ChanjoKE Immunization Implementation Guide
0.1.0 - ci-build

ChanjoKE Immunization Implementation Guide, published by Intellisoft Consulting Ltd. 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/IntelliSOFT-Consulting/ChanjoKe-FHIR-IG/ and changes regularly. See the Directory of published versions

Resource Profile: KenyanImmunizationRecommendation - Detailed Descriptions

Draft as of 2024-11-08

Definitions for the KenyanImmunizationRecommendation resource profile.

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

0. ImmunizationRecommendation
2. ImmunizationRecommendation.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..1
Must Supporttrue
4. ImmunizationRecommendation.date
Must Supporttrue
6. ImmunizationRecommendation.authority
Must Supporttrue
8. ImmunizationRecommendation.recommendation
10. ImmunizationRecommendation.recommendation.vaccineCode
Control1..1
12. ImmunizationRecommendation.recommendation.targetDisease
Control1..?
14. ImmunizationRecommendation.recommendation.contraindicatedVaccineCode
Control1..1
16. ImmunizationRecommendation.recommendation.forecastReason
Control1..1
18. ImmunizationRecommendation.recommendation.dateCriterion
Control1..1
20. ImmunizationRecommendation.recommendation.description
Control1..?
22. ImmunizationRecommendation.recommendation.series
Control1..?
24. ImmunizationRecommendation.recommendation.doseNumber[x]
Control1..?
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
SlicingThis element introduces a set of slices on ImmunizationRecommendation.recommendation.doseNumber[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • type @ $this
  • 26. ImmunizationRecommendation.recommendation.doseNumber[x]:doseNumberString
    Slice NamedoseNumberString
    Control1..1
    Typestring
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    28. ImmunizationRecommendation.recommendation.seriesDoses[x]
    Control1..?
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    SlicingThis element introduces a set of slices on ImmunizationRecommendation.recommendation.seriesDoses[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • type @ $this
    • 30. ImmunizationRecommendation.recommendation.seriesDoses[x]:seriesDosesString
      Slice NameseriesDosesString
      Control1..1
      Typestring
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension

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

      0. ImmunizationRecommendation
      Definition

      A patient's point-in-time set of recommendations (i.e. forecasting) according to a published schedule with optional supporting justification.

      ShortGuidance or advice relating to an immunization
      Control0..*
      Is Modifierfalse
      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 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: 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. ImmunizationRecommendation.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 it's 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 it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      4. ImmunizationRecommendation.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 manageable, 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
      Summaryfalse
      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()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      6. ImmunizationRecommendation.identifier
      Definition

      A unique identifier assigned to this particular recommendation record.

      ShortBusiness identifier
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control10..1*
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. ImmunizationRecommendation.patient
      Definition

      The patient the recommendation(s) are for.

      ShortWho this profile is for
      Control1..1
      TypeReference(Patient)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. ImmunizationRecommendation.date
      Definition

      The date the immunization recommendation(s) were created.

      ShortDate recommendation(s) created
      Control1..1
      TypedateTime
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. ImmunizationRecommendation.authority
      Definition

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

      ShortWho is responsible for protocol
      Control0..1
      TypeReference(Organization)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. ImmunizationRecommendation.recommendation
      Definition

      Vaccine administration recommendations.

      ShortVaccine administration recommendations
      Control1..*
      TypeBackboneElement
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      imr-1: One of vaccineCode or targetDisease SHALL be present (vaccineCode.exists() or targetDisease.exists())
      imr-1: One of vaccineCode or targetDisease SHALL be present (vaccineCode.exists() or targetDisease.exists())
      16. ImmunizationRecommendation.recommendation.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 manageable, 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. 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 even if unrecognized
      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 element that contains them
      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, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      18. ImmunizationRecommendation.recommendation.vaccineCode
      Definition

      Vaccine(s) or vaccine group that pertain to the recommendation.

      ShortVaccine or vaccine group recommendation applies to
      Control10..1*
      BindingFor example codes, see VaccineAdministeredValueSethttp://hl7.org/fhir/ValueSet/vaccine-code
      (example to http://hl7.org/fhir/ValueSet/vaccine-code)

      The type of vaccine administered.

      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. ImmunizationRecommendation.recommendation.targetDisease
      Definition

      The targeted disease for the recommendation.

      ShortDisease to be immunized against
      Control10..1
      BindingFor example codes, see ImmunizationRecommendationTargetDiseaseCodeshttp://hl7.org/fhir/ValueSet/immunization-recommendation-target-disease
      (example to http://hl7.org/fhir/ValueSet/immunization-recommendation-target-disease)

      The disease that the recommended vaccination targets.

