Introduction

This profile is used to represent de-identified Immunization information. The de-identification process has to remove all data elements not explicitly identified as "SUPPORTED" in the profile.

The HHS De-identification Guidance is to be followed to ensure appropriate level of de-identification is performed.

According to the HHS guidance, dates should not have a precision of more than the year. This means month and day cannot be included. This includes Immunization.occurenceDateTime.

In FHIR Resources, text elements and reference.display elements which provide human readable information to the providers may be generated using programs and tools from the data present within the resource. For e.g a Immunization resource text element may contain information such as the Immunization date, patient information. This type of information will enable identification of the individuals. In order to avoid inadvertent revealing of PII/PHI, text elements cannot be included in the De-identified FHIR resource and the submission will be rejected when text elements are present by the validation process.

Ids and References

The original Immunization resource id should not be included in the De-identified Immunization instance. Instead a new id should be created and provided as part of the FHIR resource. The Data Submitter should be capable of using the generated id to relink the data to the original Immunization. All resource references to the Immunization submitted as part of the UDS+ report should refer to newly generated id.

Resource references cannot contain text element as it may contain PHI/PII. The text element for following references are not allowed

• patient

Date Truncation

The Data Submitter has to truncate the following dates to only have a precision of year

• occurence[x]
• recorded

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Immunization		0..*	Immunization	De-Identified UDS Plus Immunization
Immunization.id	S This element must be supported. Σ This element is included in summaries.	0..1	id	The de-identified Immunization identifier created by the health center to send data to UDS+ Data Receiver
Immunization.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Immunization.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Immunization.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	completed | entered-in-error | not-done Binding: ImmunizationStatusCodes (required): A set of codes indicating the current status of an Immunization.
Immunization.statusReason	S This element must be supported.	0..1	CodeableConcept	Reason not done Binding: ImmunizationStatusReasonCodes (example): The reason why a vaccine was not administered.
Immunization.vaccineCode	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	Vaccine product administered Binding: VaccineAdministeredValueSet (example): The code for vaccine product administered.
Immunization.patient	S This element must be supported. Σ This element is included in summaries.	1..1	Reference(De-Identified UDS Plus Patient)	Who was immunized
Immunization.occurrence[x]	S This element must be supported. Σ This element is included in summaries. C	1..1	dateTime	Vaccine administration date Constraints: uds-plus-imm-1, uds-plus-imm-1a, uds-plus-imm-1b
Immunization.recorded	S This element must be supported. C	0..1	dateTime	When the immunization was first captured in the subject's record Constraints: uds-plus-imm-2, uds-plus-imm-2a, uds-plus-imm-2b
Immunization.primarySource	S This element must be supported. Σ This element is included in summaries.	1..1	boolean	Indicates context the data was recorded in
Immunization.expirationDate	C	0..1	date	Vaccine expiration date Constraints: uds-plus-imm-3, uds-plus-imm-3a, uds-plus-imm-3b
Immunization.isSubpotent	?! This element is a modifier element. Σ This element is included in summaries.	0..1	boolean	Dose potency
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Immunization.status	Base	required	Immunization Status Codes	📍4.0.1	FHIR Std.
Immunization.statusReason	Base	example	Immunization Status Reason Codes	📍4.0.1	FHIR Std.
Immunization.vaccineCode	Base	example	Vaccine Administered Value Set	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Immunization	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Immunization	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	error	Immunization	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	error	Immunization	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Immunization	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
uds-plus-imm-1	error	Immunization.occurrence[x]	All dateTime data elements should be truncated to a year only for de-identified resources.	$this is DateTime implies $this.toString().length() = 4
uds-plus-imm-1a	error	Immunization.occurrence[x]	All dateTime data elements should have valid year > 1900	$this is DateTime implies $this.toString() >= '1900'
uds-plus-imm-1b	error	Immunization.occurrence[x]	All dateTime data elements should have valid year < 2030	$this is DateTime implies $this.toString() <= '2030'
uds-plus-imm-2	error	Immunization.recorded	All dateTime data elements should be truncated to a year only for de-identified resources.	$this is DateTime implies $this.toString().length() = 4
uds-plus-imm-2a	error	Immunization.recorded	All dateTime data elements should have valid year > 1900	$this is DateTime implies $this.toString() >= '1900'
uds-plus-imm-2b	error	Immunization.recorded	All dateTime data elements should have valid year < 2030	$this is DateTime implies $this.toString() <= '2030'
uds-plus-imm-3	error	Immunization.expirationDate	All date data elements should be truncated to a year only for de-identified resources.	$this is date implies $this.toString().length() = 4
uds-plus-imm-3a	error	Immunization.expirationDate	All dateTime data elements should have valid year > 1900	$this is DateTime implies $this.toString() >= '1900'
uds-plus-imm-3b	error	Immunization.expirationDate	All dateTime data elements should have valid year < 2050	$this is DateTime implies $this.toString() <= '2050'

