ICVP
type: Questionnaire
node role: treeRoot
id:
  v: ICVP
meta:
  profile:
    v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extr-smap
    l: sdc-questionnaire-extr-smap
text:
  status:
    v: extensions
  div:
    v: Generated Narrative: Questionnaire ICVP Profile: Extractable Questionnaire - StructureMap LinkID Text Cardinality Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> Questionnaire for DVC Logical Model with the WHO ICVP Questionnaire http://smart.who.int/icvp/Questionnaire/ICVP#0.3.0 #xD; name Full Name of the client 1..1 string #xD; dob Date of Birth 1..1 date #xD; sex Sex 0..1 choice Value Set: v2 SEX #xD; nationality Nationality 0..1 choice Value Set: Country #xD; ndt National ID Document Type 0..1 choice Value Set: hl7VS-identifierType #xD; nid National Identification Document 0..1 string #xD; guardian Parent or Guardian Details 0..1 group #xD; guardianName Name of Parent or Guardian 0..1 string #xD; guardianRelationship Relationship Status 0..1 choice Value Set: Relationship Status for Contact in Patient #xD; vaccineDetails Vaccine Certificate Details 1..* group #xD; productID Vaccine or Prophylaxis ID 1..1 choice Value Set: WHO ICVP Vaccine Product Ids #xD; date Date of Vaccination 1..1 date #xD; clinicianName Name of supervising clinician 0..1 string #xD; issuer Relevant authoring responsible for issuing the certificate, or for overseeing the administration center 0..1 string #xD; batchNo.text Batch Number 1..1 string #xD; validityPeriod Certificate Validity Period 0..1 group #xD; startDate From 0..1 date #xD; endDate To 0..1 date #xD; <img src="[binary]" alt="doco" style="background-color: inherit"/> Documentation for this format Contained Resources ValueSet #v3-Country Language: en Include codes fromurn:iso:std:iso:3166 version Not Stated (use latest from terminology server) where code matches (by regex) [A-Z]{3} ValueSet #v2-0001 Language: en Profile: Shareable ValueSet Include all codes defined in http://terminology.hl7.org/CodeSystem/v2-0001 version ?3.0.0 ValueSet #ICVPProductIds Include these codes as defined in http://smart.who.int/pcmt-vaxprequal/CodeSystem/PreQualProductIds version ?0.2.0 Code Display C…
contained: ValueSet
  id:
    v: v3-Country
  language:
    v: en
  text:
    status:
      v: generated
    div:
      v: Generated Narrative: ValueSet v3-Country Language: en Include codes fromurn:iso:std:iso:3166 version ⏿20210120 where code matches (by regex) [A-Z]{3}
  url:
    v: http://terminology.hl7.org/ValueSet/v3-Country
    l: v3-Country
  identifier:
    system:
      v: urn:ietf:rfc:3986
      l: 3986
    value:
      v: urn:oid:2.16.840.1.113883.1.11.171
  version:
    v: 3.0.0
  name:
    v: Country
  title:
    v: Country
  status:
    v: active
  experimental:
    v: false
  date:
    v: 2014-03-26
  publisher:
    v: Health Level Seven International
  contact:
    telecom:
      system:
        v: url
      value:
        v: http://hl7.org
    telecom:
      system:
        v: email
  description:
    v: Countries of the world. ISO 3166, part 1, alpha-3 set.
  copyright:
    v: This material derives from the HL7 Terminology THO. THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html
  compose:
    include:
      system:
        v: urn:iso:std:iso:3166
        l: 3166
contained: ValueSet
  id:
    v: v2-0001
  meta:
    profile:
      v: http://hl7.org/fhir/StructureDefinition/shareablevalueset
      l: shareablevalueset
  language:
    v: en
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status
      l: structuredefinition-standards-status
    value: Code
      v: external
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm
      l: structuredefinition-fmm
    value: Integer
      v: 0
  url:
    v: http://terminology.hl7.org/ValueSet/v2-0001
    l: v2-0001
  version:
    v: 2.9
  name:
    v: v2.0001
  title:
    v: v2 SEX
  status:
    v: active
  experimental:
    v: false
  publisher:
    v: HL7, Inc
  contact:
    telecom:
      system:
        v: url
      value:
        v: http://hl7.org
  description:
    v: FHIR Value set/code system definition for HL7 v2 table 0001 ( SEX)
  immutable:
    v: true
  compose:
    include:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0001
        l: v2-0001
contained: ValueSet
  id:
    v: ICVPProductIds
  url:
    v: http://smart.who.int/icvp/ValueSet/ICVPProductIds
    l: ICVPProductIds
  name:
    v: ICVPProductIds
  title:
    v: WHO ICVP Vaccine Product Ids
  status:
    v: active
  experimental:
    v: true
  description:
    v: WHO ICVP Vaccine Product Ids
  compose:
    include:
      system:
        v: http://smart.who.int/pcmt-vaxprequal/CodeSystem/PreQualProductIds
        l: PreQualProductIds
contained: ValueSet
  id:
    v: DVCRelationshipStatus
  text:
    status:
      v: generated
    div:
      v: Generated Narrative: ValueSet DVCRelationshipStatus Include all codes defined in http://smart.who.int/trust-phw/CodeSystem/DVCRelationshipStatus version ?0.1.0
  url:
    v: http://smart.who.int/trust-phw/ValueSet/DVCRelationshipStatus
    l: DVCRelationshipStatus
  version:
    v: 0.1.0
  name:
    v: DVCRelationshipStatus
  title:
    v: Relationship Status for Contact in Patient
  status:
    v: draft
  date:
    v: 2025-10-07T06:40:24+00:00
  publisher:
    v: WHO
  contact:
    name:
      v: WHO
    telecom:
      system:
        v: url
      value:
        v: http://who.int
  description:
    v: Relationship Status for Contact in Patient
  jurisdiction:
    coding:
      system:
        v: http://unstats.un.org/unsd/methods/m49/m49.htm
        l: m49.htm
      code:
        v: 001
      display:
        v: World
  compose:
    include:
      system:
        v: http://smart.who.int/trust-phw/CodeSystem/DVCRelationshipStatus
        l: DVCRelationshipStatus
url:
  v: http://smart.who.int/icvp/Questionnaire/ICVP
  l: ICVP
version:
  v: 0.3.0
title:
  v: ICVP Model Questionnaire
status:
  v: active
date:
  v: 2026-03-25T12:06:50+00:00
publisher:
  v: WHO
contact:
  name:
    v: WHO
  telecom:
    system:
      v: url