      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. ImmunizationRecommendation.recommendation.contraindicatedVaccineCode
      Definition

      Vaccine(s) which should not be used to fulfill the recommendation.

      ShortVaccine which is contraindicated to fulfill the recommendation
      Control10..1*
      BindingFor example codes, see VaccineAdministeredValueSethttp://hl7.org/fhir/ValueSet/vaccine-code
      (example to http://hl7.org/fhir/ValueSet/vaccine-code)

      The type of vaccine administered.

      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. ImmunizationRecommendation.recommendation.forecastStatus
      Definition

      Indicates the patient status with respect to the path to immunity for the target disease.

      ShortVaccine recommendation status
      Control1..1
      BindingFor example codes, see ImmunizationRecommendationStatusCodeshttp://hl7.org/fhir/ValueSet/immunization-recommendation-status
      (example to http://hl7.org/fhir/ValueSet/immunization-recommendation-status)

      The patient's status with respect to a vaccination protocol.

      TypeCodeableConcept
      Is Modifiertrue because This element is labeled as a modifier because the forecastStatus indicates whether a patient needs additional doses (due, overdue, etc) or not (contraindicated, complete, etc).
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. ImmunizationRecommendation.recommendation.forecastReason
      Definition

      The reason for the assigned forecast status.

      ShortVaccine administration status reason
      Control10..1*
      BindingFor example codes, see ImmunizationRecommendationReasonCodeshttp://hl7.org/fhir/ValueSet/immunization-recommendation-reason
      (example to http://hl7.org/fhir/ValueSet/immunization-recommendation-reason)

      The reason for the patient's status with respect to a vaccination protocol.

      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. ImmunizationRecommendation.recommendation.dateCriterion
      Definition

      Vaccine date recommendations. For example, earliest date to administer, latest date to administer, etc.

      ShortDates governing proposed immunization
      Control10..1*
      TypeBackboneElement
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. ImmunizationRecommendation.recommendation.dateCriterion.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 manageable, 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. 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 even if unrecognized
      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 element that contains them
      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, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      32. ImmunizationRecommendation.recommendation.dateCriterion.code
      Definition

      Date classification of recommendation. For example, earliest date to give, latest date to give, etc.

      ShortType of date
      Control1..1
      BindingFor example codes, see ImmunizationRecommendationDateCriterionCodeshttp://hl7.org/fhir/ValueSet/immunization-recommendation-date-criterion
      (example to http://hl7.org/fhir/ValueSet/immunization-recommendation-date-criterion)

      Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.).

      TypeCodeableConcept
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. ImmunizationRecommendation.recommendation.dateCriterion.value
      Definition

      The date whose meaning is specified by dateCriterion.code.

      ShortRecommended date
      Control1..1
      TypedateTime
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. ImmunizationRecommendation.recommendation.description
      Definition

      Contains the description about the protocol under which the vaccine was administered.

      ShortProtocol details
      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. ImmunizationRecommendation.recommendation.series
      Definition

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

      ShortName of vaccination series
      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. ImmunizationRecommendation.recommendation.doseNumber[x]
      Definition

      Nominal position of the recommended dose in a series (e.g. dose 2 is the next recommended dose).

      ShortRecommended dose number within series
      Comments

      The use of an integer is prefered if known. A string should only be used in cases where an interger is not available (such as when documenting a recurring booster dose).

      Control10..1
      Typestring, positiveInt
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      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 ImmunizationRecommendation.recommendation.doseNumber[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
      • type @ $this
      • 42. ImmunizationRecommendation.recommendation.doseNumber[x]:doseNumberString
        Slice NamedoseNumberString
        Definition

        Nominal position of the recommended dose in a series (e.g. dose 2 is the next recommended dose).

        ShortRecommended dose number within series
        Comments

        The use of an integer is prefered if known. A string should only be used in cases where an interger is not available (such as when documenting a recurring booster dose).

        Control10..1
        Typestring, positiveInt
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. ImmunizationRecommendation.recommendation.seriesDoses[x]
        Definition

        The recommended number of doses to achieve immunity.

        ShortRecommended number of doses for immunity
        Comments

        The use of an integer is prefered if known. A string should only be used in cases where an interger is not available (such as when documenting a recurring booster dose).