This structure is derived from Immunization

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Immunization		0..*	Immunization	De-Identified UDS Plus Immunization
Immunization.id	S This element must be supported.	0..1	id	The de-identified Immunization identifier created by the health center to send data to UDS+ Data Receiver
Immunization.text		0..0		Cannot include any text in the resource as part of the de-identified data.
Immunization.contained		0..0		Cannot include any contained resources in the resource as part of the de-identified data.
Immunization.status	S This element must be supported.	1..1	code	completed | entered-in-error | not-done
Immunization.statusReason	S This element must be supported.	0..1	CodeableConcept	Reason not done
Immunization.vaccineCode	S This element must be supported.	1..1	CodeableConcept	Vaccine product administered
Immunization.patient	S This element must be supported.	1..1	Reference(De-Identified UDS Plus Patient)	Who was immunized
Immunization.patient.display		0..0		Text alternative for the resource
Immunization.occurrence[x]	S This element must be supported. C	1..1	dateTime	Vaccine administration date Constraints: uds-plus-imm-1, uds-plus-imm-1a, uds-plus-imm-1b
Immunization.recorded	S This element must be supported. C	0..1	dateTime	When the immunization was first captured in the subject's record Constraints: uds-plus-imm-2, uds-plus-imm-2a, uds-plus-imm-2b
Immunization.primarySource	S This element must be supported.	1..1	boolean	Indicates context the data was recorded in
Immunization.expirationDate	C	0..1	date	Vaccine expiration date Constraints: uds-plus-imm-3, uds-plus-imm-3a, uds-plus-imm-3b
Immunization.note		0..0		Additional immunization notes
Immunization.reaction
Immunization.reaction.date	C	0..1	dateTime	When reaction started Constraints: uds-plus-imm-4, uds-plus-imm-4a, uds-plus-imm-4b
Documentation for this format

Constraints

Id	Grade	Path(s)	Description	Expression
uds-plus-imm-1	error	Immunization.occurrence[x]	All dateTime data elements should be truncated to a year only for de-identified resources.	$this is DateTime implies $this.toString().length() = 4
uds-plus-imm-1a	error	Immunization.occurrence[x]	All dateTime data elements should have valid year > 1900	$this is DateTime implies $this.toString() >= '1900'
uds-plus-imm-1b	error	Immunization.occurrence[x]	All dateTime data elements should have valid year < 2030	$this is DateTime implies $this.toString() <= '2030'
uds-plus-imm-2	error	Immunization.recorded	All dateTime data elements should be truncated to a year only for de-identified resources.	$this is DateTime implies $this.toString().length() = 4
uds-plus-imm-2a	error	Immunization.recorded	All dateTime data elements should have valid year > 1900	$this is DateTime implies $this.toString() >= '1900'
uds-plus-imm-2b	error	Immunization.recorded	All dateTime data elements should have valid year < 2030	$this is DateTime implies $this.toString() <= '2030'
uds-plus-imm-3	error	Immunization.expirationDate	All date data elements should be truncated to a year only for de-identified resources.	$this is date implies $this.toString().length() = 4
uds-plus-imm-3a	error	Immunization.expirationDate	All dateTime data elements should have valid year > 1900	$this is DateTime implies $this.toString() >= '1900'
uds-plus-imm-3b	error	Immunization.expirationDate	All dateTime data elements should have valid year < 2050	$this is DateTime implies $this.toString() <= '2050'
uds-plus-imm-4	error	Immunization.reaction.date	All dateTime data elements should be truncated to a year only for de-identified resources.	$this is dateTime implies $this.toString().length() = 4
uds-plus-imm-4a	error	Immunization.reaction.date	All dateTime data elements should have valid year > 1900	$this is DateTime implies $this.toString() >= '1900'
uds-plus-imm-4b	error	Immunization.reaction.date	All dateTime data elements should have valid year < 2030	$this is DateTime implies $this.toString() <= '2030'

