XpanDH Hospital Discharge Report, published by XpanDH Project. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/xpandh-hdr/ and changes regularly. See the Directory of published versions

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Resource Profile: Xpandh Immunization Profile

This profile sets minimum expectations for the Immunization resource to record, search, and fetch immunization details. It is based on the Immunization profile and identifies the additional mandatory core elements, extensions, vocabularies and value sets which SHALL be present in the Immunization resource when using this profile.

Usage:

• Refer to this Resource Profile: Composition: Hospital Discharge Report

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

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

Name	Flags	Card.	Type	Description & Constraints
Immunization		0..*	Immunization	Immunization Profile dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	?!Σ	1..1	code	completed | entered-in-error | not-done Binding: ImmunizationStatusCodes (required): A set of codes indicating the current status of an Immunization. ele-1: All FHIR elements must have a @value or children
vaccineCode	Σ	1..1	CodeableConceptIPS	Vaccine that was administered or was to be administered.Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent / unknown code. Other coded information can be provided as well as: the IDMP Pharmaceutical Product Identifiers (PhPID), Medicinal Product Identifier (MPID), Packaged Medicinal Product Identifier (PCID), when available, or equivalent coded concepts; the WHO ATC codes; or any other kind of code that that identifies, classifies or cluster the administered product. Binding: Vaccines - IPS (preferred): The type of vaccine for particular disease or diseases against which the patient has been immunised, or a code for absent/unknown immunization. Additional Bindings Purpose Documentation Vaccines WHO ATC - IPS candidate For when WHO ATC code system is preferred ele-1: All FHIR elements must have a @value or children
patient	Σ	1..1	Reference(Patient: HDR)	Who was immunized ele-1: All FHIR elements must have a @value or children
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL ele-1: All FHIR elements must have a @value or children
occurrence[x]	Σ	1..1		Vaccine administration date ele-1: All FHIR elements must have a @value or children
occurrence[x]All Types				Content/Rules for all Types
Slices for extension				Content/Rules for all slices
data-absent-reason		0..1	code	occurrence[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
occurrenceDateTime			dateTime
occurrenceString			string
site		0..1	CodeableConceptIPS	Body site vaccine was administered Binding: SNOMEDCTBodyStructures (preferred) ele-1: All FHIR elements must have a @value or children
route		0..1	CodeableConceptIPS	How vaccine entered body Binding: Medicine Route of Administration - IPS (preferred) ele-1: All FHIR elements must have a @value or children
isSubpotent	?!Σ	0..1	boolean	Dose potency ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Immunization.status	required	ImmunizationStatusCodes http://hl7.org/fhir/ValueSet/immunization-status|4.0.1 from the FHIR Standard
Immunization.vaccineCode	preferred	VaccinesUvIps http://hl7.org/fhir/uv/ips/ValueSet/vaccines-uv-ips
Immunization.site	preferred	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Immunization.route	preferred	MedicineRouteOfAdministrationUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Immunization	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Immunization	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Immunization	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Immunization	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Immunization	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from Immunization

