HL7 Belgium Vaccination (Patient Dossier)
1.1.0 - STU Belgium flag

HL7 Belgium Vaccination (Patient Dossier), published by eHealth Platform. This guide is not an authorized publication; it is the continuous build for version 1.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-be/vaccination/ and changes regularly. See the Directory of published versions

Resource Profile: BeVaccination - Detailed Descriptions

Active as of 2024-09-04 Maturity Level: 1

Definitions for the be-vaccination resource profile.

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

0. Immunization
Invariantsbe-rule-vaccination-1: If vaccineCode.code is other, then vaccinecode text must exist ((vaccineCode.coding.where(code = 'other').exists() or vaccineCode.coding.where(code = '787859002' and system = 'http://snomed.info/sct').exists() ) implies vaccineCode.text.exists())
be-rule-vaccination-2: The product code SHALL be cnk, cti extended or atc ((extension('https://www.ehealth.fgov.be/standards/fhir/vaccination/StructureDefinition/be-ext-administeredProduct').extension('coded').select($this.value as CodeableConcept)).exists().not() or (extension('https://www.ehealth.fgov.be/standards/fhir/vaccination/StructureDefinition/be-ext-administeredProduct').extension('coded').select($this.value as CodeableConcept)).coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/medication/NamingSystem/be-ns-cnk-codes').exists() or (extension('https://www.ehealth.fgov.be/standards/fhir/vaccination/StructureDefinition/be-ext-administeredProduct').extension('coded').select($this.value as CodeableConcept)).coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/medication/NamingSystem/be-ns-cti-extended-code').exists() or (extension('https://www.ehealth.fgov.be/standards/fhir/vaccination/StructureDefinition/be-ext-administeredProduct').extension('coded').select($this.value as CodeableConcept)).coding.where(system = 'http://whocc.no/atc').exists())
be-rule-vaccination-3: The reaction detail code SHALL come from be-vs-reaction-manifestation (reaction.detail.empty() or reaction.detail.resolve().code.memberOf('https://www.ehealth.fgov.be/standards/fhir/core-clinical/ValueSet/be-vs-reaction-manifestation-code').anyTrue())
be-rule-vaccination-4: If the encounter has a location, and it has a type, its type should be from be-vs-care-location (encounter.empty() or encounter.resolve().location.empty() or encounter.resolve().location.location.resolve().type.empty() or encounter.resolve().location.location.resolve().type.coding.memberOf('https://www.ehealth.fgov.be/standards/fhir/vaccination/ValueSet/be-vs-care-location').anyTrue())
2. Immunization.extension
Control1..?
SlicingThis element introduces a set of slices on Immunization.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. Immunization.extension:vaccination-originalorder
    Slice Namevaccination-originalorder
    Control0..1
    TypeExtension(BeVaccinationOriginalOrder) (Extension Type: Reference(ImmunizationRecommendation, MedicationRequest, CarePlan))
    6. Immunization.extension:administeredProduct
    Slice NameadministeredProduct
    Control0..1
    TypeExtension(BeAdministeredProduct) (Complex Extension)
    8. Immunization.extension:vaccination-confirmationStatus
    Slice Namevaccination-confirmationStatus
    Control0..1
    TypeExtension(BeVaccinationConfirmationStatus) (Extension Type: code)
    10. Immunization.extension:recorder
    Slice Namerecorder
    Control1..1
    TypeExtension(BeExtRecorder) (Extension Type: Choice of: CodeableConcept, Reference)
    12. Immunization.extension:note
    Slice Namenote
    Control0..1
    TypeExtension(BeExtSimpleNote) (Extension Type: Annotation)
    14. Immunization.extension:vaccination-stock-location
    Slice Namevaccination-stock-location