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Immunization		0..*	Immunization	De-Identified UDS Plus Immunization
Immunization.id	S This element must be supported. Σ This element is included in summaries.	0..1	id	The de-identified Immunization identifier created by the health center to send data to UDS+ Data Receiver
Immunization.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
Immunization.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Immunization.language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
Immunization.extension		0..*	Extension	Additional content defined by implementations
Immunization.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Immunization.identifier		0..*	Identifier	Business identifier
Immunization.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	completed | entered-in-error | not-done Binding: ImmunizationStatusCodes (required): A set of codes indicating the current status of an Immunization.
Immunization.statusReason	S This element must be supported.	0..1	CodeableConcept	Reason not done Binding: ImmunizationStatusReasonCodes (example): The reason why a vaccine was not administered.
Immunization.vaccineCode	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	Vaccine product administered Binding: VaccineAdministeredValueSet (example): The code for vaccine product administered.
Immunization.patient	S This element must be supported. Σ This element is included in summaries.	1..1	Reference(De-Identified UDS Plus Patient)	Who was immunized
Immunization.patient.id		0..1	string	Unique id for inter-element referencing
Immunization.patient.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Immunization.patient.reference	Σ This element is included in summaries. C	0..1	string	Literal reference, Relative, internal or absolute URL
Immunization.patient.type	Σ This element is included in summaries.	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
Immunization.patient.identifier	Σ This element is included in summaries.	0..1	Identifier	Logical reference, when literal reference is not known
Immunization.encounter		0..1	Reference(Encounter)	Encounter immunization was part of
Immunization.occurrence[x]	S This element must be supported. Σ This element is included in summaries. C	1..1	dateTime	Vaccine administration date Constraints: uds-plus-imm-1, uds-plus-imm-1a, uds-plus-imm-1b
Immunization.recorded	S This element must be supported. C	0..1	dateTime	When the immunization was first captured in the subject's record Constraints: uds-plus-imm-2, uds-plus-imm-2a, uds-plus-imm-2b
Immunization.primarySource	S This element must be supported. Σ This element is included in summaries.	1..1	boolean	Indicates context the data was recorded in
Immunization.reportOrigin		0..1	CodeableConcept	Indicates the source of a secondarily reported record Binding: ImmunizationOriginCodes (example): The source of the data for a record which is not from a primary source.
Immunization.location		0..1	Reference(Location)	Where immunization occurred
Immunization.manufacturer		0..1	Reference(Organization)	Vaccine manufacturer
Immunization.lotNumber		0..1	string	Vaccine lot number
Immunization.expirationDate	C	0..1	date	Vaccine expiration date Constraints: uds-plus-imm-3, uds-plus-imm-3a, uds-plus-imm-3b
Immunization.site		0..1	CodeableConcept	Body site vaccine was administered Binding: CodesForImmunizationSiteOfAdministration (example): The site at which the vaccine was administered.
Immunization.route		0..1	CodeableConcept	How vaccine entered body Binding: ImmunizationRouteCodes (example): The route by which the vaccine was administered.
Immunization.doseQuantity	C	0..1	SimpleQuantity(4.0.1)	Amount of vaccine administered Constraints: sqty-1
Immunization.performer	Σ This element is included in summaries.	0..*	BackboneElement	Who performed event
Immunization.performer.id		0..1	string	Unique id for inter-element referencing
Immunization.performer.extension		0..*	Extension	Additional content defined by implementations
Immunization.performer.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Immunization.performer.function	Σ This element is included in summaries.	0..1	CodeableConcept	What type of performance was done Binding: ImmunizationFunctionCodes (extensible): The role a practitioner or organization plays in the immunization event.
Immunization.performer.actor	Σ This element is included in summaries.	1..1	Reference(Practitioner | PractitionerRole | Organization)	Individual or organization who was performing
Immunization.reasonCode		0..*	CodeableConcept	Why immunization occurred Binding: ImmunizationReasonCodes (example): The reason why a vaccine was administered.
Immunization.reasonReference		0..*	Reference(Condition | Observation | DiagnosticReport)	Why immunization occurred
Immunization.isSubpotent	?! This element is a modifier element. Σ This element is included in summaries.	0..1	boolean	Dose potency
Immunization.subpotentReason		0..*	CodeableConcept	Reason for being subpotent Binding: ImmunizationSubpotentReason (example): The reason why a dose is considered to be subpotent.
Immunization.education	C	0..*	BackboneElement	Educational material presented to patient Constraints: imm-1
Immunization.education.id		0..1	string	Unique id for inter-element referencing
Immunization.education.extension		0..*	Extension	Additional content defined by implementations
Immunization.education.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Immunization.education.documentType		0..1	string	Educational material document identifier
Immunization.education.reference		0..1	uri	Educational material reference pointer
Immunization.education.publicationDate		0..1	dateTime	Educational material publication date
Immunization.education.presentationDate		0..1	dateTime	Educational material presentation date
Immunization.programEligibility		0..*	CodeableConcept	Patient eligibility for a vaccination program Binding: ImmunizationProgramEligibility (example): The patient's eligibility for a vaccation program.