v: code

v: regex

v: [A-Z]{3}

v: 26/03/2009Yellow Fevern/aAmpoule2Federal State Autonomous Scientific Institution «Chumakov Federal Scientific Center for Research & Development of Immune-And Biological Products», Russian Academy of SciencesFederal Service on Surveillance in Healthcare (ROSZDRAVNADZOR) of the Russian Federation

v: 26/03/2009Yellow Fevern/aAmpoule5Federal State Autonomous Scientific Institution «Chumakov Federal Scientific Center for Research & Development of Immune-And Biological Products», Russian Academy of SciencesFederal Service on Surveillance in Healthcare (ROSZDRAVNADZOR) of the Russian Federation

v: 26/03/2009Yellow Fevern/aAmpoule10Federal State Autonomous Scientific Institution «Chumakov Federal Scientific Center for Research & Development of Immune-And Biological Products», Russian Academy of SciencesFederal Service on Surveillance in Healthcare (ROSZDRAVNADZOR) of the Russian Federation

v: 14/10/2022Yellow FeverSinSaVac™Vial10Federal State Autonomous Scientific Institution «Chumakov Federal Scientific Center for Research & Development of Immune-And Biological Products», Russian Academy of SciencesFederal Service on Surveillance in Healthcare (ROSZDRAVNADZOR) of the Russian Federation