    Control0..1
    TypeExtension(BeVaccinationStockOrigin) (Extension Type: Reference(Location))
    16. Immunization.extension:vaccination-stock-funding-organization
    Slice Namevaccination-stock-funding-organization
    Control0..1
    TypeExtension(BeVaccinationStockFundingOrganization) (Extension Type: Reference(Organization))
    18. Immunization.identifier
    ShortA unique business identifier for a vaccination entry
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Must Supporttrue
    20. Immunization.identifier.system
    Control1..?
    Must Supporttrue
    22. Immunization.identifier.value
    Control1..?
    Must Supporttrue
    24. Immunization.status
    ShortThe status of this vaccination record entry
    Must Supporttrue
    26. Immunization.statusReason
    BindingThe codes SHALL be taken from BeVSVaccinationStatusReason
    (required to https://www.ehealth.fgov.be/standards/fhir/vaccination/ValueSet/be-vs-vaccination-status-reason)
    Must Supporttrue
    28. Immunization.vaccineCode
    ShortThe vaccine code - a type of vaccine, typically identified by the diseas(s) it covers. For example MMR, HPV, Tetanus, DTPa
    BindingThe codes SHALL be taken from BeVSVaccineCode
    (required to https://www.ehealth.fgov.be/standards/fhir/vaccination/ValueSet/be-vs-vaccine-code)
    Must Supporttrue
    30. Immunization.patient
    ShortThe patient that this received vaccination entry refers to
    TypeReference(BePatient)
    Must Supporttrue
    32. Immunization.encounter
    Must Supporttrue
    34. 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
    • 36. 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
      Must Supporttrue
      38. Immunization.occurrence[x]:occurrenceString
      Slice NameoccurrenceString
      Control0..1
      Typestring
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      40. Immunization.recorded
      ShortThe date/time when the vaccination event has been recorded
      Control1..?
      Must Supporttrue
      42. Immunization.location
      Control0..0
      44. Immunization.lotNumber
      Control0..0
      46. Immunization.expirationDate
      Control0..0
      48. Immunization.site
      BindingThe codes SHALL be taken from BeVSVaccinationBodySite
      (required to https://www.ehealth.fgov.be/standards/fhir/vaccination/ValueSet/be-vs-vaccination-bodysite)
      Must Supporttrue
      50. Immunization.site.extension:bodyLaterality
      Slice NamebodyLaterality
      Control0..1
      TypeExtension(BeExtLaterality) (Extension Type: Coding)
      52. Immunization.route
      BindingThe codes SHALL be taken from BeVSVaccineAdministrationRoute
      (required to https://www.ehealth.fgov.be/standards/fhir/vaccination/ValueSet/be-vs-vaccination-administration-route)
      Must Supporttrue
      54. Immunization.doseQuantity
      Must Supporttrue
      56. Immunization.performer
      Control0..1
      Must Supporttrue
      58. Immunization.performer.actor
      TypeReference(BePractitioner, BeOrganization, BePractitionerRole)
      60. Immunization.reasonCode
      ShortCan be used to indicate whether vaccination/prophylaxis took place pre- or post-exposition
      BindingThe codes SHOULD be taken from BeVSVaccinationReasonCode
      (preferred to https://www.ehealth.fgov.be/standards/fhir/vaccination/ValueSet/be-vs-vaccination-reason-code)
      Must Supporttrue
      62. Immunization.reasonReference
      ShortWhy vaccination has occurred or not (reference to a finding)
      Must Supporttrue
      64. Immunization.reaction
      ShortReaction immediately after vaccination (15-30 minutes)
      Must Supporttrue
      66. Immunization.reaction.date
      Control1..?
      68. Immunization.protocolApplied
      Control0..0
      Must Supporttrue

