HL7 Europe Patient Summary
1.0.0-ci-build - ci-build 150

HL7 Europe Patient Summary, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/eps/ and changes regularly. See the Directory of published versions

Resource Profile: ImmunizationOblEuEps - Detailed Descriptions

Draft as of 2026-02-06

Definitions for the immunization-obl-eu-eps resource profile.

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

0. Immunization
Definition

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

ShortImmunization event information
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Immunization.implicitRules
Definition

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

ShortA set of rules under which this content was created
Comments

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

Control0..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:administeredProduct
Slice NameadministeredProduct
Definition

An indication of which product was administered to the patient. This is typically a more detailed representation of the concept conveyed by the vaccineCode data element. If a Medication resource is referenced, it may be to a stand-alone resource or a contained resource within the Immunization resource.

ShortProduct that was administered
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(Cross-version Extension for R5.Immunization.administeredProduct for use in FHIR R4) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)
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())
ele-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())
6. Immunization.extension:administeredProduct.extension:concept
Slice Nameconcept
Definition

A reference to a concept - e.g. the information is identified by its general class to the degree of precision found in the terminology.

ShortReference to a concept (by class)Additional content defined by implementations
Control0..1*
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())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. Immunization.extension:administeredProduct.extension:concept.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Shortidentifies the meaning of the extension
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Control1..1
Typeuri
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
Fixed Valueconcept
10. Immunization.extension:administeredProduct.extension:reference
Slice Namereference
Definition

An Extension

ShortExtensionAdditional content defined by implementations
Control0..1*
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())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
12. Immunization.extension:administeredProduct.extension:reference.extension
Definition

An Extension


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.

ShortExtensionAdditional content defined by implementations
Comments

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

Control0..0*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-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.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 14. Immunization.extension:administeredProduct.extension:reference.url
    Definition

    Source of the definition for the extension code - a logical name or a URL.

    Shortidentifies the meaning of the extension
    Comments

    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

    Control1..1
    Typeuri
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    Fixed Valuereference
    16. Immunization.extension:administeredProduct.extension:_datatype
    Slice Name_datatype
    Definition

    Data type name for Immunization.administeredProduct from FHIR R5

    ShortData type name for Immunization.administeredProduct from FHIR R5
    Control0..1
    TypeExtension(Datatype) (Extension Type: string)
    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())
    ele-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.extension:_datatype.extension
    Definition

    An Extension


    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.

    ShortExtensionAdditional content defined by implementations
    Comments

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

    Control0..0*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-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.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 20. Immunization.extension:administeredProduct.extension:_datatype.url
      Definition

      Source of the definition for the extension code - a logical name or a URL.

      Shortidentifies the meaning of the extension
      Comments

      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed Valuehttp://hl7.org/fhir/StructureDefinition/_datatype
      22. Immunization.extension:administeredProduct.extension:_datatype.value[x]
      Definition

      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).


      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      ShortValue of extension
      Comments

      Must be: CodeableReference

      Control10..1
      This element is affected by the following invariants: ext-1
      Typestring, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Fixed ValueCodeableReference
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. Immunization.extension:administeredProduct.url
      Definition

      Source of the definition for the extension code - a logical name or a URL.

      Shortidentifies the meaning of the extension
      Comments

      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.administeredProduct
      26. Immunization.extension:administeredProduct.value[x]
      Definition

      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      ShortValue of extension
      Control0..01
      TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
      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()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. 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())
      30. Immunization.status
      Definition

      Indicates the current status of the immunization event.

      ShortImmunization status.completed | 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
      Obligations
        ObligationsActor
        SHALL:populate-if-knownCreator (IPS)
        SHALL:handleConsumer (IPS)
        SHOULD:displayConsumer (IPS)
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. Immunization.vaccineCode
        Definition

        Vaccine that was administered or was to be administered.