        Control10..1
        Typestring, positiveInt
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        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 ImmunizationRecommendation.recommendation.seriesDoses[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
        • type @ $this
        • 46. ImmunizationRecommendation.recommendation.seriesDoses[x]:seriesDosesString
          Slice NameseriesDosesString
          Definition

          The recommended number of doses to achieve immunity.

          ShortRecommended number of doses for immunity
          Comments

          The use of an integer is prefered if known. A string should only be used in cases where an interger is not available (such as when documenting a recurring booster dose).

          Control10..1
          Typestring, positiveInt
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

          0. ImmunizationRecommendation
          Definition

          A patient's point-in-time set of recommendations (i.e. forecasting) according to a published schedule with optional supporting justification.

          ShortGuidance or advice relating to an immunization
          Control0..*
          Is Modifierfalse
          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 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: 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. ImmunizationRecommendation.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

          The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

          Control0..1
          Typeid
          Is Modifierfalse
          Summarytrue
          4. ImmunizationRecommendation.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
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          6. ImmunizationRecommendation.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 it's 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 it's meaning or interpretation
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          8. ImmunizationRecommendation.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 SHOULD be taken from CommonLanguages
          (preferred to http://hl7.org/fhir/ValueSet/languages)

          A human language.

          Additional BindingsPurpose
          AllLanguagesMax Binding
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          10. ImmunizationRecommendation.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 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
          TypeNarrative
          Is Modifierfalse
          Summaryfalse
          Alternate Namesnarrative, html, xhtml, display
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          12. ImmunizationRecommendation.contained
          Definition

          These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

          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.

          Control0..*
          TypeResource
          Is Modifierfalse
          Summaryfalse
          Alternate Namesinline resources, anonymous resources, contained resources
          14. ImmunizationRecommendation.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 manageable, 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
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          16. ImmunizationRecommendation.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 manageable, 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
          Summaryfalse
          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()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          18. ImmunizationRecommendation.identifier
          Definition

          A unique identifier assigned to this particular recommendation record.

          ShortBusiness identifier
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control1..1
          TypeIdentifier
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          20. ImmunizationRecommendation.patient
          Definition

          The patient the recommendation(s) are for.

          ShortWho this profile is for
          Control1..1
          TypeReference(Patient)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          22. ImmunizationRecommendation.date
          Definition

          The date the immunization recommendation(s) were created.

          ShortDate recommendation(s) created
          Control1..1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          24. ImmunizationRecommendation.authority
          Definition

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

          ShortWho is responsible for protocol
          Control0..1
          TypeReference(Organization)
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          26. ImmunizationRecommendation.recommendation
          Definition

          Vaccine administration recommendations.

          ShortVaccine administration recommendations
          Control1..*
          TypeBackboneElement
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          imr-1: One of vaccineCode or targetDisease SHALL be present (vaccineCode.exists() or targetDisease.exists())
          28. ImmunizationRecommendation.recommendation.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          30. ImmunizationRecommendation.recommendation.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, 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
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          32. ImmunizationRecommendation.recommendation.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 manageable, 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. 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 even if unrecognized
          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 element that contains them
          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, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          34. ImmunizationRecommendation.recommendation.vaccineCode
          Definition

          Vaccine(s) or vaccine group that pertain to the recommendation.

          ShortVaccine or vaccine group recommendation applies to
          Control1..1
          BindingFor example codes, see VaccineAdministeredValueSet
          (example to http://hl7.org/fhir/ValueSet/vaccine-code)

          The type of vaccine administered.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          36. ImmunizationRecommendation.recommendation.targetDisease
          Definition

          The targeted disease for the recommendation.

          ShortDisease to be immunized against
          Control1..1
          BindingFor example codes, see ImmunizationRecommendationTargetDiseaseCodes
          (example to http://hl7.org/fhir/ValueSet/immunization-recommendation-target-disease)

          The disease that the recommended vaccination targets.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          38. ImmunizationRecommendation.recommendation.contraindicatedVaccineCode
          Definition

          Vaccine(s) which should not be used to fulfill the recommendation.

          ShortVaccine which is contraindicated to fulfill the recommendation
          Control1..1
          BindingFor example codes, see VaccineAdministeredValueSet
          (example to http://hl7.org/fhir/ValueSet/vaccine-code)

          The type of vaccine administered.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          40. ImmunizationRecommendation.recommendation.forecastStatus
          Definition

          Indicates the patient status with respect to the path to immunity for the target disease.