      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())
      be-rule-vaccination-1: If vaccineCode.code is other, then vaccinecode text must exist ((vaccineCode.coding.where(code = 'other').exists() or vaccineCode.coding.where(code = '787859002' and system = 'http://snomed.info/sct').exists() ) implies vaccineCode.text.exists())
      be-rule-vaccination-2: The product code SHALL be cnk, cti extended or atc ((extension('https://www.ehealth.fgov.be/standards/fhir/vaccination/StructureDefinition/be-ext-administeredProduct').extension('coded').select($this.value as CodeableConcept)).exists().not() or (extension('https://www.ehealth.fgov.be/standards/fhir/vaccination/StructureDefinition/be-ext-administeredProduct').extension('coded').select($this.value as CodeableConcept)).coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/medication/NamingSystem/be-ns-cnk-codes').exists() or (extension('https://www.ehealth.fgov.be/standards/fhir/vaccination/StructureDefinition/be-ext-administeredProduct').extension('coded').select($this.value as CodeableConcept)).coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/medication/NamingSystem/be-ns-cti-extended-code').exists() or (extension('https://www.ehealth.fgov.be/standards/fhir/vaccination/StructureDefinition/be-ext-administeredProduct').extension('coded').select($this.value as CodeableConcept)).coding.where(system = 'http://whocc.no/atc').exists())
      be-rule-vaccination-3: The reaction detail code SHALL come from be-vs-reaction-manifestation (reaction.detail.empty() or reaction.detail.resolve().code.memberOf('https://www.ehealth.fgov.be/standards/fhir/core-clinical/ValueSet/be-vs-reaction-manifestation-code').anyTrue())
      be-rule-vaccination-4: If the encounter has a location, and it has a type, its type should be from be-vs-care-location (encounter.empty() or encounter.resolve().location.empty() or encounter.resolve().location.location.resolve().type.empty() or encounter.resolve().location.location.resolve().type.coding.memberOf('https://www.ehealth.fgov.be/standards/fhir/vaccination/ValueSet/be-vs-care-location').anyTrue())
      2. Immunization.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      4. Immunization.extension
      Definition

      An Extension


      May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortExtensionAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control10..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Immunization.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 6. Immunization.extension:vaccination-originalorder
        Slice Namevaccination-originalorder
        Definition

        A plan, proposal or order that is fulfilled in whole or in part by an event.

        ShortBeVaccinationOriginalOrder
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(BeVaccinationOriginalOrder) (Extension Type: Reference(ImmunizationRecommendation, MedicationRequest, CarePlan))
        Is Modifierfalse
        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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        8. Immunization.extension:administeredProduct
        Slice NameadministeredProduct
        Definition

        The product administered

        ShortBeAdministeredProduct
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(BeAdministeredProduct) (Complex Extension)
        Is Modifierfalse
        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())
        10. Immunization.extension:vaccination-confirmationStatus
        Slice Namevaccination-confirmationStatus
        Definition

        How certain/reliable is the vaccination information

        ShortBeVaccinationConfirmationStatus
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(BeVaccinationConfirmationStatus) (Extension Type: code)
        Is Modifierfalse
        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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        12. Immunization.extension:recorder
        Slice Namerecorder
        Definition

        The recorder of the information - note that this may not always be the same as the asserter - when a patient reports to a nurse and the nurse enters the data, the asserter is the patient, but the recorder is the nurse

        ShortBeExtRecorder
        Control1..1
        This element is affected by the following invariants: ele-1
        TypeExtension(BeExtRecorder) (Extension Type: Choice of: CodeableConcept, Reference)
        Is Modifierfalse
        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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        14. Immunization.extension:note
        Slice Namenote
        Definition

        Simple note extension if the element doesn't have a note. To be replaced by https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-ext-simple-note

        ShortBeExtSimpleNote
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(BeExtSimpleNote) (Extension Type: Annotation)
        Is Modifierfalse
        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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        16. Immunization.extension:vaccination-stock-location
        Slice Namevaccination-stock-location
        Definition

        The coded inventory location or type of inventory where the vaccine product was dispensed from.