v: 20/03/2001Yellow FeverStabilized Yellow Fever VaccineAmpoule5Institut Pasteur de DakarMinistère de la Santé publique

v: 20/03/2001Yellow FeverStabilized Yellow Fever VaccineAmpoule10Institut Pasteur de DakarMinistère de la Santé publique

v: 20/03/2001Yellow FeverStabilized Yellow Fever VaccineAmpoule20Institut Pasteur de DakarMinistère de la Santé publique

v: 01/01/1987Yellow FeverSTAMARILVial + Ampoule10Sanofi PasteurAgence nationale de sécurité du médicament et des produits de santé

v: 17/10/2001Yellow FeverYellow FeverTwo vial set (active + excipient)5Bio-Manguinhos/FiocruzAgencia Nacional da Vigilancia Sanitaria

v: 10/12/2007Yellow FeverYellow FeverTwo vial set (active + excipient)10Bio-Manguinhos/FiocruzAgencia Nacional da Vigilancia Sanitaria

v: 17/10/2001Yellow FeverYellow FeverTwo vial set (active + excipient)50Bio-Manguinhos/FiocruzAgencia Nacional da Vigilancia Sanitaria

v: 20/03/2015Polio Vaccine - Oral (OPV) TrivalentBIOPOLIOVial10Bharat Biotech International LimitedCentral Drugs Standard Control Organization

v: 20/03/2015Polio Vaccine - Oral (OPV) TrivalentBIOPOLIOVial20Bharat Biotech International LimitedCentral Drugs Standard Control Organization

v: 25/08/2017Polio Vaccine - Oral (OPV) Bivalent Types 1 and 3BIOPOLIO B1/3Vial10Bharat Biotech International LimitedCentral Drugs Standard Control Organization

v: 20/03/2015Polio Vaccine - Oral (OPV) Bivalent Types 1 and 3BIOPOLIO B1/3Vial20Bharat Biotech International LimitedCentral Drugs Standard Control Organization

v: 16/11/2021Polio Vaccine - Oral (OPV) Bivalent Types 1 and 3Bivalent OPV Type 1 and 3 Poliomyelitis Vaccine, Live (Oral)Vial10Panacea Biotec Ltd.Central Drugs Standard Control Organization

v: 07/12/2018Polio Vaccine - Oral (OPV) Bivalent Types 1 and 3Bivalent OPV Type 1 and 3 Poliomyelitis Vaccine, Live (Oral)Vial20Panacea Biotec Ltd.Central Drugs Standard Control Organization

v: 05/11/2015Polio Vaccine - Oral (OPV) Bivalent Types 1 and 3Bivalent Oral Poliomyelitis Vaccine Type 1&3 (bOPV 1&3)Vial10PT Bio Farma (Persero)National Agency of Drug and Food Control Indonesia

v: 26/05/2010Polio Vaccine - Oral (OPV) Bivalent Types 1 and 3Bivalent Oral Poliomyelitis Vaccine Type 1&3 (bOPV 1&3)Vial20PT Bio Farma (Persero)National Agency of Drug and Food Control Indonesia

v: 19/03/2010Polio Vaccine - Oral (OPV) Bivalent Types 1 and 3Bivalent type 1&3 Oral Poliomyelitis vaccine, IP (bOPV1&3)Vial20Haffkine Bio Pharmaceutical Corporation LtdCentral Drugs Standard Control Organization

v: 01/06/2021Polio Vaccine - Inactivated Sabin (sIPV)Eupolio Inj.Vial1LG Chem LtdMinistry of Food and Drug Safety

v: 21/12/2020Polio Vaccine - Inactivated Sabin (sIPV)Eupolio Inj.Vial5LG Chem LtdMinistry of Food and Drug Safety