          ShortVaccine recommendation status
          Control1..1
          BindingFor example codes, see ImmunizationRecommendationStatusCodes
          (example to http://hl7.org/fhir/ValueSet/immunization-recommendation-status)

          The patient's status with respect to a vaccination protocol.

          TypeCodeableConcept
          Is Modifiertrue because This element is labeled as a modifier because the forecastStatus indicates whether a patient needs additional doses (due, overdue, etc) or not (contraindicated, complete, etc).
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          42. ImmunizationRecommendation.recommendation.forecastReason
          Definition

          The reason for the assigned forecast status.

          ShortVaccine administration status reason
          Control1..1
          BindingFor example codes, see ImmunizationRecommendationReasonCodes
          (example to http://hl7.org/fhir/ValueSet/immunization-recommendation-reason)

          The reason for the patient's status with respect to a vaccination protocol.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          44. ImmunizationRecommendation.recommendation.dateCriterion
          Definition

          Vaccine date recommendations. For example, earliest date to administer, latest date to administer, etc.

          ShortDates governing proposed immunization
          Control1..1
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          46. ImmunizationRecommendation.recommendation.dateCriterion.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          48. ImmunizationRecommendation.recommendation.dateCriterion.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, 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
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          50. ImmunizationRecommendation.recommendation.dateCriterion.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 manageable, 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. 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 even if unrecognized
          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 element that contains them
          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, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          52. ImmunizationRecommendation.recommendation.dateCriterion.code
          Definition

          Date classification of recommendation. For example, earliest date to give, latest date to give, etc.

          ShortType of date
          Control1..1
          BindingFor example codes, see ImmunizationRecommendationDateCriterionCodes
          (example to http://hl7.org/fhir/ValueSet/immunization-recommendation-date-criterion)

          Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.).

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          54. ImmunizationRecommendation.recommendation.dateCriterion.value
          Definition

          The date whose meaning is specified by dateCriterion.code.

          ShortRecommended date
          Control1..1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          56. ImmunizationRecommendation.recommendation.description
          Definition

          Contains the description about the protocol under which the vaccine was administered.

          ShortProtocol details
          Control1..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          58. ImmunizationRecommendation.recommendation.series
          Definition

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

          ShortName of vaccination series
          Control1..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          60. ImmunizationRecommendation.recommendation.doseNumber[x]
          Definition

          Nominal position of the recommended dose in a series (e.g. dose 2 is the next recommended dose).

          ShortRecommended dose number within series
          Comments

          The use of an integer is prefered if known. A string should only be used in cases where an interger is not available (such as when documenting a recurring booster dose).

          Control1..1
          Typestring
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          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 ImmunizationRecommendation.recommendation.doseNumber[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
          • type @ $this
          • 62. ImmunizationRecommendation.recommendation.doseNumber[x]:doseNumberString
            Slice NamedoseNumberString
            Definition

            Nominal position of the recommended dose in a series (e.g. dose 2 is the next recommended dose).

            ShortRecommended dose number within series
            Comments

            The use of an integer is prefered if known. A string should only be used in cases where an interger is not available (such as when documenting a recurring booster dose).

            Control1..1
            Typestring
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            64. ImmunizationRecommendation.recommendation.seriesDoses[x]
            Definition

            The recommended number of doses to achieve immunity.

            ShortRecommended number of doses for immunity
            Comments

            The use of an integer is prefered if known. A string should only be used in cases where an interger is not available (such as when documenting a recurring booster dose).

            Control1..1
            Typestring
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            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 ImmunizationRecommendation.recommendation.seriesDoses[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
            • type @ $this
            • 66. ImmunizationRecommendation.recommendation.seriesDoses[x]:seriesDosesString
              Slice NameseriesDosesString
              Definition

              The recommended number of doses to achieve immunity.

              ShortRecommended number of doses for immunity
              Comments

              The use of an integer is prefered if known. A string should only be used in cases where an interger is not available (such as when documenting a recurring booster dose).

              Control1..1
              Typestring
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              68. ImmunizationRecommendation.recommendation.supportingImmunization
              Definition

              Immunization event history and/or evaluation that supports the status and recommendation.

              ShortPast immunizations supporting recommendation
              Control0..*
              TypeReference(Immunization, ImmunizationEvaluation)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              70. ImmunizationRecommendation.recommendation.supportingPatientInformation
              Definition

              Patient Information that supports the status and recommendation. This includes patient observations, adverse reactions and allergy/intolerance information.

              ShortPatient observations supporting recommendation
              Control0..*
              TypeReference(Resource)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))