        ShortVaccine product administered
        Control1..1
        BindingThe codes SHOULD be taken from For example codes, see Vaccines - IPShttp://hl7.org/fhir/ValueSet/vaccine-code|4.0.1
        (preferred to http://hl7.org/fhir/uv/ips/ValueSet/vaccines-uv-ips)

        The type of vaccine for particular disease or diseases against which the patient has been immunised, or a code for absent/unknown immunization.


        The code for vaccine product administered.

        TypeCodeableConcept
        Is Modifierfalse
        Obligations
          ObligationsActor
          SHALL:populate-if-knownCreator (IPS)
          SHALL:handleConsumer (IPS)
          SHOULD:displayConsumer (IPS)
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          34. Immunization.patient
          Definition

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

          ShortWho was immunized
          Control1..1
          TypeReference(Patient (EU core), Patient)
          Is Modifierfalse
          Obligations
            ObligationsActor
            SHALL:populate-if-knownCreator (IPS)
            SHALL:handleConsumer (IPS)
            SHOULD:displayConsumer (IPS)
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            36. Immunization.patient.reference
            Definition

            A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

            ShortLiteral reference, Relative, internal or absolute URL
            Comments

            Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

            Control0..1
            This element is affected by the following invariants: ref-1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Obligations
              ObligationsActor
              SHALL:populate-if-knownCreator (IPS)
              SHALL:handleConsumer (IPS)
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              38. Immunization.occurrence[x]
              Definition

              Date vaccine administered or was to be administered.

              ShortDate of vaccinationVaccine 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
              Obligations
                ObligationsActor
                SHALL:populate-if-knownCreator (IPS)
                SHALL:handleConsumer (IPS)
                SHOULD:displayConsumer (IPS)
                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
                • 40. 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
                  Obligations
                    ObligationsActor
                    SHOULD:able-to-populateCreator (IPS)
                    SHALL:handleConsumer (IPS)
                    SHOULD:displayConsumer (IPS)
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    42. Immunization.occurrence[x]:occurrenceDateTime.extension:periodOfLife
                    Slice NameperiodOfLife
                    Definition

                    Extensions used to indicate a time period in a person's life as a reference to a coded value for that life period.

                    ShortMany: Periods of Life
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(Many: Periods of Life) (Extension Type: CodeableConcept)
                    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())
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    44. Immunization.occurrence[x]:occurrenceDateTime.extension:periodOfLife.extension
                    Definition

                    An Extension


                    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.

                    ShortExtensionAdditional content defined by implementations
                    Comments

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

                    Control0..0*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingThis element introduces a set of slices on Immunization.occurrence[x].extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 46. Immunization.occurrence[x]:occurrenceDateTime.extension:periodOfLife.url
                      Definition

                      Source of the definition for the extension code - a logical name or a URL.

                      Shortidentifies the meaning of the extension
                      Comments

                      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                      Control1..1
                      Typeuri
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      Fixed Valuehttp://hl7.eu/fhir/extensions/StructureDefinition/periods-of-life
                      48. Immunization.performer
                      Definition

                      Indicates who performed the immunization event.

                      ShortWho performed event
                      Control0..*
                      TypeBackboneElement
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      SlicingThis element introduces a set of slices on Immunization.performer. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ $this.function
                      • 50. 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())
                        52. 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(Practitioner, PractitionerRole, Organization)
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        54. Immunization.performer:administeringCentreOrHp
                        Slice NameadministeringCentreOrHp
                        Definition

                        Indicates who performed the immunization event.

