NHDR Implementation Guide Release 1.0
0.1.0 - ci-build

NHDR Implementation Guide Release 1.0, published by NHDR. 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/UP-Manila-SILab/PhilHealth-NHDR-IG-Review/ and changes regularly. See the Directory of published versions

Resource Profile: PH_Immunization - Detailed Descriptions

Page standards status: Draft

Definitions for the PH-Immunization resource profile.

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

0. Immunization
Definition

Describes the event of a patient being administered a vaccine or a record of an immunization as reported by a patient, a clinician or another party.

ShortImmunization event information
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. Immunization.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..01
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. Immunization.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..01
BindingThe codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages|4.0.1
(preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

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()))
6. Immunization.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..01
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()))
8. Immunization.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..0*
TypeResource
Is Modifierfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
10. Immunization.extension
Definition

An Extension


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.

ShortExtensionAdditional 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..0*
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())
12. Immunization.modifierExtension
Definition

An Extension


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).

ShortExtensionExtensions 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..0*
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())
14. Immunization.status
Definition

Indicates the current status of the immunization event.

Shortcompleted | entered-in-error | not-done
Comments

Will generally be set to show that the immunization has been completed or not done. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Control1..1
BindingThe codes SHALL be taken from ImmunizationStatusCodeshttp://hl7.org/fhir/ValueSet/immunization-status|4.0.1
(required to http://hl7.org/fhir/ValueSet/immunization-status)
Typecode
Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains statuses entered-in-error and not-done 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
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. Immunization.statusReason
Definition

Indicates the reason the immunization event was not performed.

ShortReason not done
Comments

This is generally only used for the status of "not-done". The reason for performing the immunization event is captured in reasonCode, not here.

Control0..1
BindingThe codes SHALL be taken from For example codes, see ActNoImmunizationReasonhttp://hl7.org/fhir/ValueSet/immunization-status-reason|4.0.1
(required to http://terminology.hl7.org/ValueSet/v3-ActNoImmunizationReason)
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. Immunization.vaccineCode
Definition

Vaccine that was administered or was to be administered.

ShortVaccine product administered
Control1..1
BindingThe codes SHALL be taken from For example codes, see Drug Codeshttp://hl7.org/fhir/ValueSet/vaccine-code|4.0.1
(required to https://nhdr.gov.ph/fhir/ValueSet/DrugCodesVS)
TypeCodeableConcept
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Immunization.patient
Definition

The patient who either received or did not receive the immunization.

ShortWho was immunized
Control1..1
TypeReference(PH Patient, Patient)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. Immunization.encounter
Definition

The visit or admission or other contact between patient and health care provider the immunization was performed as part of.

ShortEncounter immunization was part of
Control0..1
TypeReference(PH Encounter, Encounter)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Immunization.occurrence[x]
Definition

Date vaccine administered or was to be administered.

ShortVaccine administration date
Comments

When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given. An exact date is always preferable, but the use of the String data type is acceptable when an exact date is not known. A small number of vaccines (e.g. live oral typhoid vaccine) are given as a series of patient self-administered dose over a span of time. In cases like this, often, only the first dose (typically a provider supervised dose) is recorded with the occurrence indicating the date/time of the first dose.

Control1..1
TypeChoice of: dateTime, string
[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()))
26. Immunization.primarySource
Definition

An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded.

ShortIndicates context the data was recorded in
Comments

Reflects the “reliability” of the content.

Control0..01
Typeboolean
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()))
28. Immunization.reportOrigin
Definition

The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.

ShortIndicates the source of a secondarily reported record
Comments

Should not be populated if primarySource = True, not required even if primarySource = False.

Control0..1
BindingThe codes SHALL be taken from For example codes, see ImmunizationOriginCodeshttp://hl7.org/fhir/ValueSet/immunization-origin|4.0.1
(required to http://hl7.org/fhir/ValueSet/immunization-origin)
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. Immunization.location
Definition

The service delivery location where the vaccine administration occurred.

ShortWhere immunization occurred
Control0..01
TypeReference(Location)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. Immunization.manufacturer
Definition

Name of vaccine manufacturer.

