Immunization Incubator Implementation Guide
0.1.0 - International flag

Immunization Incubator Implementation Guide, published by HL7 International / Public Health. 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/immunization-incubator/ and changes regularly. See the Directory of published versions

Resource: Immunization Evaluation - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 1

Definitions for the ImmunizationEvaluation resource

Guidance on how to interpret the contents of this table can be foundhere

0. ImmunizationEvaluation
Definition

Describes a comparison of an immunization event against published recommendations to determine if the administration is "valid" in relation to those recommendations.


A resource that includes narrative, extensions, and contained resources.

ShortImmunization evaluation informationA resource with narrative, extensions, and contained resources
Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: 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.trace('id') in %resource.descendants().select(reference | as(uri))) or descendants().where(reference='#' | as(uri)='#').exists()).not()).trace('unmatched', id).empty())
dom-4: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. ImmunizationEvaluation.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortLogical id of this artifact
Comments

Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

Control0..1
Typeid
Is Modifierfalse
Must Supportfalse
Summarytrue
4. ImmunizationEvaluation.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

ShortMetadata about the resource
Control0..1
TypeMeta
Is Modifierfalse
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. ImmunizationEvaluation.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. ImmunizationEvaluation.language
Definition

The base language in which the resource is written.

ShortLanguage of the resource content
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Control0..1
BindingThe codes SHALL be taken from AllLanguageshttp://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot3
(required to http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot3)

IETF language tag for a human language

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. ImmunizationEvaluation.text
Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

ShortText summary of the resource, for human interpretation
Comments

Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Control0..1
This element is affected by the following invariants: dom-6
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. ImmunizationEvaluation.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

ShortContained, inline Resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels. Contained resources may be a resource type defined in the FHIR specification, or an additional resource.

Control0..*
This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
TypeResource
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
14. ImmunizationEvaluation.extension
Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on ImmunizationEvaluation.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 16. ImmunizationEvaluation.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Must Supportfalse
    Summarytrue
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on ImmunizationEvaluation.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 18. ImmunizationEvaluation.identifier
      Definition

      A unique identifier assigned to this immunization evaluation record.

      ShortBusiness identifier
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      20. ImmunizationEvaluation.status
      Definition

      Indicates the current status of the evaluation of the vaccination administration event.

      Shortcompleted | entered-in-error
      Control1..1
      BindingThe codes SHALL be taken from ImmunizationEvaluationStatusCodeshttp://hl7.org/fhir/ValueSet/immunization-evaluation-status
      (required to http://hl7.org/fhir/ValueSet/immunization-evaluation-status)

      The status of the evaluation being done.

      Typecode
      Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid).
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      22. ImmunizationEvaluation.patient
      Definition

      The individual for whom the evaluation is being done.

      ShortWho this evaluation is for
      Control1..1
      TypeReference(Patient)
      Summarytrue
      24. ImmunizationEvaluation.date
      Definition

      The date the evaluation of the vaccine administration event was performed.

      ShortDate evaluation was performed
      Control0..1
      TypedateTime
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      26. ImmunizationEvaluation.authority
      Definition

      Indicates the authority who published the protocol (e.g. ACIP).

      ShortWho is responsible for publishing the recommendations
      Control0..1
      TypeReference(Organization)
      28. ImmunizationEvaluation.targetDisease
      Definition

      The vaccine preventable disease the dose is being evaluated against.

      ShortThe vaccine preventable disease schedule being evaluated
      Control1..1
      BindingFor example codes, see ImmunizationTargetDiseaseCodeshttp://hl7.org/fhir/ValueSet/immunization-target-disease
      (example to http://hl7.org/fhir/ValueSet/immunization-target-disease)

      The vaccine preventable disease the dose is being evaluated against.

      TypeCodeableConcept
      Summarytrue
      30. ImmunizationEvaluation.immunizationEvent
      Definition

      The vaccine administration event being evaluated.

      ShortImmunization being evaluated
      Control1..1
      TypeReference(Immunization)
      Summarytrue
      32. ImmunizationEvaluation.doseStatus
      Definition

      Indicates if the dose is valid or not valid with respect to the published recommendations.