        ShortBeVaccinationStockOrigin
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(BeVaccinationStockOrigin) (Extension Type: Reference(Location))
        Is Modifierfalse
        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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        18. Immunization.extension:vaccination-stock-funding-organization
        Slice Namevaccination-stock-funding-organization
        Definition

        The funding source for the vaccine product.

        ShortBeVaccinationStockFundingOrganization
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(BeVaccinationStockFundingOrganization) (Extension Type: Reference(Organization))
        Is Modifierfalse
        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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        20. 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())
        22. Immunization.identifier
        Definition

        A unique identifier assigned to this immunization record.

        ShortA unique business identifier for a vaccination entryBusiness identifier
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. Immunization.identifier.use
        Definition

        The purpose of this identifier.

        Shortusual | official | temp | secondary | old (If known)
        Comments

        Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

        Control0..1
        BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

        Identifies the purpose for this identifier, if known .

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. Immunization.identifier.system
        Definition

        Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

        ShortThe namespace for the identifier value
        Comments

        Identifier.system is always case sensitive.

        Control10..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

        Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. Immunization.identifier.value
        Definition

        The portion of the identifier typically relevant to the user and which is unique within the context of the system.

        ShortThe value that is unique
        Comments

        If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Example<br/><b>General</b>:123456
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. Immunization.status
        Definition

        Indicates the current status of the immunization event.

        ShortThe status of this vaccination record entrycompleted | 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
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. Immunization.statusReason
        Definition

        Indicates the reason the immunization event was not performed.

        ShortReason not done
        Comments

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

        Control0..1
        BindingThe codes SHALL be taken from For example codes, see BeVSVaccinationStatusReasonhttp://hl7.org/fhir/ValueSet/immunization-status-reason
        (required to https://www.ehealth.fgov.be/standards/fhir/vaccination/ValueSet/be-vs-vaccination-status-reason)
        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. Immunization.vaccineCode
        Definition

        Vaccine that was administered or was to be administered.

        ShortThe vaccine code - a type of vaccine, typically identified by the diseas(s) it covers. For example MMR, HPV, Tetanus, DTPaVaccine product administered
        Control1..1
        BindingThe codes SHALL be taken from For example codes, see BeVSVaccineCodehttp://hl7.org/fhir/ValueSet/vaccine-code
        (required to https://www.ehealth.fgov.be/standards/fhir/vaccination/ValueSet/be-vs-vaccine-code)
        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. Immunization.patient
        Definition

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

        ShortThe patient that this received vaccination entry refers toWho was immunized
        Control1..1
        TypeReference(BePatient, Patient)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. 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(Encounter)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. 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 Closed, and can be differentiated using the following discriminators:
        • type @ $this
        • 42. 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
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          44. Immunization.occurrence[x]:occurrenceString
          Slice NameoccurrenceString
          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
          Typestring, dateTime
          [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
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          46. Immunization.recorded
          Definition

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

          ShortThe date/time when the vaccination event has been recordedWhen the immunization was first captured in the subject's record
          Control10..1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          48. Immunization.location
          Definition

          The service delivery location where the vaccine administration occurred.

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

          Lot number of the vaccine product.

          ShortVaccine lot number
          Control0..01
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. Immunization.expirationDate
          Definition

          Date vaccine batch expires.

          ShortVaccine expiration date
          Control0..01
          Typedate
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          54. Immunization.site
          Definition

          Body site where vaccine was administered.

          ShortBody site vaccine was administered
          Control0..1
          BindingThe codes SHALL be taken from For example codes, see BeVSVaccinationBodySitehttp://hl7.org/fhir/ValueSet/immunization-site
          (required to https://www.ehealth.fgov.be/standards/fhir/vaccination/ValueSet/be-vs-vaccination-bodysite)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          56. Immunization.site.extension:bodyLaterality
          Slice NamebodyLaterality
          Definition

          An explicit statement of laterality of a lesion, or a treatment, etc.