ShortVaccine manufacturer
Control0..01
TypeReference(Organization)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. Immunization.lotNumber
Definition

Lot number of the vaccine product.

ShortVaccine lot number
Control0..01
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()))
36. Immunization.expirationDate
Definition

Date vaccine batch expires.

ShortVaccine expiration date
Control0..01
Typedate
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. Immunization.site
Definition

Body site where vaccine was administered.

ShortBody site vaccine was administered
Control0..01
BindingFor example codes, see CodesForImmunizationSiteOfAdministrationhttp://hl7.org/fhir/ValueSet/immunization-site|4.0.1
(example to http://hl7.org/fhir/ValueSet/immunization-site|4.0.1)

The site at which the vaccine was administered.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. Immunization.route
Definition

The path by which the vaccine product is taken into the body.

ShortHow vaccine entered body
Control0..1
BindingThe codes SHALL be taken from For example codes, see ImmunizationRouteCodeshttp://hl7.org/fhir/ValueSet/immunization-route|4.0.1
(required to http://hl7.org/fhir/ValueSet/immunization-route)
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. Immunization.reasonCode
Definition

Reasons why the vaccine was administered.

ShortWhy immunization occurred
Control0..*
BindingThe codes SHALL be taken from For example codes, see ActNoImmunizationReasonhttp://hl7.org/fhir/ValueSet/immunization-reason|4.0.1
(required to http://terminology.hl7.org/ValueSet/v3-ActNoImmunizationReason)
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. Immunization.reasonReference
Definition

Condition, Observation or DiagnosticReport that supports why the immunization was administered.

ShortWhy immunization occurred
Control0..0*
TypeReference(Condition, Observation, DiagnosticReport)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. Immunization.isSubpotent
Definition

Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent.

ShortDose potency
Comments

Typically, the recognition of the dose being sub-potent is retrospective, after the administration (ex. notification of a manufacturer recall after administration). However, in the case of a partial administration (the patient moves unexpectedly and only some of the dose is actually administered), subpotency may be recognized immediately, but it is still important to record the event.

Control0..01
Typeboolean
Is Modifiertrue because This element is labeled as a modifier because an immunization event with a subpotent vaccine doesn't protect the patient the same way as a potent dose.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Meaning if MissingBy default, a dose should be considered to be potent.
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. Immunization.subpotentReason
Definition

Reason why a dose is considered to be subpotent.

ShortReason for being subpotent
Control0..0*
BindingFor example codes, see ImmunizationSubpotentReasonhttp://hl7.org/fhir/ValueSet/immunization-subpotent-reason|4.0.1
(example to http://hl7.org/fhir/ValueSet/immunization-subpotent-reason|4.0.1)

The reason why a dose is considered to be subpotent.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. Immunization.education
Definition

Educational material presented to the patient (or guardian) at the time of vaccine administration.

ShortEducational material presented to patient
Control0..0*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
imm-1: One of documentType or reference SHALL be present (documentType.exists() or reference.exists())
imm-1: One of documentType or reference SHALL be present (documentType.exists() or reference.exists())
53. Immunization.programEligibility
Definition

Indicates a patient's eligibility for a funding program.

ShortPatient eligibility for a vaccination program
Control0..0*
BindingFor example codes, see ImmunizationProgramEligibilityhttp://hl7.org/fhir/ValueSet/immunization-program-eligibility|4.0.1
(example to http://hl7.org/fhir/ValueSet/immunization-program-eligibility|4.0.1)

The patient's eligibility for a vaccation program.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
55. Immunization.fundingSource
Definition

Indicates the source of the vaccine actually administered. This may be different than the patient eligibility (e.g. the patient may be eligible for a publically purchased vaccine but due to inventory issues, vaccine purchased with private funds was actually administered).

ShortFunding source for the vaccine
Control0..01
BindingFor example codes, see ImmunizationFundingSourcehttp://hl7.org/fhir/ValueSet/immunization-funding-source|4.0.1
(example to http://hl7.org/fhir/ValueSet/immunization-funding-source|4.0.1)

The source of funding used to purchase the vaccine administered.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
57. Immunization.protocolApplied
Definition

The protocol (set of recommendations) being followed by the provider who administered the dose.