Name	Flags	Card.	Type	Description & Constraints
Immunization		0..*	Immunization	Immunization Profile
vaccineCode		1..1	CodeableConceptIPS	Vaccine that was administered or was to be administered.Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent / unknown code. Other coded information can be provided as well as: the IDMP Pharmaceutical Product Identifiers (PhPID), Medicinal Product Identifier (MPID), Packaged Medicinal Product Identifier (PCID), when available, or equivalent coded concepts; the WHO ATC codes; or any other kind of code that that identifies, classifies or cluster the administered product. Binding: Vaccines - IPS (preferred): The type of vaccine for particular disease or diseases against which the patient has been immunised, or a code for absent/unknown immunization. Additional Bindings Purpose Documentation Vaccines WHO ATC - IPS candidate For when WHO ATC code system is preferred
patient		1..1	Reference(Patient: HDR)	Who was immunized
reference		1..1	string	Literal reference, Relative, internal or absolute URL
occurrence[x]
Slices for extension				Content/Rules for all slices
data-absent-reason		0..1	code	occurrence[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
site		0..1	CodeableConceptIPS	Body site vaccine was administered Binding: SNOMEDCTBodyStructures (preferred)
route		0..1	CodeableConceptIPS	How vaccine entered body Binding: Medicine Route of Administration - IPS (preferred)
performer
actor		1..1	Reference(Practitioner | PractitionerRole | Xpandh Organization Profile)	Individual or organization who was performing
protocolApplied
targetDisease		0..*	CodeableConcept	Vaccine preventable disease being targeted Binding: Xpandh Immunization Target Disease or Agent (preferred): The particular disease or diseases against which the patient has been immunized.
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Immunization.vaccineCode	preferred	VaccinesUvIps http://hl7.org/fhir/uv/ips/ValueSet/vaccines-uv-ips
Immunization.site	preferred	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Immunization.route	preferred	MedicineRouteOfAdministrationUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration
Immunization.protocolApplied.targetDisease	preferred	ImmunicationTargetVS http://hl7.eu/fhir/ig/xpandh/hdr/ValueSet/immunization-target-vs from this IG