v: 21/03/2024Diphtheria-Tetanus-Pertussis (whole cell)-Hepatitis B-Haemophilus influenzae type b-Polio (Inactivated)HEXASIILVial1Serum Institute of India Pvt. Ltd.Central Drugs Standard Control Organization

v: 21/03/2024Diphtheria-Tetanus-Pertussis (whole cell)-Hepatitis B-Haemophilus influenzae type b-Polio (Inactivated)HEXASIILVial10Serum Institute of India Pvt. Ltd.Central Drugs Standard Control Organization

v: 19/12/2014Diphtheria-Tetanus-Pertussis (acellular)-Hepatitis B-Haemophilus influenzae type b-Polio (Inactivated)HexaximVial1Sanofi PasteurEuropean Medicines Agency

v: 09/12/2005Polio Vaccine - Inactivated (IPV)IMOVAX POLIOVial10Sanofi PasteurAgence nationale de sécurité du médicament et des produits de santé

v: 23/12/2010Polio Vaccine - Inactivated (IPV)IPV Vaccine AJVVial1AJ Vaccines A/SDanish Medicines Agency

v: 03/11/2009Polio Vaccine - Oral (OPV) Monovalent Type 1Monovalent Oral Poliomyelitis Vaccine Type 1 (mOPV1)Vial20PT Bio Farma (Persero)National Agency of Drug and Food Control Indonesia

v: 21/06/2019Polio Vaccine - Oral (OPV) Monovalent Type 2Monovalent Oral Poliomyelitis Vaccine Type 2Vial20PT Bio Farma (Persero)National Agency of Drug and Food Control Indonesia

v: 03/11/2009Polio Vaccine - Oral (OPV) Monovalent Type 1Monovalent type 1 Oral Poliomyelitis vaccine, IP (mOPV1)Vial20Haffkine Bio Pharmaceutical Corporation LtdCentral Drugs Standard Control Organization

v: 14/01/2016Polio Vaccine - Oral (OPV) Monovalent Type 2ORAL MONOVALENT TYPE 2 POLIOMYELITIS VACCINE (mOPV2)Vial20Sanofi PasteurAgence nationale de sécurité du médicament et des produits de santé

v: 31/08/2020Polio Vaccine - Oral (OPV) TrivalentOral Poliomyelitis Vaccines (Oral Drops)Vial20PT Bio Farma (Persero)National Agency of Drug and Food Control Indonesia

v: 21/04/2020Polio Vaccine - Inactivated (IPV)PicovaxVial5AJ Vaccines A/SDanish Medicines Agency

v: 29/10/2009Polio Vaccine - Oral (OPV) Monovalent Type 1Polio Sabin Mono T1Vial10GlaxoSmithKline Biologicals SAFederal Agency for Medicines and Health Products

v: 29/10/2009Polio Vaccine - Oral (OPV) Monovalent Type 1Polio Sabin Mono T1Vial20GlaxoSmithKline Biologicals SAFederal Agency for Medicines and Health Products

v: 05/10/2010Polio Vaccine - Oral (OPV) Monovalent Type 3Polio Sabin Mono Three (oral)Vial10GlaxoSmithKline Biologicals SAFederal Agency for Medicines and Health Products

v: 05/10/2010Polio Vaccine - Oral (OPV) Monovalent Type 3Polio Sabin Mono Three (oral)Vial20GlaxoSmithKline Biologicals SAFederal Agency for Medicines and Health Products

v: 11/05/2011Polio Vaccine - Oral (OPV) Monovalent Type 2Polio Sabin Mono Two (oral)Vial10GlaxoSmithKline Biologicals SAFederal Agency for Medicines and Health Products

v: 11/05/2011Polio Vaccine - Oral (OPV) Monovalent Type 2Polio Sabin Mono Two (oral)Vial20GlaxoSmithKline Biologicals SAFederal Agency for Medicines and Health Products