Immunization.fundingSource		0..1	CodeableConcept	Funding source for the vaccine Binding: ImmunizationFundingSource (example): The source of funding used to purchase the vaccine administered.
Immunization.reaction		0..*	BackboneElement	Details of a reaction that follows immunization
Immunization.reaction.id		0..1	string	Unique id for inter-element referencing
Immunization.reaction.extension		0..*	Extension	Additional content defined by implementations
Immunization.reaction.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Immunization.reaction.date	C	0..1	dateTime	When reaction started Constraints: uds-plus-imm-4, uds-plus-imm-4a, uds-plus-imm-4b
Immunization.reaction.detail		0..1	Reference(Observation)	Additional information on reaction
Immunization.reaction.reported		0..1	boolean	Indicates self-reported reaction
Immunization.protocolApplied		0..*	BackboneElement	Protocol followed by the provider
Immunization.protocolApplied.id		0..1	string	Unique id for inter-element referencing
Immunization.protocolApplied.extension		0..*	Extension	Additional content defined by implementations
Immunization.protocolApplied.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Immunization.protocolApplied.series		0..1	string	Name of vaccine series
Immunization.protocolApplied.authority		0..1	Reference(Organization)	Who is responsible for publishing the recommendations
Immunization.protocolApplied.targetDisease		0..*	CodeableConcept	Vaccine preventatable disease being targetted Binding: ImmunizationTargetDiseaseCodes (example): The vaccine preventable disease the dose is being administered for.
Immunization.protocolApplied.doseNumber[x]		1..1		Dose number within series
Immunization.protocolApplied.doseNumber[x].doseNumberPositiveInt			positiveInt
Immunization.protocolApplied.doseNumber[x].doseNumberString			string
Immunization.protocolApplied.seriesDoses[x]		0..1		Recommended number of doses for immunity
Immunization.protocolApplied.seriesDoses[x].seriesDosesPositiveInt			positiveInt
Immunization.protocolApplied.seriesDoses[x].seriesDosesString			string
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Immunization.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Immunization.status	Base	required	Immunization Status Codes	📍4.0.1	FHIR Std.
Immunization.statusReason	Base	example	Immunization Status Reason Codes	📍4.0.1	FHIR Std.
Immunization.vaccineCode	Base	example	Vaccine Administered Value Set	📍4.0.1	FHIR Std.
Immunization.patient.​type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Immunization.reportOrigin	Base	example	Immunization Origin Codes	📍4.0.1	FHIR Std.
Immunization.site	Base	example	Codes for Immunization Site of Administration	📍4.0.1	FHIR Std.
Immunization.route	Base	example	Immunization Route Codes	📍4.0.1	FHIR Std.
Immunization.performer.​function	Base	extensible	Immunization Function Codes	📍4.0.1	FHIR Std.
Immunization.reasonCode	Base	example	Immunization Reason Codes	📍4.0.1	FHIR Std.
Immunization.subpotentReason	Base	example	Immunization Subpotent Reason	📍4.0.1	FHIR Std.
Immunization.programEligibility	Base	example	Immunization Program Eligibility	📍4.0.1	FHIR Std.
Immunization.fundingSource	Base	example	Immunization Funding Source	📍4.0.1	FHIR Std.
Immunization.protocolApplied.​targetDisease	Base	example	Immunization Target Disease Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Immunization	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Immunization	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	error	Immunization	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	error	Immunization	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Immunization	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
imm-1	error	Immunization.education	One of documentType or reference SHALL be present	documentType.exists() or reference.exists()
sqty-1	error	Immunization.doseQuantity	The comparator is not used on a SimpleQuantity	comparator.empty()
uds-plus-imm-1	error	Immunization.occurrence[x]	All dateTime data elements should be truncated to a year only for de-identified resources.	$this is DateTime implies $this.toString().length() = 4
uds-plus-imm-1a	error	Immunization.occurrence[x]	All dateTime data elements should have valid year > 1900	$this is DateTime implies $this.toString() >= '1900'
uds-plus-imm-1b	error	Immunization.occurrence[x]	All dateTime data elements should have valid year < 2030	$this is DateTime implies $this.toString() <= '2030'
uds-plus-imm-2	error	Immunization.recorded	All dateTime data elements should be truncated to a year only for de-identified resources.	$this is DateTime implies $this.toString().length() = 4
uds-plus-imm-2a	error	Immunization.recorded	All dateTime data elements should have valid year > 1900	$this is DateTime implies $this.toString() >= '1900'
uds-plus-imm-2b	error	Immunization.recorded	All dateTime data elements should have valid year < 2030	$this is DateTime implies $this.toString() <= '2030'
uds-plus-imm-3	error	Immunization.expirationDate	All date data elements should be truncated to a year only for de-identified resources.	$this is date implies $this.toString().length() = 4
uds-plus-imm-3a	error	Immunization.expirationDate	All dateTime data elements should have valid year > 1900	$this is DateTime implies $this.toString() >= '1900'
uds-plus-imm-3b	error	Immunization.expirationDate	All dateTime data elements should have valid year < 2050	$this is DateTime implies $this.toString() <= '2050'
uds-plus-imm-4	error	Immunization.reaction.date	All dateTime data elements should be truncated to a year only for de-identified resources.	$this is dateTime implies $this.toString().length() = 4
uds-plus-imm-4a	error	Immunization.reaction.date	All dateTime data elements should have valid year > 1900	$this is DateTime implies $this.toString() >= '1900'
uds-plus-imm-4b	error	Immunization.reaction.date	All dateTime data elements should have valid year < 2030	$this is DateTime implies $this.toString() <= '2030'