Name	Flags	Card.	Type	Description & Constraints
Immunization		0..*	Immunization	Immunization Profile
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	Business identifier
status	?!Σ	1..1	code	completed | entered-in-error | not-done Binding: ImmunizationStatusCodes (required): A set of codes indicating the current status of an Immunization.
statusReason		0..1	CodeableConcept	Reason not done Binding: ImmunizationStatusReasonCodes (example): The reason why a vaccine was not administered.
vaccineCode	Σ	1..1	CodeableConceptIPS	Vaccine that was administered or was to be administered.Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent / unknown code. Other coded information can be provided as well as: the IDMP Pharmaceutical Product Identifiers (PhPID), Medicinal Product Identifier (MPID), Packaged Medicinal Product Identifier (PCID), when available, or equivalent coded concepts; the WHO ATC codes; or any other kind of code that that identifies, classifies or cluster the administered product. Binding: Vaccines - IPS (preferred): The type of vaccine for particular disease or diseases against which the patient has been immunised, or a code for absent/unknown immunization. Additional Bindings Purpose Documentation Vaccines WHO ATC - IPS candidate For when WHO ATC code system is preferred
patient	Σ	1..1	Reference(Patient: HDR)	Who was immunized
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
encounter		0..1	Reference(Encounter)	Encounter immunization was part of
occurrence[x]	Σ	1..1		Vaccine administration date
occurrence[x]All Types				Content/Rules for all Types
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
data-absent-reason		0..1	code	occurrence[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
occurrenceDateTime			dateTime
occurrenceString			string
recorded		0..1	dateTime	When the immunization was first captured in the subject's record
primarySource	Σ	0..1	boolean	Indicates context the data was recorded in
reportOrigin		0..1	CodeableConcept	Indicates the source of a secondarily reported record Binding: ImmunizationOriginCodes (example): The source of the data for a record which is not from a primary source.
location		0..1	Reference(Location)	Where immunization occurred
manufacturer		0..1	Reference(Organization)	Vaccine manufacturer
lotNumber		0..1	string	Vaccine lot number
expirationDate		0..1	date	Vaccine expiration date
site		0..1	CodeableConceptIPS	Body site vaccine was administered Binding: SNOMEDCTBodyStructures (preferred)
route		0..1	CodeableConceptIPS	How vaccine entered body Binding: Medicine Route of Administration - IPS (preferred)
doseQuantity		0..1	SimpleQuantity	Amount of vaccine administered
performer	Σ	0..*	BackboneElement	Who performed event
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	Σ	0..1	CodeableConcept	What type of performance was done Binding: ImmunizationFunctionCodes (extensible): The role a practitioner or organization plays in the immunization event.
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Xpandh Organization Profile)	Individual or organization who was performing
note	Σ	0..*	Annotation	Additional immunization notes
reasonCode		0..*	CodeableConcept	Why immunization occurred Binding: ImmunizationReasonCodes (example): The reason why a vaccine was administered.
reasonReference		0..*	Reference(Condition | Observation | DiagnosticReport)	Why immunization occurred
isSubpotent	?!Σ	0..1	boolean	Dose potency
subpotentReason		0..*	CodeableConcept	Reason for being subpotent Binding: ImmunizationSubpotentReason (example): The reason why a dose is considered to be subpotent.
education	C	0..*	BackboneElement	Educational material presented to patient imm-1: One of documentType or reference SHALL be present
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
documentType		0..1	string	Educational material document identifier
reference		0..1	uri	Educational material reference pointer
publicationDate		0..1	dateTime	Educational material publication date
presentationDate		0..1	dateTime	Educational material presentation date
programEligibility		0..*	CodeableConcept	Patient eligibility for a vaccination program Binding: ImmunizationProgramEligibility (example): The patient's eligibility for a vaccation program.
fundingSource		0..1	CodeableConcept	Funding source for the vaccine Binding: ImmunizationFundingSource (example): The source of funding used to purchase the vaccine administered.
reaction		0..*	BackboneElement	Details of a reaction that follows immunization
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
date		0..1	dateTime	When reaction started
detail		0..1	Reference(Observation)	Additional information on reaction
reported		0..1	boolean	Indicates self-reported reaction
protocolApplied		0..*	BackboneElement	Protocol followed by the provider
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
series		0..1	string	Name of vaccine series
authority		0..1	Reference(Organization)	Who is responsible for publishing the recommendations
targetDisease		0..*	CodeableConcept	Vaccine preventable disease being targeted Binding: Xpandh Immunization Target Disease or Agent (preferred): The particular disease or diseases against which the patient has been immunized.
doseNumber[x]		1..1		Dose number within series
doseNumberPositiveInt			positiveInt
doseNumberString			string
seriesDoses[x]		0..1		Recommended number of doses for immunity
seriesDosesPositiveInt			positiveInt
seriesDosesString			string
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Immunization.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Immunization.status	required	ImmunizationStatusCodes http://hl7.org/fhir/ValueSet/immunization-status|4.0.1 from the FHIR Standard
Immunization.statusReason	example	ImmunizationStatusReasonCodes http://hl7.org/fhir/ValueSet/immunization-status-reason from the FHIR Standard
Immunization.vaccineCode	preferred	VaccinesUvIps http://hl7.org/fhir/uv/ips/ValueSet/vaccines-uv-ips
Immunization.patient.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Immunization.reportOrigin	example	ImmunizationOriginCodes http://hl7.org/fhir/ValueSet/immunization-origin from the FHIR Standard
Immunization.site	preferred	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Immunization.route	preferred	MedicineRouteOfAdministrationUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration
Immunization.performer.function	extensible	ImmunizationFunctionCodes http://hl7.org/fhir/ValueSet/immunization-function from the FHIR Standard
Immunization.reasonCode	example	ImmunizationReasonCodes http://hl7.org/fhir/ValueSet/immunization-reason from the FHIR Standard
Immunization.subpotentReason	example	ImmunizationSubpotentReason http://hl7.org/fhir/ValueSet/immunization-subpotent-reason from the FHIR Standard
Immunization.programEligibility	example	ImmunizationProgramEligibility http://hl7.org/fhir/ValueSet/immunization-program-eligibility from the FHIR Standard
Immunization.fundingSource	example	ImmunizationFundingSource http://hl7.org/fhir/ValueSet/immunization-funding-source from the FHIR Standard
Immunization.protocolApplied.targetDisease	preferred	ImmunicationTargetVS http://hl7.eu/fhir/ig/xpandh/hdr/ValueSet/immunization-target-vs from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Immunization	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Immunization	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Immunization	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Immunization	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Immunization	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
imm-1	error	Immunization.education	One of documentType or reference SHALL be present : documentType.exists() or reference.exists()

This structure is derived from Immunization

Summary

Mandatory: 1 element

Structures

This structure refers to these other structures:

• Codeable Concept (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips)
• Patient: HDR (http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/Patient-eu-xpandh)
• Practitioner (http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/Practitioner-eu-xpandh)
• PractitionerRole (http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/PractitionerRole-eu-xpandh)
• Xpandh Organization Profile (http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/organization-expandh)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/data-absent-reason