          ShortBeExtLaterality
          Control0..1
          TypeExtension(BeExtLaterality) (Extension Type: Coding)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          58. Immunization.route
          Definition

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

          ShortHow vaccine entered body
          Control0..1
          BindingThe codes SHALL be taken from For example codes, see BeVSVaccineAdministrationRoutehttp://hl7.org/fhir/ValueSet/immunization-route
          (required to https://www.ehealth.fgov.be/standards/fhir/vaccination/ValueSet/be-vs-vaccination-administration-route)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          60. Immunization.doseQuantity
          Definition

          The quantity of vaccine product that was administered.

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

          Indicates who performed the immunization event.

          ShortWho performed event
          Control0..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          64. 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())
          66. 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(BePractitioner, BeOrganization, BePractitionerRole, Practitioner, PractitionerRole, Organization)
          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.

          ShortCan be used to indicate whether vaccination/prophylaxis took place pre- or post-expositionWhy immunization occurred
          Control0..*
          BindingThe codes SHOULD be taken from For example codes, see BeVSVaccinationReasonCodehttp://hl7.org/fhir/ValueSet/immunization-reason
          (preferred to https://www.ehealth.fgov.be/standards/fhir/vaccination/ValueSet/be-vs-vaccination-reason-code)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          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 vaccination has occurred or not (reference to a finding)Why immunization occurred
          Control0..*
          TypeReference(Condition, Observation, DiagnosticReport)
          Is Modifierfalse
          Must Supporttrue
          Must Support TypesNo must-support rules about the choice of types/profiles
          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..1
          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.reaction
          Definition

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

          ShortReaction immediately after vaccination (15-30 minutes)Details of a reaction that follows immunization
          Comments

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

          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          76. Immunization.reaction.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())
          78. Immunization.reaction.date
          Definition

          Date of reaction to the immunization.

          ShortWhen reaction started
          Control10..1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          80. Immunization.protocolApplied
          Definition

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

          ShortProtocol followed by the provider
          Control0..0*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          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())
          be-rule-vaccination-1: If vaccineCode.code is other, then vaccinecode text must exist ((vaccineCode.coding.where(code = 'other').exists() or vaccineCode.coding.where(code = '787859002' and system = 'http://snomed.info/sct').exists() ) implies vaccineCode.text.exists())
          be-rule-vaccination-2: The product code SHALL be cnk, cti extended or atc ((extension('https://www.ehealth.fgov.be/standards/fhir/vaccination/StructureDefinition/be-ext-administeredProduct').extension('coded').select($this.value as CodeableConcept)).exists().not() or (extension('https://www.ehealth.fgov.be/standards/fhir/vaccination/StructureDefinition/be-ext-administeredProduct').extension('coded').select($this.value as CodeableConcept)).coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/medication/NamingSystem/be-ns-cnk-codes').exists() or (extension('https://www.ehealth.fgov.be/standards/fhir/vaccination/StructureDefinition/be-ext-administeredProduct').extension('coded').select($this.value as CodeableConcept)).coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/medication/NamingSystem/be-ns-cti-extended-code').exists() or (extension('https://www.ehealth.fgov.be/standards/fhir/vaccination/StructureDefinition/be-ext-administeredProduct').extension('coded').select($this.value as CodeableConcept)).coding.where(system = 'http://whocc.no/atc').exists())
          be-rule-vaccination-3: The reaction detail code SHALL come from be-vs-reaction-manifestation (reaction.detail.empty() or reaction.detail.resolve().code.memberOf('https://www.ehealth.fgov.be/standards/fhir/core-clinical/ValueSet/be-vs-reaction-manifestation-code').anyTrue())
          be-rule-vaccination-4: If the encounter has a location, and it has a type, its type should be from be-vs-care-location (encounter.empty() or encounter.resolve().location.empty() or encounter.resolve().location.location.resolve().type.empty() or encounter.resolve().location.location.resolve().type.coding.memberOf('https://www.ehealth.fgov.be/standards/fhir/vaccination/ValueSet/be-vs-care-location').anyTrue())
          2. Immunization.id
          Definition