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Immunization		0..*	Immunization	De-Identified UDS Plus Immunization
Immunization.id	S This element must be supported. Σ This element is included in summaries.	0..1	id	The de-identified Immunization identifier created by the health center to send data to UDS+ Data Receiver
Immunization.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Immunization.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Immunization.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	completed | entered-in-error | not-done Binding: ImmunizationStatusCodes (required): A set of codes indicating the current status of an Immunization.
Immunization.statusReason	S This element must be supported.	0..1	CodeableConcept	Reason not done Binding: ImmunizationStatusReasonCodes (example): The reason why a vaccine was not administered.
Immunization.vaccineCode	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	Vaccine product administered Binding: VaccineAdministeredValueSet (example): The code for vaccine product administered.
Immunization.patient	S This element must be supported. Σ This element is included in summaries.	1..1	Reference(De-Identified UDS Plus Patient)	Who was immunized
Immunization.occurrence[x]	S This element must be supported. Σ This element is included in summaries. C	1..1	dateTime	Vaccine administration date Constraints: uds-plus-imm-1, uds-plus-imm-1a, uds-plus-imm-1b
Immunization.recorded	S This element must be supported. C	0..1	dateTime	When the immunization was first captured in the subject's record Constraints: uds-plus-imm-2, uds-plus-imm-2a, uds-plus-imm-2b
Immunization.primarySource	S This element must be supported. Σ This element is included in summaries.	1..1	boolean	Indicates context the data was recorded in
Immunization.expirationDate	C	0..1	date	Vaccine expiration date Constraints: uds-plus-imm-3, uds-plus-imm-3a, uds-plus-imm-3b
Immunization.isSubpotent	?! This element is a modifier element. Σ This element is included in summaries.	0..1	boolean	Dose potency
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Immunization.status	Base	required	Immunization Status Codes	📍4.0.1	FHIR Std.
Immunization.statusReason	Base	example	Immunization Status Reason Codes	📍4.0.1	FHIR Std.
Immunization.vaccineCode	Base	example	Vaccine Administered Value Set	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Immunization	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Immunization	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	error	Immunization	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	error	Immunization	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Immunization	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
uds-plus-imm-1	error	Immunization.occurrence[x]	All dateTime data elements should be truncated to a year only for de-identified resources.	$this is DateTime implies $this.toString().length() = 4
uds-plus-imm-1a	error	Immunization.occurrence[x]	All dateTime data elements should have valid year > 1900	$this is DateTime implies $this.toString() >= '1900'
uds-plus-imm-1b	error	Immunization.occurrence[x]	All dateTime data elements should have valid year < 2030	$this is DateTime implies $this.toString() <= '2030'
uds-plus-imm-2	error	Immunization.recorded	All dateTime data elements should be truncated to a year only for de-identified resources.	$this is DateTime implies $this.toString().length() = 4
uds-plus-imm-2a	error	Immunization.recorded	All dateTime data elements should have valid year > 1900	$this is DateTime implies $this.toString() >= '1900'
uds-plus-imm-2b	error	Immunization.recorded	All dateTime data elements should have valid year < 2030	$this is DateTime implies $this.toString() <= '2030'
uds-plus-imm-3	error	Immunization.expirationDate	All date data elements should be truncated to a year only for de-identified resources.	$this is date implies $this.toString().length() = 4
uds-plus-imm-3a	error	Immunization.expirationDate	All dateTime data elements should have valid year > 1900	$this is DateTime implies $this.toString() >= '1900'
uds-plus-imm-3b	error	Immunization.expirationDate	All dateTime data elements should have valid year < 2050	$this is DateTime implies $this.toString() <= '2050'