                        ShortAdministering centreWho performed event
                        Control0..*
                        TypeBackboneElement
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        56. Immunization.performer:administeringCentreOrHp.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())
                        58. Immunization.performer:administeringCentreOrHp.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 ImmunizationFunctionCodeshttp://hl7.org/fhir/ValueSet/immunization-function|4.0.1
                        (extensible to http://hl7.org/fhir/ValueSet/immunization-function|4.0.1)

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

                        TypeCodeableConcept
                        Is Modifierfalse
                        Summarytrue
                        Pattern Value{
                          "coding" : [{
                            "system" : "http://terminology.hl7.org/CodeSystem/v2-0443",
                            "code" : "AP"
                          }]
                        }
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        60. Immunization.performer:administeringCentreOrHp.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(Organization (EU core), PractitionerRole (EU core), Practitioner (EU core), Practitioner, PractitionerRole, Organization)
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        62. 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()))

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

                        0. Immunization
                        2. Immunization.status
                        Obligations
                          ObligationsActor
                          SHALL:populate-if-knownCreator (IPS)
                          SHALL:handleConsumer (IPS)
                          SHOULD:displayConsumer (IPS)
                          4. Immunization.vaccineCode
                          Obligations
                            ObligationsActor
                            SHALL:populate-if-knownCreator (IPS)
                            SHALL:handleConsumer (IPS)
                            SHOULD:displayConsumer (IPS)
                            6. Immunization.patient
                            Obligations
                              ObligationsActor
                              SHALL:populate-if-knownCreator (IPS)
                              SHALL:handleConsumer (IPS)
                              SHOULD:displayConsumer (IPS)
                              8. Immunization.patient.reference
                              Obligations
                                ObligationsActor
                                SHALL:populate-if-knownCreator (IPS)
                                SHALL:handleConsumer (IPS)
                                10. Immunization.occurrence[x]
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Obligations
                                  ObligationsActor
                                  SHALL:populate-if-knownCreator (IPS)
                                  SHALL:handleConsumer (IPS)
                                  SHOULD:displayConsumer (IPS)
                                  12. Immunization.occurrence[x]:occurrenceDateTime
                                  Slice NameoccurrenceDateTime
                                  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
                                  Obligations
                                    ObligationsActor
                                    SHOULD:able-to-populateCreator (IPS)
                                    SHALL:handleConsumer (IPS)
                                    SHOULD:displayConsumer (IPS)

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

                                    0. Immunization
                                    Definition

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

                                    ShortImmunization event information
                                    Control0..*
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                    dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                                    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                                    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                                    dom-6: A resource should have narrative for robust management (text.`div`.exists())
                                    2. Immunization.id
                                    Definition

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

                                    ShortLogical id of this artifact
                                    Comments

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

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

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

                                    ShortMetadata about the resource
                                    Control0..1
                                    TypeMeta
                                    Is Modifierfalse
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    6. Immunization.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|4.0.1)

                                    A human language.

                                    Additional BindingsPurpose
                                    AllLanguagesMax Binding
                                    Typecode
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    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
                                    Control0..*
                                    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:administeredProduct
                                      Slice NameadministeredProduct
                                      Definition

                                      An indication of which product was administered to the patient. This is typically a more detailed representation of the concept conveyed by the vaccineCode data element. If a Medication resource is referenced, it may be to a stand-alone resource or a contained resource within the Immunization resource.

                                      ShortProduct that was administered
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension(Cross-version Extension for R5.Immunization.administeredProduct for use in FHIR R4) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)
                                      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())
                                      18. Immunization.extension:administeredProduct.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
                                      20. Immunization.extension:administeredProduct.extension
                                      Definition

                                      An Extension

                                      ShortExtension
                                      Control0..*
                                      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.extension. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 22. Immunization.extension:administeredProduct.extension:concept
                                        Slice Nameconcept
                                        Definition

                                        A reference to a concept - e.g. the information is identified by its general class to the degree of precision found in the terminology.

                                        ShortReference to a concept (by class)
                                        Control0..1
                                        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())
                                        24. Immunization.extension:administeredProduct.extension:concept.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
                                        26. Immunization.extension:administeredProduct.extension:concept.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.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 28. Immunization.extension:administeredProduct.extension:concept.url
                                          Definition

                                          Source of the definition for the extension code - a logical name or a URL.

                                          Shortidentifies the meaning of the extension
                                          Comments

                                          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                          Control1..1
                                          Typeuri
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          Fixed Valueconcept
                                          30. Immunization.extension:administeredProduct.extension:concept.value[x]
                                          Definition

                                          A reference to a concept - e.g. the information is identified by its general class to the degree of precision found in the terminology.