      ShortStatus of the dose relative to published recommendations
      Control1..1
      BindingFor example codes, see ImmunizationEvaluationDoseStatusCodeshttp://hl7.org/fhir/ValueSet/immunization-evaluation-dose-status
      (example to http://hl7.org/fhir/ValueSet/immunization-evaluation-dose-status)

      The status of the administered dose relative to the published recommendations for the target disease.

      TypeCodeableConcept
      Summarytrue
      34. ImmunizationEvaluation.doseStatusReason
      Definition

      Provides an explanation as to why the vaccine administration event is valid or not relative to the published recommendations.

      ShortReason why the doese is considered valid, invalid or some other status
      Control0..*
      BindingFor example codes, see ImmunizationEvaluationDoseStatusReasonCodeshttp://hl7.org/fhir/ValueSet/immunization-evaluation-dose-status-reason
      (example to http://hl7.org/fhir/ValueSet/immunization-evaluation-dose-status-reason)

      The reason the dose status was assigned.

      TypeCodeableConcept
      36. ImmunizationEvaluation.description
      Definition

      Additional information about the evaluation.

      ShortEvaluation notes
      Control0..1
      Typemarkdown
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      38. ImmunizationEvaluation.series
      Definition

      One possible path to achieve presumed immunity against a disease - within the context of an authority.

      ShortName of vaccine series
      Control0..1
      Typestring
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      40. ImmunizationEvaluation.doseNumber
      Definition

      Nominal position in a series as determined by the outcome of the evaluation process.

      ShortDose number within series
      Comments

      The dose number may be communicated as either a coded concept (for example Dose 1, Dose 2 or Booster) or as free text as needed by the use case.

      Control0..1
      Binding

      A code expressing the vaccine dose number - several coding schemes exist or will be defined for each jurisdiction.

      TypeCodeableConcept
      42. ImmunizationEvaluation.seriesDoses
      Definition

      The recommended number of doses to achieve immunity as determined by the outcome of the evaluation process.

      ShortRecommended number of doses for immunity
      Comments

      The number of doses in a series may be communicated as either a coded concept or as free text as needed by the use case.

      Control0..1
      Binding

      A code expressing the doses recommended or expected - several coding schemes exist or will be defined for each jurisdiction.

      TypeCodeableConcept

      Guidance on how to interpret the contents of this table can be foundhere

      0. ImmunizationEvaluation
      Definition

      Describes a comparison of an immunization event against published recommendations to determine if the administration is "valid" in relation to those recommendations.

      ShortImmunization evaluation information
      Control0..*
      2. ImmunizationEvaluation.identifier
      Definition

      A unique identifier assigned to this immunization evaluation record.

      ShortBusiness identifier
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      4. ImmunizationEvaluation.status
      Definition

      Indicates the current status of the evaluation of the vaccination administration event.

      Shortcompleted | entered-in-error
      Control1..1
      BindingThe codes SHALL be taken from ImmunizationEvaluationStatusCodes
      (required to http://hl7.org/fhir/ValueSet/immunization-evaluation-status)

      The status of the evaluation being done.

      Typecode
      Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid).
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      6. ImmunizationEvaluation.patient
      Definition

      The individual for whom the evaluation is being done.

      ShortWho this evaluation is for
      Control1..1
      TypeReference(Patient)
      8. ImmunizationEvaluation.date
      Definition

      The date the evaluation of the vaccine administration event was performed.

      ShortDate evaluation was performed
      Control0..1
      TypedateTime
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      10. ImmunizationEvaluation.authority
      Definition

      Indicates the authority who published the protocol (e.g. ACIP).

      ShortWho is responsible for publishing the recommendations
      Control0..1
      TypeReference(Organization)
      12. ImmunizationEvaluation.targetDisease
      Definition

      The vaccine preventable disease the dose is being evaluated against.

      ShortThe vaccine preventable disease schedule being evaluated
      Control1..1
      BindingFor example codes, see ImmunizationTargetDiseaseCodes
      (example to http://hl7.org/fhir/ValueSet/immunization-target-disease)

      The vaccine preventable disease the dose is being evaluated against.