ShortProtocol followed by the provider
Control0..0*
TypeBackboneElement
Is Modifierfalse
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 foundhere

0. Immunization
2. Immunization.meta
4. Immunization.meta.extension:hfRecordedDate
Slice NamehfRecordedDate
Control0..1
TypeExtension(The recorded date indicating when the record was uploaded by the health facility.) (Extension Type: dateTime)
6. Immunization.meta.extension:hfLastUpdated
Slice NamehfLastUpdated
Control0..*
TypeExtension(The date indicating when the record was last updated by the health facility.) (Extension Type: dateTime)
8. Immunization.meta.lastUpdated
ShortWhen the resource was uploaded to the NHDR.
10. Immunization.implicitRules
Control0..0
12. Immunization.language
Control0..0
14. Immunization.text
Control0..0
16. Immunization.contained
Control0..0
18. Immunization.extension
Control0..0
20. Immunization.modifierExtension
Control0..0
22. Immunization.status
BindingThe codes SHALL be taken from ImmunizationStatusCodes
(required to http://hl7.org/fhir/ValueSet/immunization-status)
24. Immunization.statusReason
BindingThe codes SHALL be taken from ActNoImmunizationReason
(required to http://terminology.hl7.org/ValueSet/v3-ActNoImmunizationReason)
26. Immunization.vaccineCode
BindingThe codes SHALL be taken from Drug Codes
(required to https://nhdr.gov.ph/fhir/ValueSet/DrugCodesVS)
28. Immunization.patient
TypeReference(PH Patient)
30. Immunization.encounter
TypeReference(PH Encounter)
32. Immunization.primarySource
Control0..0
34. Immunization.reportOrigin
BindingThe codes SHALL be taken from ImmunizationOriginCodes
(required to http://hl7.org/fhir/ValueSet/immunization-origin)
36. Immunization.location
Control0..0
38. Immunization.manufacturer
Control0..0
40. Immunization.lotNumber
Control0..0
42. Immunization.expirationDate
Control0..0
44. Immunization.site
Control0..0
46. Immunization.route
BindingThe codes SHALL be taken from ImmunizationRouteCodes
(required to http://hl7.org/fhir/ValueSet/immunization-route)
48. Immunization.performer
50. Immunization.performer.extension
Control0..0
52. Immunization.performer.modifierExtension
Control0..0
54. Immunization.performer.function
Control0..0
56. Immunization.performer.actor
TypeReference(PH Practitioner, PH PractitionerRole, PH Organization)
58. Immunization.reasonCode
BindingThe codes SHALL be taken from ActNoImmunizationReason
(required to http://terminology.hl7.org/ValueSet/v3-ActNoImmunizationReason)
60. Immunization.reasonReference
Control0..0
62. Immunization.isSubpotent
Control0..0
64. Immunization.subpotentReason
Control0..0
66. Immunization.education
Control0..0
68. Immunization.programEligibility
Control0..0
70. Immunization.fundingSource
Control0..0
72. Immunization.reaction
74. Immunization.reaction.id
Control0..0
76. Immunization.reaction.extension
Control0..0
78. Immunization.reaction.modifierExtension
Control0..0
80. Immunization.reaction.detail
TypeReference(PH Observation)
82. Immunization.protocolApplied
Control0..0

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

0. Immunization
Definition

Describes the event of a patient being administered a vaccine or a record of an immunization as reported by a patient, a clinician or another party.

ShortImmunization event information
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. Immunization.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. Immunization.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. Immunization.meta.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
8. Immunization.meta.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())
SlicingThis element introduces a set of slices on Immunization.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 10. Immunization.meta.extension:hfRecordedDate
    Slice NamehfRecordedDate
    Definition

    The recorded date indicating when the record was uploaded by the health facility.