                                          ShortReference to a concept (by class)
                                          Control0..1
                                          TypeCodeableConcept
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          32. Immunization.extension:administeredProduct.extension:reference
                                          Slice Namereference
                                          Definition

                                          An Extension

                                          ShortExtension
                                          Control0..1
                                          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())
                                          34. Immunization.extension:administeredProduct.extension:reference.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.extension:administeredProduct.extension:reference.extension
                                          Definition

                                          An Extension

                                          ShortExtension
                                          Control0..0
                                          TypeExtension
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          SlicingThis element introduces a set of slices on Immunization.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 38. Immunization.extension:administeredProduct.extension:reference.url
                                            Definition

                                            Source of the definition for the extension code - a logical name or a URL.

                                            Shortidentifies the meaning of the extension
                                            Comments

                                            The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                            Control1..1
                                            Typeuri
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            Fixed Valuereference
                                            40. Immunization.extension:administeredProduct.extension:reference.value[x]
                                            Definition

                                            A reference to a resource the provides exact details about the information being referenced.

                                            ShortReference to a resource (by instance)
                                            Control0..1
                                            TypeReference(Medication (EU core))
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            42. Immunization.extension:administeredProduct.extension:_datatype
                                            Slice Name_datatype
                                            Definition

                                            Data type name for Immunization.administeredProduct from FHIR R5

                                            ShortData type name for Immunization.administeredProduct from FHIR R5
                                            Control0..1
                                            TypeExtension(Datatype) (Extension Type: string)
                                            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())
                                            44. Immunization.extension:administeredProduct.extension:_datatype.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
                                            This element is affected by the following invariants: ele-1
                                            Typeid
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            46. Immunization.extension:administeredProduct.extension:_datatype.extension
                                            Definition

                                            An Extension

                                            ShortExtension
                                            Control0..0
                                            TypeExtension
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            SlicingThis element introduces a set of slices on Immunization.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 48. Immunization.extension:administeredProduct.extension:_datatype.url
                                              Definition

                                              Source of the definition for the extension code - a logical name or a URL.

                                              Shortidentifies the meaning of the extension
                                              Comments

                                              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                              Control1..1
                                              Typeuri
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              Fixed Valuehttp://hl7.org/fhir/StructureDefinition/_datatype
                                              50. Immunization.extension:administeredProduct.extension:_datatype.value[x]
                                              Definition

                                              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                              ShortValue of extension
                                              Comments

                                              Must be: CodeableReference

                                              Control1..1
                                              This element is affected by the following invariants: ext-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
                                              Summaryfalse
                                              Fixed ValueCodeableReference
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              52. Immunization.extension:administeredProduct.url
                                              Definition

                                              Source of the definition for the extension code - a logical name or a URL.

                                              Shortidentifies the meaning of the extension
                                              Comments

                                              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                              Control1..1
                                              Typeuri
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-Immunization.administeredProduct
                                              54. Immunization.extension:administeredProduct.value[x]
                                              Definition

                                              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                              ShortValue of extension
                                              Control0..0
                                              TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                              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()))
                                              56. 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())
                                              58. Immunization.identifier
                                              Definition

                                              A unique identifier assigned to this immunization record.

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

                                              Indicates the current status of the immunization event.

                                              ShortImmunization status.
                                              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
                                              Obligations
                                                ObligationsActor
                                                SHALL:populate-if-knownCreator (IPS)
                                                SHALL:handleConsumer (IPS)
                                                SHOULD:displayConsumer (IPS)
                                                Summarytrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                62. Immunization.statusReason
                                                Definition

                                                Indicates the reason the immunization event was not performed.

                                                ShortReason for not performing.
                                                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
                                                BindingFor example codes, see ImmunizationStatusReasonCodes
                                                (example to http://hl7.org/fhir/ValueSet/immunization-status-reason|4.0.1)

                                                The reason why a vaccine was not administered.