      TypeCodeableConcept
      14. ImmunizationEvaluation.immunizationEvent
      Definition

      The vaccine administration event being evaluated.

      ShortImmunization being evaluated
      Control1..1
      TypeReference(Immunization)
      16. ImmunizationEvaluation.doseStatus
      Definition

      Indicates if the dose is valid or not valid with respect to the published recommendations.

      ShortStatus of the dose relative to published recommendations
      Control1..1
      BindingFor example codes, see ImmunizationEvaluationDoseStatusCodes
      (example to http://hl7.org/fhir/ValueSet/immunization-evaluation-dose-status)

      The status of the administered dose relative to the published recommendations for the target disease.

      TypeCodeableConcept
      18. ImmunizationEvaluation.doseStatusReason
      Definition

      Provides an explanation as to why the vaccine administration event is valid or not relative to the published recommendations.

      ShortReason why the doese is considered valid, invalid or some other status
      Control0..*
      BindingFor example codes, see ImmunizationEvaluationDoseStatusReasonCodes
      (example to http://hl7.org/fhir/ValueSet/immunization-evaluation-dose-status-reason)

      The reason the dose status was assigned.

      TypeCodeableConcept
      20. ImmunizationEvaluation.description
      Definition

      Additional information about the evaluation.

      ShortEvaluation notes
      Control0..1
      Typemarkdown
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      22. ImmunizationEvaluation.series
      Definition

      One possible path to achieve presumed immunity against a disease - within the context of an authority.

      ShortName of vaccine series
      Control0..1
      Typestring
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      24. ImmunizationEvaluation.doseNumber
      Definition

      Nominal position in a series as determined by the outcome of the evaluation process.

      ShortDose number within series
      Comments

      The dose number may be communicated as either a coded concept (for example Dose 1, Dose 2 or Booster) or as free text as needed by the use case.

      Control0..1
      Binding

      A code expressing the vaccine dose number - several coding schemes exist or will be defined for each jurisdiction.

      TypeCodeableConcept
      26. ImmunizationEvaluation.seriesDoses
      Definition

      The recommended number of doses to achieve immunity as determined by the outcome of the evaluation process.

      ShortRecommended number of doses for immunity
      Comments

      The number of doses in a series may be communicated as either a coded concept or as free text as needed by the use case.

      Control0..1
      Binding

      A code expressing the doses recommended or expected - several coding schemes exist or will be defined for each jurisdiction.

      TypeCodeableConcept

      Guidance on how to interpret the contents of this table can be foundhere

      0. ImmunizationEvaluation
      Definition

      Describes a comparison of an immunization event against published recommendations to determine if the administration is "valid" in relation to those recommendations.

      ShortImmunization evaluation information
      Control0..*
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: 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.trace('id') in %resource.descendants().select(reference | as(uri))) or descendants().where(reference='#' | as(uri)='#').exists()).not()).trace('unmatched', id).empty())
      dom-4: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. ImmunizationEvaluation.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortLogical id of this artifact
      Comments

      Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

      Control0..1
      Typeid
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      4. ImmunizationEvaluation.meta
      Definition

      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. ImmunizationEvaluation.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. ImmunizationEvaluation.language
      Definition

      The base language in which the resource is written.

      ShortLanguage of the resource content
      Comments

      Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

      Control0..1
      BindingThe codes SHALL be taken from AllLanguages
      (required to http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot3)

      IETF language tag for a human language

      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. ImmunizationEvaluation.text
      Definition

      A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

      ShortText summary of the resource, for human interpretation
      Comments

      Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

      Control0..1
      This element is affected by the following invariants: dom-6
      TypeNarrative
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. ImmunizationEvaluation.contained
      Definition

      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

      ShortContained, inline Resources
      Comments

      This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels. Contained resources may be a resource type defined in the FHIR specification, or an additional resource.

      Control0..*
      This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
      TypeResource
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      14. ImmunizationEvaluation.extension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on ImmunizationEvaluation.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 16. ImmunizationEvaluation.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Must Supportfalse
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on ImmunizationEvaluation.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 18. ImmunizationEvaluation.identifier
          Definition

          A unique identifier assigned to this immunization evaluation record.