          The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

          ShortLogical id of this artifact
          Comments

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

          Control0..1
          Typeid
          Is Modifierfalse
          Summarytrue
          4. Immunization.meta
          Definition

          The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

          ShortMetadata about the resource
          Control0..1
          TypeMeta
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          6. Immunization.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

          An Extension

          ShortExtension
          Control1..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on Immunization.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 16. Immunization.extension:vaccination-originalorder
            Slice Namevaccination-originalorder
            Definition

            A plan, proposal or order that is fulfilled in whole or in part by an event.

            ShortBeVaccinationOriginalOrder
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(BeVaccinationOriginalOrder) (Extension Type: Reference(ImmunizationRecommendation, MedicationRequest, CarePlan))
            Is Modifierfalse
            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.extension:administeredProduct
            Slice NameadministeredProduct
            Definition

            The product administered

            ShortBeAdministeredProduct
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(BeAdministeredProduct) (Complex Extension)
            Is Modifierfalse
            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())
            20. Immunization.extension:vaccination-confirmationStatus
            Slice Namevaccination-confirmationStatus
            Definition

            How certain/reliable is the vaccination information

            ShortBeVaccinationConfirmationStatus
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(BeVaccinationConfirmationStatus) (Extension Type: code)
            Is Modifierfalse
            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())
            22. Immunization.extension:recorder
            Slice Namerecorder
            Definition

            The recorder of the information - note that this may not always be the same as the asserter - when a patient reports to a nurse and the nurse enters the data, the asserter is the patient, but the recorder is the nurse

            ShortBeExtRecorder
            Control1..1
            This element is affected by the following invariants: ele-1
            TypeExtension(BeExtRecorder) (Extension Type: Choice of: CodeableConcept, Reference)
            Is Modifierfalse
            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())
            24. Immunization.extension:note
            Slice Namenote
            Definition

            Simple note extension if the element doesn't have a note. To be replaced by https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-ext-simple-note

            ShortBeExtSimpleNote
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(BeExtSimpleNote) (Extension Type: Annotation)
            Is Modifierfalse
            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())
            26. Immunization.extension:vaccination-stock-location
            Slice Namevaccination-stock-location
            Definition

            The coded inventory location or type of inventory where the vaccine product was dispensed from.

            ShortBeVaccinationStockOrigin
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(BeVaccinationStockOrigin) (Extension Type: Reference(Location))
            Is Modifierfalse
            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())
            28. Immunization.extension:vaccination-stock-funding-organization
            Slice Namevaccination-stock-funding-organization
            Definition

            The funding source for the vaccine product.

            ShortBeVaccinationStockFundingOrganization
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(BeVaccinationStockFundingOrganization) (Extension Type: Reference(Organization))
            Is Modifierfalse
            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())
            30. 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())
            32. Immunization.identifier
            Definition

            A unique identifier assigned to this immunization record.

            ShortA unique business identifier for a vaccination entry
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..*
            TypeIdentifier
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            34. Immunization.identifier.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
            36. Immunization.identifier.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on Immunization.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 38. Immunization.identifier.use
              Definition

              The purpose of this identifier.

              Shortusual | official | temp | secondary | old (If known)
              Comments

              Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

              Control0..1
              BindingThe codes SHALL be taken from IdentifierUse
              (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

              Identifies the purpose for this identifier, if known .

              Typecode
              Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              40. Immunization.identifier.type
              Definition

              A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

              ShortDescription of identifier
              Comments

              This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

              Control0..1
              BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
              (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

              A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

              TypeCodeableConcept
              Is Modifierfalse
              Summarytrue
              Requirements

              Allows users to make use of identifiers when the identifier system is not known.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              42. Immunization.identifier.system
              Definition

              Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

              ShortThe namespace for the identifier value
              Comments

              Identifier.system is always case sensitive.