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

                                                Vaccine that was administered or was to be administered.

                                                ShortVaccine product administered
                                                Control1..1
                                                BindingThe codes SHOULD be taken from Vaccines - IPS
                                                (preferred to http://hl7.org/fhir/uv/ips/ValueSet/vaccines-uv-ips)

                                                The type of vaccine for particular disease or diseases against which the patient has been immunised, or a code for absent/unknown immunization.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Obligations
                                                  ObligationsActor
                                                  SHALL:populate-if-knownCreator (IPS)
                                                  SHALL:handleConsumer (IPS)
                                                  SHOULD:displayConsumer (IPS)
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  66. Immunization.patient
                                                  Definition

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

                                                  ShortWho was immunized
                                                  Control1..1
                                                  TypeReference(Patient (EU core))
                                                  Is Modifierfalse
                                                  Obligations
                                                    ObligationsActor
                                                    SHALL:populate-if-knownCreator (IPS)
                                                    SHALL:handleConsumer (IPS)
                                                    SHOULD:displayConsumer (IPS)
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    68. Immunization.patient.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
                                                    70. Immunization.patient.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.patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 72. Immunization.patient.reference
                                                      Definition

                                                      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                      ShortLiteral reference, Relative, internal or absolute URL
                                                      Comments

                                                      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                      Control0..1
                                                      This element is affected by the following invariants: ref-1
                                                      Typestring
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Obligations
                                                        ObligationsActor
                                                        SHALL:populate-if-knownCreator (IPS)
                                                        SHALL:handleConsumer (IPS)
                                                        Summarytrue
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        74. Immunization.patient.type
                                                        Definition

                                                        The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                        The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                        ShortType the reference refers to (e.g. "Patient")
                                                        Comments

                                                        This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                        Control0..1
                                                        BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                        (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                                                        Aa resource (or, for logical models, the URI of the logical model).

                                                        Typeuri
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        76. Immunization.patient.identifier
                                                        Definition

                                                        An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                        ShortLogical reference, when literal reference is not known
                                                        Comments

                                                        When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                        When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                        Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                        Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

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

                                                        Plain text narrative that identifies the resource in addition to the resource reference.

                                                        ShortText alternative for the resource
                                                        Comments

                                                        This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                        Control0..1
                                                        Typestring
                                                        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()))
                                                        80. 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
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        82. Immunization.occurrence[x]
                                                        Definition

                                                        Date vaccine administered or was to be administered.

                                                        ShortDate of vaccination
                                                        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
                                                        Obligations
                                                          ObligationsActor
                                                          SHALL:populate-if-knownCreator (IPS)
                                                          SHALL:handleConsumer (IPS)
                                                          SHOULD:displayConsumer (IPS)
                                                          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
                                                          • 84. 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
                                                            Obligations
                                                              ObligationsActor
                                                              SHOULD:able-to-populateCreator (IPS)
                                                              SHALL:handleConsumer (IPS)
                                                              SHOULD:displayConsumer (IPS)
                                                              Summarytrue
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              86. Immunization.occurrence[x]:occurrenceDateTime.id
                                                              Definition

                                                              unique id for the element within a resource (for internal references)

                                                              Shortxml:id (or equivalent in JSON)
                                                              Control0..1
                                                              Typestring
                                                              Is Modifierfalse
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Summaryfalse
                                                              88. Immunization.occurrence[x]:occurrenceDateTime.extension
                                                              Definition

                                                              An Extension

                                                              ShortExtension
                                                              Control0..*
                                                              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.occurrence[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • value @ url
                                                              • 90. Immunization.occurrence[x]:occurrenceDateTime.extension:periodOfLife
                                                                Slice NameperiodOfLife
                                                                Definition

                                                                Extensions used to indicate a time period in a person's life as a reference to a coded value for that life period.