    ShortThe recorded date indicating when the record was uploaded by the health facility.
    Control0..1
    TypeExtension(The recorded date indicating when the record was uploaded by the health facility.) (Extension Type: dateTime)
    Is Modifierfalse
    Summaryfalse
    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())
    12. Immunization.meta.extension:hfLastUpdated
    Slice NamehfLastUpdated
    Definition

    The date indicating when the record was last updated by the health facility.

    ShortThe date indicating when the record was last updated by the health facility.
    Control0..*
    TypeExtension(The date indicating when the record was last updated by the health facility.) (Extension Type: dateTime)
    Is Modifierfalse
    Summaryfalse
    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())
    14. Immunization.meta.versionId
    Definition

    The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

    ShortVersion specific identifier
    Comments

    The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

    Control0..1
    Typeid
    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()))
    16. Immunization.meta.lastUpdated
    Definition

    When the resource last changed - e.g. when the version changed.

    ShortWhen the resource was uploaded to the NHDR.
    Comments

    This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

    Control0..1
    Typeinstant
    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()))
    18. Immunization.meta.source
    Definition

    A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

    ShortIdentifies where the resource comes from
    Comments

    In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

    This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

    Control0..1
    Typeuri
    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()))
    20. Immunization.meta.profile
    Definition

    A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

    ShortProfiles this resource claims to conform to
    Comments

    It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

    Control0..*
    Typecanonical(StructureDefinition)
    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()))
    22. Immunization.meta.security
    Definition

    Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

    ShortSecurity Labels applied to this resource
    Comments

    The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

    Control0..*
    BindingUnless not suitable, these codes SHALL be taken from All Security Labels
    (extensible to http://hl7.org/fhir/ValueSet/security-labels|4.0.1)

    Security Labels from the Healthcare Privacy and Security Classification System.

    TypeCoding
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. Immunization.meta.tag
    Definition

    Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

    ShortTags applied to this resource
    Comments

    The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

    Control0..*
    BindingFor example codes, see CommonTags
    (example to http://hl7.org/fhir/ValueSet/common-tags|4.0.1)

    Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

    TypeCoding
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. Immunization.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..0
    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()))
    28. Immunization.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..0
    BindingThe codes SHOULD be taken from CommonLanguages
    (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

    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()))
    30. Immunization.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..0
    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()))
    32. Immunization.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..0
    TypeResource
    Is Modifierfalse
    Summaryfalse
    Alternate Namesinline resources, anonymous resources, contained resources
    34. Immunization.extension
    Definition

    An Extension

    ShortExtension
    Control0..0
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    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())
    36. Immunization.modifierExtension
    Definition

    An Extension

    ShortExtension
    Control0..0
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Summaryfalse
    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())
    38. Immunization.identifier
    Definition

    A unique identifier assigned to this immunization record.

    ShortBusiness identifier
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    TypeIdentifier
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    40. Immunization.status
    Definition

    Indicates the current status of the immunization event.

    Shortcompleted | entered-in-error | not-done
    Comments

    Will generally be set to show that the immunization has been completed or not done. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

    Control1..1
    BindingThe codes SHALL be taken from ImmunizationStatusCodes
    (required to http://hl7.org/fhir/ValueSet/immunization-status)
    Typecode
    Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains statuses entered-in-error and not-done 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
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    42. Immunization.statusReason
    Definition

    Indicates the reason the immunization event was not performed.

    ShortReason not done
    Comments

    This is generally only used for the status of "not-done". The reason for performing the immunization event is captured in reasonCode, not here.

    Control0..1
    BindingThe codes SHALL be taken from ActNoImmunizationReason
    (required to http://terminology.hl7.org/ValueSet/v3-ActNoImmunizationReason)
    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    44. Immunization.vaccineCode
    Definition

    Vaccine that was administered or was to be administered.

    ShortVaccine product administered
    Control1..1
    BindingThe codes SHALL be taken from Drug Codes
    (required to https://nhdr.gov.ph/fhir/ValueSet/DrugCodesVS)
    TypeCodeableConcept
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    46. Immunization.patient
    Definition

    The patient who either received or did not receive the immunization.

    ShortWho was immunized
    Control1..1
    TypeReference(PH Patient)
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    48. Immunization.encounter
    Definition

    The visit or admission or other contact between patient and health care provider the immunization was performed as part of.