              Control1..1
              Typeuri
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Requirements

              There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

              Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              44. Immunization.identifier.value
              Definition

              The portion of the identifier typically relevant to the user and which is unique within the context of the system.

              ShortThe value that is unique
              Comments

              If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

              Control1..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Example<br/><b>General</b>:123456
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              46. Immunization.identifier.period
              Definition

              Time period during which identifier is/was valid for use.

              ShortTime period when id is/was valid for use
              Control0..1
              TypePeriod
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              48. Immunization.identifier.assigner
              Definition

              Organization that issued/manages the identifier.

              ShortOrganization that issued id (may be just text)
              Comments

              The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

              Control0..1
              TypeReference(Organization)
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              50. Immunization.status
              Definition

              Indicates the current status of the immunization event.

              ShortThe status of this vaccination record entry
              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
              Must Supporttrue
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              52. Immunization.statusReason
              Definition

              Indicates the reason the immunization event was not performed.

              ShortReason not done
              Comments

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

              Control0..1
              BindingThe codes SHALL be taken from BeVSVaccinationStatusReason
              (required to https://www.ehealth.fgov.be/standards/fhir/vaccination/ValueSet/be-vs-vaccination-status-reason)
              TypeCodeableConcept
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              54. Immunization.vaccineCode
              Definition

              Vaccine that was administered or was to be administered.

              ShortThe vaccine code - a type of vaccine, typically identified by the diseas(s) it covers. For example MMR, HPV, Tetanus, DTPa
              Control1..1
              BindingThe codes SHALL be taken from BeVSVaccineCode
              (required to https://www.ehealth.fgov.be/standards/fhir/vaccination/ValueSet/be-vs-vaccine-code)
              TypeCodeableConcept
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              56. Immunization.patient
              Definition

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

              ShortThe patient that this received vaccination entry refers to
              Control1..1
              TypeReference(BePatient)
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              58. 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(Encounter)
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              60. 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 Closed, and can be differentiated using the following discriminators:
              • type @ $this
              • 62. 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
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                64. Immunization.occurrence[x]:occurrenceString
                Slice NameoccurrenceString
                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
                Typestring
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                66. Immunization.recorded
                Definition

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

                ShortThe date/time when the vaccination event has been recorded
                Control1..1
                TypedateTime
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                68. 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..1
                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()))
                70. Immunization.reportOrigin
                Definition

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

                ShortIndicates the source of a secondarily reported record
                Comments

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

                Control0..1
                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()))
                72. Immunization.location
                Definition

                The service delivery location where the vaccine administration occurred.

                ShortWhere immunization occurred
                Control0..0
                TypeReference(Location)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                74. 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()))
                76. Immunization.lotNumber
                Definition

                Lot number of the vaccine product.

                ShortVaccine lot number
                Control0..0
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                78. Immunization.expirationDate
                Definition

                Date vaccine batch expires.

                ShortVaccine expiration date
                Control0..0
                Typedate
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                80. Immunization.site
                Definition

                Body site where vaccine was administered.

                ShortBody site vaccine was administered
                Control0..1
                BindingThe codes SHALL be taken from BeVSVaccinationBodySite
                (required to https://www.ehealth.fgov.be/standards/fhir/vaccination/ValueSet/be-vs-vaccination-bodysite)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                82. Immunization.site.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
                84. Immunization.site.extension
                Definition

                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                ShortAdditional content defined by implementations
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on Immunization.site.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 86. Immunization.site.extension:bodyLaterality
                  Slice NamebodyLaterality
                  Definition

                  An explicit statement of laterality of a lesion, or a treatment, etc.

                  ShortBeExtLaterality
                  Control0..1
                  TypeExtension(BeExtLaterality) (Extension Type: Coding)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  88. Immunization.site.coding
                  Definition

                  A reference to a code defined by a terminology system.