                                                                ShortMany: Periods of Life
                                                                Control0..1
                                                                This element is affected by the following invariants: ele-1
                                                                TypeExtension(Many: Periods of Life) (Extension Type: CodeableConcept)
                                                                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())
                                                                92. Immunization.occurrence[x]:occurrenceDateTime.extension:periodOfLife.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
                                                                94. Immunization.occurrence[x]:occurrenceDateTime.extension:periodOfLife.extension
                                                                Definition

                                                                An Extension

                                                                ShortExtension
                                                                Control0..0
                                                                TypeExtension
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                SlicingThis element introduces a set of slices on Immunization.occurrence[x].extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • value @ url
                                                                • 96. Immunization.occurrence[x]:occurrenceDateTime.extension:periodOfLife.url
                                                                  Definition

                                                                  Source of the definition for the extension code - a logical name or a URL.

                                                                  Shortidentifies the meaning of the extension
                                                                  Comments

                                                                  The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                  Control1..1
                                                                  Typeuri
                                                                  Is Modifierfalse
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  Summaryfalse
                                                                  Fixed Valuehttp://hl7.eu/fhir/extensions/StructureDefinition/periods-of-life
                                                                  98. Immunization.occurrence[x]:occurrenceDateTime.extension:periodOfLife.value[x]
                                                                  Definition

                                                                  Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                  ShortValue of extension
                                                                  Control0..1
                                                                  BindingThe codes SHOULD be taken from Periods of Life
                                                                  (preferred to http://hl7.eu/fhir/base/ValueSet/periodsOfLife-eu)
                                                                  TypeCodeableConcept
                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  100. Immunization.occurrence[x]:occurrenceDateTime.value
                                                                  Definition

                                                                  The actual value

                                                                  ShortPrimitive value for dateTime
                                                                  Control0..1
                                                                  TypedateTime
                                                                  Is Modifierfalse
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  Summaryfalse
                                                                  102. Immunization.recorded
                                                                  Definition

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

                                                                  ShortWhen the immunization was first captured in the subject's record
                                                                  Control0..1
                                                                  TypedateTime
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  104. 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()))
                                                                  106. 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|4.0.1)

                                                                  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()))
                                                                  108. Immunization.location
                                                                  Definition

                                                                  The service delivery location where the vaccine administration occurred.

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

                                                                  Name of vaccine manufacturer.

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

                                                                  Lot number of the vaccine product.

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

                                                                  Date vaccine batch expires.

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

                                                                  Body site where vaccine was administered.

                                                                  ShortBody site vaccine was administered
                                                                  Control0..1
                                                                  BindingFor example codes, see CodesForImmunizationSiteOfAdministration
                                                                  (example to http://hl7.org/fhir/ValueSet/immunization-site|4.0.1)

                                                                  The site at which the vaccine was administered.

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

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

                                                                  ShortHow vaccine entered body
                                                                  Control0..1
                                                                  BindingFor example codes, see ImmunizationRouteCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/immunization-route|4.0.1)

                                                                  The route by which the vaccine was administered.

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

                                                                  The quantity of vaccine product that was administered.

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

                                                                  Indicates who performed the immunization event.

                                                                  ShortWho performed event
                                                                  Control0..*
                                                                  TypeBackboneElement
                                                                  Is Modifierfalse
                                                                  Summarytrue
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  SlicingThis element introduces a set of slices on Immunization.performer. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                  • value @ $this.function
                                                                  • 124. 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
                                                                    126. 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())
                                                                    128. 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())
                                                                    130. 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|4.0.1)

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

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    132. 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(Practitioner, PractitionerRole, Organization)
                                                                    Is Modifierfalse
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    134. Immunization.performer:administeringCentreOrHp
                                                                    Slice NameadministeringCentreOrHp
                                                                    Definition

                                                                    Indicates who performed the immunization event.