    ShortEncounter immunization was part of
    Control0..1
    TypeReference(PH Encounter)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    50. Immunization.occurrence[x]
    Definition

    Date vaccine administered or was to be administered.

    ShortVaccine administration date
    Comments

    When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given. An exact date is always preferable, but the use of the String data type is acceptable when an exact date is not known. A small number of vaccines (e.g. live oral typhoid vaccine) are given as a series of patient self-administered dose over a span of time. In cases like this, often, only the first dose (typically a provider supervised dose) is recorded with the occurrence indicating the date/time of the first dose.

    Control1..1
    TypeChoice of: dateTime, string
    [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()))
    52. Immunization.recorded
    Definition

    The date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event.

    ShortWhen the immunization was first captured in the subject's record
    Control0..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()))
    54. Immunization.primarySource
    Definition

    An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded.

    ShortIndicates context the data was recorded in
    Comments

    Reflects the “reliability” of the content.

    Control0..0
    Typeboolean
    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()))
    56. Immunization.reportOrigin
    Definition

    The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.

    ShortIndicates the source of a secondarily reported record
    Comments

    Should not be populated if primarySource = True, not required even if primarySource = False.

    Control0..1
    BindingThe codes SHALL be taken from ImmunizationOriginCodes
    (required to http://hl7.org/fhir/ValueSet/immunization-origin)
    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    58. Immunization.location
    Definition

    The service delivery location where the vaccine administration occurred.

    ShortWhere immunization occurred
    Control0..0
    TypeReference(Location)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    60. Immunization.manufacturer
    Definition

    Name of vaccine manufacturer.

    ShortVaccine manufacturer
    Control0..0
    TypeReference(Organization)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    62. Immunization.lotNumber
    Definition

    Lot number of the vaccine product.

    ShortVaccine lot number
    Control0..0
    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()))
    64. Immunization.expirationDate
    Definition

    Date vaccine batch expires.

    ShortVaccine expiration date
    Control0..0
    Typedate
    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()))
    66. Immunization.site
    Definition

    Body site where vaccine was administered.

    ShortBody site vaccine was administered
    Control0..0
    BindingFor example codes, see CodesForImmunizationSiteOfAdministration
    (example to http://hl7.org/fhir/ValueSet/immunization-site|4.0.1)

    The site at which the vaccine was administered.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    68. Immunization.route
    Definition

    The path by which the vaccine product is taken into the body.

    ShortHow vaccine entered body
    Control0..1
    BindingThe codes SHALL be taken from ImmunizationRouteCodes
    (required to http://hl7.org/fhir/ValueSet/immunization-route)
    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    70. Immunization.doseQuantity
    Definition

    The quantity of vaccine product that was administered.

    ShortAmount of vaccine administered
    Control0..1
    TypeQuantity(SimpleQuantity)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    72. Immunization.performer
    Definition

    Indicates who performed the immunization event.

    ShortWho performed event
    Control0..*
    TypeBackboneElement
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    74. Immunization.performer.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
    76. Immunization.performer.extension
    Definition

    An Extension

    ShortExtension
    Control0..0
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    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())
    78. Immunization.performer.modifierExtension
    Definition

    An Extension

    ShortExtension
    Control0..0
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    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())
    80. Immunization.performer.function
    Definition

    Describes the type of performance (e.g. ordering provider, administering provider, etc.).

    ShortWhat type of performance was done
    Control0..0
    BindingUnless not suitable, these codes SHALL be taken from ImmunizationFunctionCodes
    (extensible to http://hl7.org/fhir/ValueSet/immunization-function|4.0.1)

    The role a practitioner or organization plays in the immunization event.

    TypeCodeableConcept
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    82. Immunization.performer.actor
    Definition

    The practitioner or organization who performed the action.

    ShortIndividual or organization who was performing
    Comments

    When the individual practitioner who performed the action is known, it is best to send.

    Control1..1
    TypeReference(PH Practitioner, PH PractitionerRole, PH Organization)
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    84. Immunization.note
    Definition

    Extra information about the immunization that is not conveyed by the other attributes.

