OpenMRS Core FHIR Implementation Guide
0.1.0 - ci-build

OpenMRS Core FHIR Implementation Guide, published by . 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/abertnamanya/openmrs-contrib-fhir2-ig/ and changes regularly. See the Directory of published versions

Resource Profile: OMRSImmunization - Detailed Descriptions

Active as of 2024-12-11

Definitions for the omrs-immunization resource profile.

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

0. Immunization
2. Immunization.id
Control1..?
4. Immunization.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..0
6. Immunization.status
8. Immunization.statusReason
Control0..0
10. Immunization.vaccineCode
12. Immunization.patient
TypeReference(OpenMRS Patient)
14. Immunization.encounter
TypeReference(Openmrs Encounter)
16. Immunization.occurrence[x]
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
SlicingThis element introduces a set of slices on Immunization.occurrence[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • type @ $this
  • 18. Immunization.occurrence[x]:occurrenceDateTime
    Slice NameoccurrenceDateTime
    Control0..1
    TypedateTime
    [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
    20. Immunization.recorded
    Control0..0
    22. Immunization.primarySource
    Control0..0
    24. Immunization.reportOrigin
    Control0..0
    26. Immunization.location
    TypeReference(OpenMRS Location)
    28. Immunization.manufacturer
    30. Immunization.lotNumber
    32. Immunization.expirationDate
    34. Immunization.site
    Control0..0
    36. Immunization.route
    Control0..0
    38. Immunization.doseQuantity
    Control0..0
    40. Immunization.performer
    42. Immunization.performer.function
    Control0..0
    44. Immunization.performer.actor
    TypeReference(Openmrs Practitioner)
    46. Immunization.note
    Control0..0
    48. Immunization.reasonCode
    Control0..0
    50. Immunization.reasonReference
    Control0..0
    52. Immunization.isSubpotent
    Control0..0
    54. Immunization.education
    Control0..0
    56. Immunization.programEligibility
    Control0..0
    58. Immunization.fundingSource
    Control0..0
    60. Immunization.reaction
    Control0..0
    62. Immunization.protocolApplied
    Control0..1
    64. Immunization.protocolApplied.doseNumber[x]
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    66. Immunization.protocolApplied.seriesDoses[x]
    Control0..0

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

    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.

    Control10..1
    Typeidstring
    Is Modifierfalse
    Summarytrue
    4. 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..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()))
    6. Immunization.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())
    8. 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..0*
    TypeIdentifier
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    10. 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|4.0.1)

    A set of codes indicating the current status of an Immunization.

    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()))
    12. 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..01
    BindingFor example codes, see ImmunizationStatusReasonCodeshttp://hl7.org/fhir/ValueSet/immunization-status-reason
    (example to http://hl7.org/fhir/ValueSet/immunization-status-reason)

    The reason why a vaccine was not administered.

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

    Vaccine that was administered or was to be administered.

    ShortVaccine product administered
    Control1..1
    BindingFor example codes, see VaccineAdministeredValueSethttp://hl7.org/fhir/ValueSet/vaccine-code
    (example to http://hl7.org/fhir/ValueSet/vaccine-code)

    The code for vaccine product administered.

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

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

    ShortWho was immunized
    Control1..1
    TypeReference(OpenMRS Patient, Patient)
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. 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(Openmrs Encounter, Encounter)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. 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()))
    SlicingThis element introduces a set of slices on Immunization.occurrence[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • type @ $this
    • 22. Immunization.occurrence[x]:occurrenceDateTime
      Slice NameoccurrenceDateTime
      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.

      Control01..1
      TypedateTime, 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()))
      24. 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..01
      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()))
      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..01
      BindingFor example codes, see ImmunizationOriginCodeshttp://hl7.org/fhir/ValueSet/immunization-origin
      (example to http://hl7.org/fhir/ValueSet/immunization-origin)

      The source of the data for a record which is not from a primary source.

      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..1
      TypeReference(OpenMRS Location, 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..1
      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..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()))
      36. Immunization.expirationDate
      Definition

      Date vaccine batch expires.

      ShortVaccine expiration date
      Control0..1
      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
      (example to http://hl7.org/fhir/ValueSet/immunization-site)

      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..01
      BindingFor example codes, see ImmunizationRouteCodeshttp://hl7.org/fhir/ValueSet/immunization-route
      (example to http://hl7.org/fhir/ValueSet/immunization-route)

      The route by 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()))
      42. Immunization.doseQuantity
      Definition

      The quantity of vaccine product that was administered.

      ShortAmount of vaccine administered
      Control0..01
      TypeQuantity(SimpleQuantity)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      44. Immunization.note
      Definition

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

      ShortAdditional immunization notes
      Control0..0*
      TypeAnnotation
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      46. Immunization.reasonCode
      Definition

      Reasons why the vaccine was administered.

      ShortWhy immunization occurred
      Control0..0*
      BindingFor example codes, see ImmunizationReasonCodeshttp://hl7.org/fhir/ValueSet/immunization-reason
      (example to http://hl7.org/fhir/ValueSet/immunization-reason)

      The reason why a vaccine was administered.