                                                                    ShortAdministering centre
                                                                    Control0..*
                                                                    TypeBackboneElement
                                                                    Is Modifierfalse
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    136. Immunization.performer:administeringCentreOrHp.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
                                                                    138. Immunization.performer:administeringCentreOrHp.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())
                                                                    140. Immunization.performer:administeringCentreOrHp.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())
                                                                    142. Immunization.performer:administeringCentreOrHp.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|4.0.1)

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

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Summarytrue
                                                                    Pattern Value{
                                                                      "coding" : [{
                                                                        "system" : "http://terminology.hl7.org/CodeSystem/v2-0443",
                                                                        "code" : "AP"
                                                                      }]
                                                                    }
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    144. Immunization.performer:administeringCentreOrHp.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(Organization (EU core), PractitionerRole (EU core), Practitioner (EU core))
                                                                    Is Modifierfalse
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    146. 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()))
                                                                    148. Immunization.reasonCode
                                                                    Definition

                                                                    Reasons why the vaccine was administered.

                                                                    ShortReasons for the administration.
                                                                    Control0..*
                                                                    BindingFor example codes, see ImmunizationReasonCodes
                                                                    (example to http://hl7.org/fhir/ValueSet/immunization-reason|4.0.1)

                                                                    The reason why a vaccine was administered.

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

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

                                                                    ShortWhy immunization occurred
                                                                    Control0..*
                                                                    TypeReference(Condition, Observation, DiagnosticReport)
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    152. 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()))
                                                                    154. 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|4.0.1)

                                                                    The reason why a dose is considered to be subpotent.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    156. 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())
                                                                    158. 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
                                                                    160. 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())
                                                                    162. 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())
                                                                    164. 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()))
                                                                    166. 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()))
                                                                    168. 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()))
                                                                    170. 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()))
                                                                    172. 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|4.0.1)

                                                                    The patient's eligibility for a vaccation program.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    174. 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|4.0.1)

                                                                    The source of funding used to purchase the vaccine administered.

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

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

                                                                    ShortDetails of a reaction that follows immunization
                                                                    Comments

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

                                                                    Control0..*
                                                                    TypeBackboneElement
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    178. 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
                                                                    180. 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())
                                                                    182. 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())
                                                                    184. Immunization.reaction.date
                                                                    Definition

                                                                    Date of reaction to the immunization.

                                                                    ShortWhen reaction started
                                                                    Control0..1
                                                                    TypedateTime
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    186. 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()))
                                                                    188. 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()))
                                                                    190. Immunization.protocolApplied
                                                                    Definition

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

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

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

                                                                    ShortUnique id for inter-element referencing
                                                                    Control0..1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    Summaryfalse
                                                                    194. Immunization.protocolApplied.extension
                                                                    Definition

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

                                                                    ShortAdditional content defined by implementations
                                                                    Comments

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

                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Alternate Namesextensions, user content
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    196. Immunization.protocolApplied.modifierExtension
                                                                    Definition

                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                    Comments

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

                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                    Summarytrue
                                                                    Requirements

                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                    Alternate Namesextensions, user content, modifiers
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    198. Immunization.protocolApplied.series
                                                                    Definition

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

                                                                    ShortName of vaccine series
                                                                    Control0..1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    200. Immunization.protocolApplied.authority
                                                                    Definition

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

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

                                                                    The vaccine preventable disease the dose is being administered against.

                                                                    ShortVaccine preventatable disease being targetted
                                                                    Control0..*
                                                                    BindingThe codes SHOULD be taken from Vaccine Target Diseases - IPS
                                                                    (preferred to http://hl7.org/fhir/uv/ips/ValueSet/target-diseases-uv-ips)

                                                                    The diseases against which the patient has been immunised

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

                                                                    Nominal position in a series.

                                                                    ShortDose Number
                                                                    Comments

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

                                                                    Control1..1
                                                                    TypeChoice of: positiveInt, string
                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    206. Immunization.protocolApplied.seriesDoses[x]
                                                                    Definition

                                                                    The recommended number of doses to achieve immunity.

                                                                    ShortNumber of doses
                                                                    Comments

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

                                                                    Control0..1
                                                                    TypeChoice of: positiveInt, string
                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))