    ShortAdditional immunization notes
    Control0..*
    TypeAnnotation
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    86. Immunization.reasonCode
    Definition

    Reasons why the vaccine was administered.

    ShortWhy immunization occurred
    Control0..*
    BindingThe codes SHALL be taken from ActNoImmunizationReason
    (required to http://terminology.hl7.org/ValueSet/v3-ActNoImmunizationReason)
    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    88. Immunization.reasonReference
    Definition

    Condition, Observation or DiagnosticReport that supports why the immunization was administered.

    ShortWhy immunization occurred
    Control0..0
    TypeReference(Condition, Observation, DiagnosticReport)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    90. Immunization.isSubpotent
    Definition

    Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent.

    ShortDose potency
    Comments

    Typically, the recognition of the dose being sub-potent is retrospective, after the administration (ex. notification of a manufacturer recall after administration). However, in the case of a partial administration (the patient moves unexpectedly and only some of the dose is actually administered), subpotency may be recognized immediately, but it is still important to record the event.

    Control0..0
    Typeboolean
    Is Modifiertrue because This element is labeled as a modifier because an immunization event with a subpotent vaccine doesn't protect the patient the same way as a potent dose.
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Meaning if MissingBy default, a dose should be considered to be potent.
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    92. Immunization.subpotentReason
    Definition

    Reason why a dose is considered to be subpotent.

    ShortReason for being subpotent
    Control0..0
    BindingFor example codes, see ImmunizationSubpotentReason
    (example to http://hl7.org/fhir/ValueSet/immunization-subpotent-reason|4.0.1)

    The reason why a dose is considered to be subpotent.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    94. Immunization.education
    Definition

    Educational material presented to the patient (or guardian) at the time of vaccine administration.

    ShortEducational material presented to patient
    Control0..0
    TypeBackboneElement
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    imm-1: One of documentType or reference SHALL be present (documentType.exists() or reference.exists())
    103. Immunization.programEligibility
    Definition

    Indicates a patient's eligibility for a funding program.

    ShortPatient eligibility for a vaccination program
    Control0..0
    BindingFor example codes, see ImmunizationProgramEligibility
    (example to http://hl7.org/fhir/ValueSet/immunization-program-eligibility|4.0.1)

    The patient's eligibility for a vaccation program.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    105. Immunization.fundingSource
    Definition

    Indicates the source of the vaccine actually administered. This may be different than the patient eligibility (e.g. the patient may be eligible for a publically purchased vaccine but due to inventory issues, vaccine purchased with private funds was actually administered).

    ShortFunding source for the vaccine
    Control0..0
    BindingFor example codes, see ImmunizationFundingSource
    (example to http://hl7.org/fhir/ValueSet/immunization-funding-source|4.0.1)

    The source of funding used to purchase the vaccine administered.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    107. Immunization.reaction
    Definition

    Categorical data indicating that an adverse event is associated in time to an immunization.

    ShortDetails of a reaction that follows immunization
    Comments

    A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case, it should be recorded as a new AllergyIntolerance resource instance as most systems will not query against past Immunization.reaction elements.

    Control0..*
    TypeBackboneElement
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    109. Immunization.reaction.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..0
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    111. Immunization.reaction.extension
    Definition

    An Extension

    ShortExtension
    Control0..0
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    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())
    113. Immunization.reaction.modifierExtension
    Definition

    An Extension

    ShortExtension
    Control0..0
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    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())
    115. Immunization.reaction.date
    Definition

    Date of reaction to the immunization.

    ShortWhen reaction started
    Control0..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()))
    117. Immunization.reaction.detail
    Definition

    Details of the reaction.

    ShortAdditional information on reaction
    Control0..1
    TypeReference(PH Observation)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    119. Immunization.reaction.reported
    Definition

    Self-reported indicator.

    ShortIndicates self-reported reaction
    Control0..1
    Typeboolean
    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()))
    121. Immunization.protocolApplied
    Definition

    The protocol (set of recommendations) being followed by the provider who administered the dose.

    ShortProtocol followed by the provider
    Control0..0
    TypeBackboneElement
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))