      TypeCodeableConcept
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      48. 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()))
      50. 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()))
      52. 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())
      55. 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
      (example to http://hl7.org/fhir/ValueSet/immunization-program-eligibility)

      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()))
      57. 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
      (example to http://hl7.org/fhir/ValueSet/immunization-funding-source)

      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()))
      59. 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..0*
      TypeBackboneElement
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      62. Immunization.protocolApplied
      Definition

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

      ShortProtocol followed by the provider
      Control0..1*
      TypeBackboneElement
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      64. Immunization.protocolApplied.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())
      66. Immunization.protocolApplied.doseNumber[x]
      Definition

      Nominal position in a series.

      ShortDose number within series
      Comments

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

      Control1..1
      TypeChoice of: positiveInt, 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
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      68. Immunization.protocolApplied.seriesDoses[x]
      Definition

      The recommended number of doses to achieve immunity.

      ShortRecommended number of doses for immunity
      Comments

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

      Control0..01
      TypeChoice of: positiveInt, string
      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. 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.

      Control1..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.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. 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..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. 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..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. 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..*
      TypeResource
      Is Modifierfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      14. Immunization.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. Immunization.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. 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..0
      TypeIdentifier
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. 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|4.0.1)

      A set of codes indicating the current status of an Immunization.

      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()))
      22. 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..0
      BindingFor example codes, see ImmunizationStatusReasonCodes
      (example to http://hl7.org/fhir/ValueSet/immunization-status-reason)

      The reason why a vaccine was not administered.

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

      Vaccine that was administered or was to be administered.

      ShortVaccine product administered
      Control1..1
      BindingFor example codes, see VaccineAdministeredValueSet
      (example to http://hl7.org/fhir/ValueSet/vaccine-code)

      The code for vaccine product administered.

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

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

      ShortWho was immunized
      Control1..1
      TypeReference(OpenMRS Patient)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. 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(Openmrs Encounter)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. 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()))
      SlicingThis element introduces a set of slices on Immunization.occurrence[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • type @ $this
      • 32. Immunization.occurrence[x]:occurrenceDateTime
        Slice NameoccurrenceDateTime
        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.

        Control0..1
        TypedateTime
        [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()))
        34. 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..0
        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. 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()))
        38. 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..0
        BindingFor example codes, see ImmunizationOriginCodes
        (example to http://hl7.org/fhir/ValueSet/immunization-origin)

        The source of the data for a record which is not from a primary source.

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

        The service delivery location where the vaccine administration occurred.

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

        Name of vaccine manufacturer.

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

        Lot number of the vaccine product.

        ShortVaccine lot number
        Control0..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()))
        46. Immunization.expirationDate
        Definition

        Date vaccine batch expires.

        ShortVaccine expiration date
        Control0..1
        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()))
        48. 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)

        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()))
        50. Immunization.route
        Definition

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

        ShortHow vaccine entered body
        Control0..0
        BindingFor example codes, see ImmunizationRouteCodes
        (example to http://hl7.org/fhir/ValueSet/immunization-route)

        The route by 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()))
        52. Immunization.doseQuantity
        Definition

        The quantity of vaccine product that was administered.

        ShortAmount of vaccine administered
        Control0..0
        TypeQuantity(SimpleQuantity)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. 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()))
        56. 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
        58. Immunization.performer.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())
        60. Immunization.performer.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())
        62. 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)

        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()))
        64. 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(Openmrs Practitioner)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        66. Immunization.note
        Definition

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

        ShortAdditional immunization notes
        Control0..0
        TypeAnnotation
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        68. Immunization.reasonCode
        Definition

        Reasons why the vaccine was administered.

        ShortWhy immunization occurred
        Control0..0
        BindingFor example codes, see ImmunizationReasonCodes
        (example to http://hl7.org/fhir/ValueSet/immunization-reason)

        The reason why a vaccine was administered.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        70. 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()))
        72. 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()))
        74. Immunization.subpotentReason
        Definition

        Reason why a dose is considered to be subpotent.

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

        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()))
        76. 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())
        85. 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)

        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()))
        87. 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)

        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()))
        89. 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..0
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        97. Immunization.protocolApplied
        Definition

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

        ShortProtocol followed by the provider
        Control0..1
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        99. Immunization.protocolApplied.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
        101. Immunization.protocolApplied.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())
        103. Immunization.protocolApplied.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())
        105. Immunization.protocolApplied.series
        Definition

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

        ShortName of vaccine series
        Control0..1
        Typestring
        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()))
        107. Immunization.protocolApplied.authority
        Definition

        Indicates the authority who published the protocol (e.g. ACIP) that is being followed.

        ShortWho is responsible for publishing the recommendations
        Control0..1
        TypeReference(Organization)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        109. Immunization.protocolApplied.targetDisease
        Definition

        The vaccine preventable disease the dose is being administered against.

        ShortVaccine preventatable disease being targetted
        Control0..*
        BindingFor example codes, see ImmunizationTargetDiseaseCodes
        (example to http://hl7.org/fhir/ValueSet/immunization-target-disease)

        The vaccine preventable disease the dose is being administered for.

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

        Nominal position in a series.

        ShortDose number within series
        Comments

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

        Control1..1
        TypeChoice of: positiveInt, 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
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        113. Immunization.protocolApplied.seriesDoses[x]
        Definition

        The recommended number of doses to achieve immunity.

        ShortRecommended number of doses for immunity
        Comments

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

        Control0..0
        TypeChoice of: positiveInt, string
        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()))