          ShortBusiness identifier
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          TypeIdentifier
          20. ImmunizationEvaluation.status
          Definition

          Indicates the current status of the evaluation of the vaccination administration event.

          Shortcompleted | entered-in-error
          Control1..1
          BindingThe codes SHALL be taken from ImmunizationEvaluationStatusCodes
          (required to http://hl7.org/fhir/ValueSet/immunization-evaluation-status)

          The status of the evaluation being done.

          Typecode
          Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid).
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          22. ImmunizationEvaluation.patient
          Definition

          The individual for whom the evaluation is being done.

          ShortWho this evaluation is for
          Control1..1
          TypeReference(Patient)
          Summarytrue
          24. ImmunizationEvaluation.date
          Definition

          The date the evaluation of the vaccine administration event was performed.

          ShortDate evaluation was performed
          Control0..1
          TypedateTime
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          26. ImmunizationEvaluation.authority
          Definition

          Indicates the authority who published the protocol (e.g. ACIP).

          ShortWho is responsible for publishing the recommendations
          Control0..1
          TypeReference(Organization)
          28. ImmunizationEvaluation.targetDisease
          Definition

          The vaccine preventable disease the dose is being evaluated against.

          ShortThe vaccine preventable disease schedule being evaluated
          Control1..1
          BindingFor example codes, see ImmunizationTargetDiseaseCodes
          (example to http://hl7.org/fhir/ValueSet/immunization-target-disease)

          The vaccine preventable disease the dose is being evaluated against.

          TypeCodeableConcept
          Summarytrue
          30. ImmunizationEvaluation.immunizationEvent
          Definition

          The vaccine administration event being evaluated.

          ShortImmunization being evaluated
          Control1..1
          TypeReference(Immunization)
          Summarytrue
          32. ImmunizationEvaluation.doseStatus
          Definition

          Indicates if the dose is valid or not valid with respect to the published recommendations.

          ShortStatus of the dose relative to published recommendations
          Control1..1
          BindingFor example codes, see ImmunizationEvaluationDoseStatusCodes
          (example to http://hl7.org/fhir/ValueSet/immunization-evaluation-dose-status)

          The status of the administered dose relative to the published recommendations for the target disease.

          TypeCodeableConcept
          Summarytrue
          34. ImmunizationEvaluation.doseStatusReason
          Definition

          Provides an explanation as to why the vaccine administration event is valid or not relative to the published recommendations.

          ShortReason why the doese is considered valid, invalid or some other status
          Control0..*
          BindingFor example codes, see ImmunizationEvaluationDoseStatusReasonCodes
          (example to http://hl7.org/fhir/ValueSet/immunization-evaluation-dose-status-reason)

          The reason the dose status was assigned.

          TypeCodeableConcept
          36. ImmunizationEvaluation.description
          Definition

          Additional information about the evaluation.

          ShortEvaluation notes
          Control0..1
          Typemarkdown
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          38. ImmunizationEvaluation.series
          Definition

          One possible path to achieve presumed immunity against a disease - within the context of an authority.

          ShortName of vaccine series
          Control0..1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          40. ImmunizationEvaluation.doseNumber
          Definition

          Nominal position in a series as determined by the outcome of the evaluation process.

          ShortDose number within series
          Comments

          The dose number may be communicated as either a coded concept (for example Dose 1, Dose 2 or Booster) or as free text as needed by the use case.

          Control0..1
          Binding

          A code expressing the vaccine dose number - several coding schemes exist or will be defined for each jurisdiction.

          TypeCodeableConcept
          42. ImmunizationEvaluation.seriesDoses
          Definition

          The recommended number of doses to achieve immunity as determined by the outcome of the evaluation process.

          ShortRecommended number of doses for immunity
          Comments

          The number of doses in a series may be communicated as either a coded concept or as free text as needed by the use case.

          Control0..1
          Binding

          A code expressing the doses recommended or expected - several coding schemes exist or will be defined for each jurisdiction.

          TypeCodeableConcept