Differential View

This structure is derived from Immunization

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Immunization		0..*	Immunization	De-Identified UDS Plus Immunization
Immunization.id	S This element must be supported.	0..1	id	The de-identified Immunization identifier created by the health center to send data to UDS+ Data Receiver
Immunization.text		0..0		Cannot include any text in the resource as part of the de-identified data.
Immunization.contained		0..0		Cannot include any contained resources in the resource as part of the de-identified data.
Immunization.status	S This element must be supported.	1..1	code	completed | entered-in-error | not-done
Immunization.statusReason	S This element must be supported.	0..1	CodeableConcept	Reason not done
Immunization.vaccineCode	S This element must be supported.	1..1	CodeableConcept	Vaccine product administered
Immunization.patient	S This element must be supported.	1..1	Reference(De-Identified UDS Plus Patient)	Who was immunized
Immunization.patient.display		0..0		Text alternative for the resource
Immunization.occurrence[x]	S This element must be supported. C	1..1	dateTime	Vaccine administration date Constraints: uds-plus-imm-1, uds-plus-imm-1a, uds-plus-imm-1b
Immunization.recorded	S This element must be supported. C	0..1	dateTime	When the immunization was first captured in the subject's record Constraints: uds-plus-imm-2, uds-plus-imm-2a, uds-plus-imm-2b
Immunization.primarySource	S This element must be supported.	1..1	boolean	Indicates context the data was recorded in
Immunization.expirationDate	C	0..1	date	Vaccine expiration date Constraints: uds-plus-imm-3, uds-plus-imm-3a, uds-plus-imm-3b
Immunization.note		0..0		Additional immunization notes
Immunization.reaction
Immunization.reaction.date	C	0..1	dateTime	When reaction started Constraints: uds-plus-imm-4, uds-plus-imm-4a, uds-plus-imm-4b
Documentation for this format

Constraints

Id	Grade	Path(s)	Description	Expression
uds-plus-imm-1	error	Immunization.occurrence[x]	All dateTime data elements should be truncated to a year only for de-identified resources.	$this is DateTime implies $this.toString().length() = 4
uds-plus-imm-1a	error	Immunization.occurrence[x]	All dateTime data elements should have valid year > 1900	$this is DateTime implies $this.toString() >= '1900'
uds-plus-imm-1b	error	Immunization.occurrence[x]	All dateTime data elements should have valid year < 2030	$this is DateTime implies $this.toString() <= '2030'
uds-plus-imm-2	error	Immunization.recorded	All dateTime data elements should be truncated to a year only for de-identified resources.	$this is DateTime implies $this.toString().length() = 4
uds-plus-imm-2a	error	Immunization.recorded	All dateTime data elements should have valid year > 1900	$this is DateTime implies $this.toString() >= '1900'
uds-plus-imm-2b	error	Immunization.recorded	All dateTime data elements should have valid year < 2030	$this is DateTime implies $this.toString() <= '2030'
uds-plus-imm-3	error	Immunization.expirationDate	All date data elements should be truncated to a year only for de-identified resources.	$this is date implies $this.toString().length() = 4
uds-plus-imm-3a	error	Immunization.expirationDate	All dateTime data elements should have valid year > 1900	$this is DateTime implies $this.toString() >= '1900'
uds-plus-imm-3b	error	Immunization.expirationDate	All dateTime data elements should have valid year < 2050	$this is DateTime implies $this.toString() <= '2050'
uds-plus-imm-4	error	Immunization.reaction.date	All dateTime data elements should be truncated to a year only for de-identified resources.	$this is dateTime implies $this.toString().length() = 4
uds-plus-imm-4a	error	Immunization.reaction.date	All dateTime data elements should have valid year > 1900	$this is DateTime implies $this.toString() >= '1900'
uds-plus-imm-4b	error	Immunization.reaction.date	All dateTime data elements should have valid year < 2030	$this is DateTime implies $this.toString() <= '2030'