v: 29/10/2009Polio Vaccine - Oral (OPV) Bivalent Types 1 and 3Polio Sabin One and ThreeVial10GlaxoSmithKline Biologicals SAFederal Agency for Medicines and Health Products

v: 29/10/2009Polio Vaccine - Oral (OPV) Bivalent Types 1 and 3Polio Sabin One and ThreeVial20GlaxoSmithKline Biologicals SAFederal Agency for Medicines and Health Products

v: 06/12/2010Polio Vaccine - Inactivated (IPV)Poliomyelitis vaccineVial1Bilthoven Biologicals B.V.Medicines Evaluation Board (MEB)

v: 29/07/2024Polio Vaccine - Novel Oral (nOPV) Type 2Poliomyelitis Vaccine - Novel Oral (nOPV) Type 2Vial20Biological E. LimitedCentral Drugs Standard Control Organization

v: 27/12/2023Polio Vaccine - Novel Oral (nOPV) Type 2Polio Vaccine - Novel Oral (nOPV) Type 2Vial50PT Bio Farma (Persero)National Agency of Drug and Food Control Indonesia

v: 29/07/2024Polio Vaccine - Novel Oral (nOPV) Type 2Poliomyelitis Vaccine - Novel Oral (nOPV) Type 2Vial50Biological E. LimitedCentral Drugs Standard Control Organization

v: 28/10/2016Polio Vaccine - Inactivated (IPV)Poliomyelitis Vaccine (Inactivated)Vial1Serum Institute of India Pvt. Ltd.Central Drugs Standard Control Organization

v: 28/10/2016Polio Vaccine - Inactivated (IPV)Poliomyelitis Vaccine (Inactivated)Vial2Serum Institute of India Pvt. Ltd.Central Drugs Standard Control Organization

v: 28/10/2016Polio Vaccine - Inactivated (IPV)Poliomyelitis Vaccine (Inactivated)Vial5Serum Institute of India Pvt. Ltd.Central Drugs Standard Control Organization

v: 11/07/2019Polio Vaccine - Inactivated (IPV)Poliomyelitis Vaccine (Inactivated)Vial10Serum Institute of India Pvt. Ltd.Central Drugs Standard Control Organization

v: 21/12/2017Polio Vaccine - Oral (OPV) Bivalent Types 1 and 3Poliomyelitis Vaccine (live, oral attenuated, human Diploid Cell), type 1 and 3Vial20Beijing Institute of Biological Products Co., Ltd.National Medical Products Administration

v: 22/10/2014Polio Vaccine - Oral (OPV) Bivalent Types 1 and 3Poliomyelitis Vaccine (Oral), Bivalent types 1 and 3Vial10Serum Institute of India Pvt. Ltd.Central Drugs Standard Control Organization

v: 04/02/2013Polio Vaccine - Oral (OPV) Bivalent Types 1 and 3Poliomyelitis Vaccine (Oral), Bivalent types 1 and 3Vial20Serum Institute of India Pvt. Ltd.Central Drugs Standard Control Organization

v: 06/06/2022Polio Vaccine - Inactivated Sabin (sIPV)Poliomyelitis Vaccine (Vero Cell), Inactivated, Sabin StrainsVial1Sinovac Biotech Co. LtdNational Medical Products Administration

v: 15/02/2022Polio Vaccine - Inactivated Sabin (sIPV)Poliomyelitis Vaccine (Vero Cell), Inactivated, Sabin StrainsVial1Beijing Institute of Biological Products Co., Ltd.National Medical Products Administration

v: 29/08/2024Polio Vaccine - Inactivated Sabin (sIPV)Poliomyelitis Vaccine (Vero Cell), Inactivated, Sabin StrainsVial5Sinovac Biotech Co. LtdNational Medical Products Administration

v: 28/11/2014Polio Vaccine - Inactivated (IPV)Poliomyelitis vaccine multidoseVial5Bilthoven Biologicals B.V.Medicines Evaluation Board (MEB)

