immunization identifier created by the health center to send data to UDS+ Data Receiver
text |  | 0..0 |  | Cannot include any text in the resource as part of the de-identified data.
contained |  | 0..0 |  | Cannot include any contained resources in the resource as part of the de-identified data.
status | S | 1..1 | code | completed | entered-in-error | not-done
statusReason | S | 0..1 | CodeableConcept | Reason not done
vaccineCode | S | 1..1 | CodeableConcept | Vaccine product administered
patient | S | 1..1 | Reference(De-Identified UDS Plus Patient) | Who was immunized
occurrence[x] | S | 1..1 | dateTime | Vaccine administration date
recorded | S | 0..1 | dateTime | When the immunization was first captured in the subject's record
primarySource | S | 1..1 | boolean | Indicates context the data was recorded in
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Immunization |  | 0..* | Immunization | De-Identified UDS Plus Immunization
id | S Σ | 0..1 | id | The de-identified Immunization identifier created by the health center to send data to UDS+ Data Receiver
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
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | Business identifier
status | ?!S Σ | 1..1 | code | completed | entered-in-error | not-done Binding: ImmunizationStatusCodes (required): A set of codes indicating the current status of an Immunization.
statusReason | S | 0..1 | CodeableConcept | Reason not done Binding: ImmunizationStatusReasonCodes (example): The reason why a vaccine was not administered.
vaccineCode | S Σ | 1..1 | CodeableConcept | Vaccine product administered Binding: VaccineAdministeredValueSet (example): The code for vaccine product administered.
patient | S Σ | 1..1 | Reference(De-Identified UDS Plus Patient) | Who was immunized
encounter |  | 0..1 | Reference(Encounter) | Encounter immunization was part of
occurrence[x] | S Σ | 1..1 | dateTime | Vaccine administration date
recorded | S | 0..1 | dateTime | When the immunization was first captured in the subject's record
primarySource | S Σ | 1..1 | boolean | Indicates context the data was recorded in
reportOrigin |  | 0..1 | CodeableConcept | Indicates the source of a secondarily reported record Binding: ImmunizationOriginCodes (example): The source of the data for a record which is not from a primary source.
location |  | 0..1 | Reference(Location) | Where immunization occurred
manufacturer |  | 0..1 | Reference(Organization) | Vaccine manufacturer
lotNumber |  | 0..1 | string | Vaccine lot number
expirationDate |  | 0..1 | date | Vaccine expiration date
site |  | 0..1 | CodeableConcept | Body site vaccine was administered Binding: CodesForImmunizationSiteOfAdministration (example): The site at which the vaccine was administered.
route |  | 0..1 | CodeableConcept | How vaccine entered body Binding: ImmunizationRouteCodes (example): The route by which the vaccine was administered.
doseQuantity |  | 0..1 | SimpleQuantity(4.0.1) | Amount of vaccine administered
performer | Σ | 0..* | BackboneElement | Who performed event
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
function | Σ | 0..1 | CodeableConcept | What type of performance was done Binding: ImmunizationFunctionCodes (extensible): The role a practitioner or organization plays in the immunization event.
actor | Σ | 1..1 | Reference(Practitioner | PractitionerRole | Organization) | Individual or organization who was performing
note | Σ | 0..* | Annotation | Additional immunization notes
reasonCode |  | 0..* | CodeableConcept | Why immunization occurred Binding: ImmunizationReasonCodes (example): The reason why a vaccine was administered.
reasonReference |  | 0..* | Reference(Condition | Observation | DiagnosticReport) | Why immunization occurred
isSubpotent | ?!Σ | 0..1 | boolean | Dose potency
subpotentReason |  | 0..* | CodeableConcept | Reason for being subpotent Binding: ImmunizationSubpotentReason (example): The reason why a dose is considered to be subpotent.
education | C | 0..* | BackboneElement | Educational material presented to patient Constraints: imm-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
documentType |  | 0..1 | string | Educational material document identifier
reference |  | 0..1 | uri | Educational material reference pointer
publicationDate |  | 0..1 | dateTime | Educational material publication date
presentationDate |  | 0..1 | dateTime | Educational material presentation date
programEligibility |  | 0..* | CodeableConcept | Patient eligibility for a vaccination program Binding: ImmunizationProgramEligibility (example): The patient's eligibility for a vaccation program.
fundingSource |  | 0..1 | CodeableConcept | Funding source for the vaccine Binding: ImmunizationFundingSource (example): The source of funding used to purchase the vaccine administered.
reaction |  | 0..* | BackboneElement | Details of a reaction that follows 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
date |  | 0..1 | dateTime | When reaction started
detail |  | 0..1 | Reference(Observation) | Additional information on reaction
reported |  | 0..1 | boolean | Indicates self-reported reaction
protocolApplied |  | 0..* | BackboneElement | Protocol followed by the provider
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
series |  | 0..1 | string | Name of vaccine series
authority |  | 0..1 | Reference(Organization) | Who is responsible for publishing the recommendations
targetDisease |  | 0..* | CodeableConcept | Vaccine preventatable disease being targetted Binding: ImmunizationTargetDiseaseCodes (example): The vaccine preventable disease the dose is being administered for.
doseNumber[x] |  | 1..1 |  | Dose number within series
doseNumberPositiveInt |  |  | positiveInt |
doseNumberString |  |  | string |
seriesDoses[x] |  | 0..1 |  | Recommended number of doses for immunity
seriesDosesPositiveInt |  |  | positiveInt |
seriesDosesString |  |  | string |
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Immunization.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Immunization.status | Base | required | Immunization Status Codes | 📍4.0.1 | FHIR Std.
Immunization.statusReason | Base | example | Immunization Status Reason Codes | 📍4.0.1 | FHIR Std.
Immunization.vaccineCode | Base | example | Vaccine Administered Value Set | 📍4.0.1 | FHIR Std.
Immunization.reportOrigin | Base | example | Immunization Origin Codes | 📍4.0.1 | FHIR Std.
Immunization.site | Base | example | Codes for Immunization Site of Administration | 📍4.0.1 | FHIR Std.
Immunization.route | Base | example | Immunization Route Codes | 📍4.0.1 | FHIR Std.
Immunization.performer.​function | Base | extensible | Immunization Function Codes | 📍4.0.1 | FHIR Std.
Immunization.reasonCode | Base | example | Immunization Reason Codes | 📍4.0.1 | FHIR Std.
Immunization.subpotentReason | Base | example | Immunization Subpotent Reason | 📍4.0.1 | FHIR Std.
Immunization.programEligibility | Base | example | Immunization Program Eligibility | 📍4.0.1 | FHIR Std.
Immunization.fundingSource | Base | example | Immunization Funding Source | 📍4.0.1 | FHIR Std.
Immunization.protocolApplied.​targetDisease | Base | example | Immunization Target Disease Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Immunization | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Immunization | 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 | Immunization | 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 | Immunization | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Immunization | 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()`
imm-1 | error | Immunization.education | One of documentType or reference SHALL be present | `documentType.exists() or reference.exists()`

This structure is derived from Immunization

Summary

Mandatory: 5 elements
Must-Support: 8 elements
Prohibited: 2 elements

Structures

This structure refers to these other structures:

- De-Identified UDS Plus Patient (http://hl7.org/fhir/us/uds-plus/StructureDefinition/de-identified-uds-plus-patient)

Maturity: 1

Other representations of profile: CSV, Excel, Schematron