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Immunization		0..*	Immunization	De-Identified UDS Plus Immunization
Immunization.id	S This element must be supported. Σ This element is included in summaries.	0..1	id	The de-identified Immunization identifier created by the health center to send data to UDS+ Data Receiver
Immunization.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
Immunization.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Immunization.language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
Immunization.extension		0..*	Extension	Additional content defined by implementations
Immunization.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Immunization.identifier		0..*	Identifier	Business identifier
Immunization.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	completed | entered-in-error | not-done Binding: ImmunizationStatusCodes (required): A set of codes indicating the current status of an Immunization.
Immunization.statusReason	S This element must be supported.	0..1	CodeableConcept	Reason not done Binding: ImmunizationStatusReasonCodes (example): The reason why a vaccine was not administered.
Immunization.vaccineCode	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	Vaccine product administered Binding: VaccineAdministeredValueSet (example): The code for vaccine product administered.
Immunization.patient	S This element must be supported. Σ This element is included in summaries.	1..1	Reference(De-Identified UDS Plus Patient)	Who was immunized
Immunization.patient.id		0..1	string	Unique id for inter-element referencing
Immunization.patient.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Immunization.patient.reference	Σ This element is included in summaries. C	0..1	string	Literal reference, Relative, internal or absolute URL
Immunization.patient.type	Σ This element is included in summaries.	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
Immunization.patient.identifier	Σ This element is included in summaries.	0..1	Identifier	Logical reference, when literal reference is not known
Immunization.encounter		0..1	Reference(Encounter)	Encounter immunization was part of
Immunization.occurrence[x]	S This element must be supported. Σ This element is included in summaries. C	1..1	dateTime	Vaccine administration date Constraints: uds-plus-imm-1, uds-plus-imm-1a, uds-plus-imm-1b
Immunization.recorded	S This element must be supported. C	0..1	dateTime	When the immunization was first captured in the subject's record Constraints: uds-plus-imm-2, uds-plus-imm-2a, uds-plus-imm-2b
Immunization.primarySource	S This element must be supported. Σ This element is included in summaries.	1..1	boolean	Indicates context the data was recorded in
Immunization.reportOrigin		0..1	CodeableConcept	Indicates the source of a secondarily reported record Binding: ImmunizationOriginCodes (example): The source of the data for a record which is not from a primary source.
Immunization.location		0..1	Reference(Location)	Where immunization occurred
Immunization.manufacturer		0..1	Reference(Organization)	Vaccine manufacturer
Immunization.lotNumber		0..1	string	Vaccine lot number
Immunization.expirationDate	C	0..1	date	Vaccine expiration date Constraints: uds-plus-imm-3, uds-plus-imm-3a, uds-plus-imm-3b
Immunization.site		0..1	CodeableConcept	Body site vaccine was administered Binding: CodesForImmunizationSiteOfAdministration (example): The site at which the vaccine was administered.
Immunization.route		0..1	CodeableConcept	How vaccine entered body Binding: ImmunizationRouteCodes (example): The route by which the vaccine was administered.
Immunization.doseQuantity	C	0..1	SimpleQuantity(4.0.1)	Amount of vaccine administered Constraints: sqty-1
Immunization.performer	Σ This element is included in summaries.	0..*	BackboneElement	Who performed event
Immunization.performer.id		0..1	string	Unique id for inter-element referencing
Immunization.performer.extension		0..*	Extension	Additional content defined by implementations
Immunization.performer.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Immunization.performer.function	Σ This element is included in summaries.	0..1	CodeableConcept	What type of performance was done Binding: ImmunizationFunctionCodes (extensible): The role a practitioner or organization plays in the immunization event.
Immunization.performer.actor	Σ This element is included in summaries.	1..1	Reference(Practitioner | PractitionerRole | Organization)	Individual or organization who was performing
Immunization.reasonCode		0..*	CodeableConcept	Why immunization occurred Binding: ImmunizationReasonCodes (example): The reason why a vaccine was administered.
Immunization.reasonReference		0..*	Reference(Condition | Observation | DiagnosticReport)	Why immunization occurred
Immunization.isSubpotent	?! This element is a modifier element. Σ This element is included in summaries.	0..1	boolean	Dose potency
Immunization.subpotentReason		0..*	CodeableConcept	Reason for being subpotent Binding: ImmunizationSubpotentReason (example): The reason why a dose is considered to be subpotent.
Immunization.education	C	0..*	BackboneElement	Educational material presented to patient Constraints: imm-1
Immunization.education.id		0..1	string	Unique id for inter-element referencing
Immunization.education.extension		0..*	Extension	Additional content defined by implementations
Immunization.education.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Immunization.education.documentType		0..1	string	Educational material document identifier
Immunization.education.reference		0..1	uri	Educational material reference pointer
Immunization.education.publicationDate		0..1	dateTime	Educational material publication date
Immunization.education.presentationDate		0..1	dateTime	Educational material presentation date
Immunization.programEligibility		0..*	CodeableConcept	Patient eligibility for a vaccination program Binding: ImmunizationProgramEligibility (example): The patient's eligibility for a vaccation program.
Immunization.fundingSource		0..1	CodeableConcept	Funding source for the vaccine Binding: ImmunizationFundingSource (example): The source of funding used to purchase the vaccine administered.