v: 29/02/2024Polio Vaccine - Inactivated (IPV)Poliomyelitis vaccine multidoseVial10Bilthoven Biologicals B.V.Medicines Evaluation Board (MEB)

v: 02/02/2006Polio Vaccine - Oral (OPV) TrivalentPolioviral vaccineVial20Haffkine Bio Pharmaceutical Corporation LtdCentral Drugs Standard Control Organization

v: 01/10/2018Polio Vaccine - Inactivated (IPV)ShanIPV™Vial5Sanofi Healthcare India Private LimitedCentral Drugs Standard Control Organization

v: 22/04/2022Polio Vaccine - Inactivated (IPV)ShanIPV™Vial10Sanofi Healthcare India Private LimitedCentral Drugs Standard Control Organization

v: Questionnaire for DVC Logical Model with the WHO ICVP

link id:
  v: name
text:
  v: Full Name of the client
type:
  v: string
required:
  v: true
repeats:
  v: false

link id:
  v: dob
text:
  v: Date of Birth
type:
  v: date
required:
  v: true
repeats:
  v: false

link id:
  v: sex
text:
  v: Sex
type:
  v: choice
required:
  v: false
repeats:
  v: false
answer value set:
  v: #v2-0001
  l: v2-0001

link id:
  v: nationality
text:
  v: Nationality
type:
  v: choice
required:
  v: false
repeats:
  v: false
answer value set:
  v: #v3-Country
  l: v3-Country

link id:
  v: ndt
text:
  v: National ID Document Type
type:
  v: choice
required:
  v: false
repeats:
  v: false
answer value set:
  v: http://terminology.hl7.org/ValueSet/v2-0203|3.0.0
  l: http://terminology.hl7.org/ValueSet/v2-0203

link id:
  v: nid
text:
  v: National Identification Document
type:
  v: string
required:
  v: false
repeats:
  v: false

link id:
  v: guardian
text:
  v: Parent or Guardian Details
type:
  v: group
required:
  v: false
repeats:
  v: false
item:
  link id:
    v: guardianName
  text:
    v: Name of Parent or Guardian
  type:
    v: string
  required:
    v: false
  repeats:
    v: false
item:
  link id:
    v: guardianRelationship
  text:
    v: Relationship Status
  type:
    v: choice
  required:
    v: false
  repeats:
    v: false
  answer value set:
    v: #DVCRelationshipStatus
    l: DVCRelationshipStatus

link id:
  v: vaccineDetails
text:
  v: Vaccine Certificate Details
type:
  v: group
required:
  v: true
repeats:
  v: true
item:
  link id:
    v: productID
  text:
    v: Vaccine or Prophylaxis ID
  type:
    v: choice
  required:
    v: true
  repeats:
    v: false
  answer value set:
    v: #ICVPProductIds
    l: ICVPProductIds
item:
  link id:
    v: date
  text:
    v: Date of Vaccination
  type:
    v: date
  required:
    v: true
  repeats:
    v: false
item:
  link id:
    v: clinicianName
  text:
    v: Name of supervising clinician
  type:
    v: string
  required:
    v: false
  repeats:
    v: false
item:
  link id:
    v: issuer
  text:
    v: Relevant authoring responsible for issuing the certificate, or for overseeing the administration center
  type:
    v: string
  required:
    v: false
  repeats:
    v: false
item:
  link id:
    v: batchNo.text
  text:
    v: Batch Number
  type:
    v: string
  required:
    v: true
  repeats:
    v: false
item:
  link id:
    v: validityPeriod
  text:
    v: Certificate Validity Period
  type:
    v: group
  required:
    v: false
  repeats:
    v: false
  item:
    link id:
      v: startDate
    text:
      v: From
    type:
      v: date
    required:
      v: false
    repeats:
      v: false
  item:
    link id:
      v: endDate
    text:
      v: To
    type:
      v: date
    required:
      v: false
    repeats:
      v: false