                  ShortCode defined by a terminology system
                  Comments

                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                  Control0..*
                  TypeCoding
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  Allows for alternative encodings within a code system, and translations to other code systems.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  90. Immunization.site.text
                  Definition

                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                  ShortPlain text representation of the concept
                  Comments

                  Very often the text is the same as a displayName of one of the codings.

                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

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

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

                  ShortHow vaccine entered body
                  Control0..1
                  BindingThe codes SHALL be taken from BeVSVaccineAdministrationRoute
                  (required to https://www.ehealth.fgov.be/standards/fhir/vaccination/ValueSet/be-vs-vaccination-administration-route)
                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  94. Immunization.doseQuantity
                  Definition

                  The quantity of vaccine product that was administered.

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

                  Indicates who performed the immunization event.

                  ShortWho performed event
                  Control0..1
                  TypeBackboneElement
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  98. 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
                  100. 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())
                  102. 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())
                  104. Immunization.performer.function
                  Definition

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

                  ShortWhat type of performance was done
                  Control0..1
                  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()))
                  106. 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(BePractitioner, BeOrganization, BePractitionerRole)
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  108. Immunization.note
                  Definition

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

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

                  Reasons why the vaccine was administered.

                  ShortCan be used to indicate whether vaccination/prophylaxis took place pre- or post-exposition
                  Control0..*
                  BindingThe codes SHOULD be taken from BeVSVaccinationReasonCode
                  (preferred to https://www.ehealth.fgov.be/standards/fhir/vaccination/ValueSet/be-vs-vaccination-reason-code)
                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  112. Immunization.reasonReference
                  Definition

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

                  ShortWhy vaccination has occurred or not (reference to a finding)
                  Control0..*
                  TypeReference(Condition, Observation, DiagnosticReport)
                  Is Modifierfalse
                  Must Supporttrue
                  Must Support TypesNo must-support rules about the choice of types/profiles
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  114. 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..1
                  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()))
                  116. 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()))
                  118. Immunization.education
                  Definition

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

                  ShortEducational material presented to patient
                  Control0..*
                  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())
                  120. Immunization.education.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
                  122. Immunization.education.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())
                  124. Immunization.education.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())
                  126. Immunization.education.documentType
                  Definition

                  Identifier of the material presented to the patient.

                  ShortEducational material document identifier
                  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()))
                  128. Immunization.education.reference
                  Definition

                  Reference pointer to the educational material given to the patient if the information was on line.

                  ShortEducational material reference pointer
                  Control0..1
                  Typeuri
                  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()))
                  130. Immunization.education.publicationDate
                  Definition

                  Date the educational material was published.

                  ShortEducational material publication date
                  Control0..1
                  TypedateTime
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  132. Immunization.education.presentationDate
                  Definition

                  Date the educational material was given to the patient.

                  ShortEducational material presentation date
                  Control0..1
                  TypedateTime
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  134. Immunization.programEligibility
                  Definition

                  Indicates a patient's eligibility for a funding program.

                  ShortPatient eligibility for a vaccination program
                  Control0..*
                  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()))
                  136. 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..1
                  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()))
                  138. Immunization.reaction
                  Definition

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

                  ShortReaction immediately after vaccination (15-30 minutes)
                  Comments

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

                  Control0..*
                  TypeBackboneElement
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  140. Immunization.reaction.id
                  Definition

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

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  142. Immunization.reaction.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())
                  144. Immunization.reaction.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())
                  146. Immunization.reaction.date
                  Definition

                  Date of reaction to the immunization.

                  ShortWhen reaction started
                  Control1..1
                  TypedateTime
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  148. Immunization.reaction.detail
                  Definition

                  Details of the reaction.

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

                  Self-reported indicator.

                  ShortIndicates self-reported reaction
                  Control0..1
                  Typeboolean
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  152. Immunization.protocolApplied
                  Definition

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

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