Immunization.reaction		0..*	BackboneElement	Details of a reaction that follows immunization
Immunization.reaction.id		0..1	string	Unique id for inter-element referencing
Immunization.reaction.extension		0..*	Extension	Additional content defined by implementations
Immunization.reaction.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Immunization.reaction.date	C	0..1	dateTime	When reaction started Constraints: uds-plus-imm-4, uds-plus-imm-4a, uds-plus-imm-4b
Immunization.reaction.detail		0..1	Reference(Observation)	Additional information on reaction
Immunization.reaction.reported		0..1	boolean	Indicates self-reported reaction
Immunization.protocolApplied		0..*	BackboneElement	Protocol followed by the provider
Immunization.protocolApplied.id		0..1	string	Unique id for inter-element referencing
Immunization.protocolApplied.extension		0..*	Extension	Additional content defined by implementations
Immunization.protocolApplied.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Immunization.protocolApplied.series		0..1	string	Name of vaccine series
Immunization.protocolApplied.authority		0..1	Reference(Organization)	Who is responsible for publishing the recommendations
Immunization.protocolApplied.targetDisease		0..*	CodeableConcept	Vaccine preventatable disease being targetted Binding: ImmunizationTargetDiseaseCodes (example): The vaccine preventable disease the dose is being administered for.
Immunization.protocolApplied.doseNumber[x]		1..1		Dose number within series
Immunization.protocolApplied.doseNumber[x].doseNumberPositiveInt			positiveInt
Immunization.protocolApplied.doseNumber[x].doseNumberString			string
Immunization.protocolApplied.seriesDoses[x]		0..1		Recommended number of doses for immunity
Immunization.protocolApplied.seriesDoses[x].seriesDosesPositiveInt			positiveInt
Immunization.protocolApplied.seriesDoses[x].seriesDosesString			string
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Immunization.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Immunization.status	Base	required	Immunization Status Codes	📍4.0.1	FHIR Std.
Immunization.statusReason	Base	example	Immunization Status Reason Codes	📍4.0.1	FHIR Std.
Immunization.vaccineCode	Base	example	Vaccine Administered Value Set	📍4.0.1	FHIR Std.
Immunization.patient.​type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Immunization.reportOrigin	Base	example	Immunization Origin Codes	📍4.0.1	FHIR Std.
Immunization.site	Base	example	Codes for Immunization Site of Administration	📍4.0.1	FHIR Std.
Immunization.route	Base	example	Immunization Route Codes	📍4.0.1	FHIR Std.
Immunization.performer.​function	Base	extensible	Immunization Function Codes	📍4.0.1	FHIR Std.
Immunization.reasonCode	Base	example	Immunization Reason Codes	📍4.0.1	FHIR Std.
Immunization.subpotentReason	Base	example	Immunization Subpotent Reason	📍4.0.1	FHIR Std.
Immunization.programEligibility	Base	example	Immunization Program Eligibility	📍4.0.1	FHIR Std.
Immunization.fundingSource	Base	example	Immunization Funding Source	📍4.0.1	FHIR Std.
Immunization.protocolApplied.​targetDisease	Base	example	Immunization Target Disease Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Immunization	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Immunization	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	error	Immunization	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	error	Immunization	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Immunization	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
imm-1	error	Immunization.education	One of documentType or reference SHALL be present	documentType.exists() or reference.exists()
sqty-1	error	Immunization.doseQuantity	The comparator is not used on a SimpleQuantity	comparator.empty()
uds-plus-imm-1	error	Immunization.occurrence[x]	All dateTime data elements should be truncated to a year only for de-identified resources.	$this is DateTime implies $this.toString().length() = 4
uds-plus-imm-1a	error	Immunization.occurrence[x]	All dateTime data elements should have valid year > 1900	$this is DateTime implies $this.toString() >= '1900'
uds-plus-imm-1b	error	Immunization.occurrence[x]	All dateTime data elements should have valid year < 2030	$this is DateTime implies $this.toString() <= '2030'
uds-plus-imm-2	error	Immunization.recorded	All dateTime data elements should be truncated to a year only for de-identified resources.	$this is DateTime implies $this.toString().length() = 4
uds-plus-imm-2a	error	Immunization.recorded	All dateTime data elements should have valid year > 1900	$this is DateTime implies $this.toString() >= '1900'
uds-plus-imm-2b	error	Immunization.recorded	All dateTime data elements should have valid year < 2030	$this is DateTime implies $this.toString() <= '2030'
uds-plus-imm-3	error	Immunization.expirationDate	All date data elements should be truncated to a year only for de-identified resources.	$this is date implies $this.toString().length() = 4
uds-plus-imm-3a	error	Immunization.expirationDate	All dateTime data elements should have valid year > 1900	$this is DateTime implies $this.toString() >= '1900'
uds-plus-imm-3b	error	Immunization.expirationDate	All dateTime data elements should have valid year < 2050	$this is DateTime implies $this.toString() <= '2050'
uds-plus-imm-4	error	Immunization.reaction.date	All dateTime data elements should be truncated to a year only for de-identified resources.	$this is dateTime implies $this.toString().length() = 4
uds-plus-imm-4a	error	Immunization.reaction.date	All dateTime data elements should have valid year > 1900	$this is DateTime implies $this.toString() >= '1900'
uds-plus-imm-4b	error	Immunization.reaction.date	All dateTime data elements should have valid year < 2030	$this is DateTime implies $this.toString() <= '2030'

This structure is derived from Immunization

Summary

Mandatory: 5 elements
Must-Support: 8 elements
Prohibited: 4 elements

Structures

This structure refers to these other structures:

• De-Identified UDS Plus Patient (http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/de-identified-uds-plus-patient)

Maturity: 2