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Immunization		0..*	Immunization	Immunization Profile dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	?!Σ	1..1	code	completed | entered-in-error | not-done Binding: ImmunizationStatusCodes (required): A set of codes indicating the current status of an Immunization. ele-1: All FHIR elements must have a @value or children
vaccineCode	Σ	1..1	CodeableConceptIPS	Vaccine that was administered or was to be administered.Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent / unknown code. Other coded information can be provided as well as: the IDMP Pharmaceutical Product Identifiers (PhPID), Medicinal Product Identifier (MPID), Packaged Medicinal Product Identifier (PCID), when available, or equivalent coded concepts; the WHO ATC codes; or any other kind of code that that identifies, classifies or cluster the administered product. Binding: Vaccines - IPS (preferred): The type of vaccine for particular disease or diseases against which the patient has been immunised, or a code for absent/unknown immunization. Additional Bindings Purpose Documentation Vaccines WHO ATC - IPS candidate For when WHO ATC code system is preferred ele-1: All FHIR elements must have a @value or children
patient	Σ	1..1	Reference(Patient: HDR)	Who was immunized ele-1: All FHIR elements must have a @value or children
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL ele-1: All FHIR elements must have a @value or children
occurrence[x]	Σ	1..1		Vaccine administration date ele-1: All FHIR elements must have a @value or children
occurrence[x]All Types				Content/Rules for all Types
Slices for extension				Content/Rules for all slices
data-absent-reason		0..1	code	occurrence[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
occurrenceDateTime			dateTime
occurrenceString			string
site		0..1	CodeableConceptIPS	Body site vaccine was administered Binding: SNOMEDCTBodyStructures (preferred) ele-1: All FHIR elements must have a @value or children
route		0..1	CodeableConceptIPS	How vaccine entered body Binding: Medicine Route of Administration - IPS (preferred) ele-1: All FHIR elements must have a @value or children
isSubpotent	?!Σ	0..1	boolean	Dose potency ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Immunization.status	required	ImmunizationStatusCodes http://hl7.org/fhir/ValueSet/immunization-status|4.0.1 from the FHIR Standard
Immunization.vaccineCode	preferred	VaccinesUvIps http://hl7.org/fhir/uv/ips/ValueSet/vaccines-uv-ips
Immunization.site	preferred	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Immunization.route	preferred	MedicineRouteOfAdministrationUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Immunization	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Immunization	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Immunization	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Immunization	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Immunization	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Differential View

This structure is derived from Immunization

Name	Flags	Card.	Type	Description & Constraints
Immunization		0..*	Immunization	Immunization Profile
vaccineCode		1..1	CodeableConceptIPS	Vaccine that was administered or was to be administered.Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent / unknown code. Other coded information can be provided as well as: the IDMP Pharmaceutical Product Identifiers (PhPID), Medicinal Product Identifier (MPID), Packaged Medicinal Product Identifier (PCID), when available, or equivalent coded concepts; the WHO ATC codes; or any other kind of code that that identifies, classifies or cluster the administered product. Binding: Vaccines - IPS (preferred): The type of vaccine for particular disease or diseases against which the patient has been immunised, or a code for absent/unknown immunization. Additional Bindings Purpose Documentation Vaccines WHO ATC - IPS candidate For when WHO ATC code system is preferred
patient		1..1	Reference(Patient: HDR)	Who was immunized
reference		1..1	string	Literal reference, Relative, internal or absolute URL
occurrence[x]
Slices for extension				Content/Rules for all slices
data-absent-reason		0..1	code	occurrence[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
site		0..1	CodeableConceptIPS	Body site vaccine was administered Binding: SNOMEDCTBodyStructures (preferred)
route		0..1	CodeableConceptIPS	How vaccine entered body Binding: Medicine Route of Administration - IPS (preferred)
performer
actor		1..1	Reference(Practitioner | PractitionerRole | Xpandh Organization Profile)	Individual or organization who was performing
protocolApplied
targetDisease		0..*	CodeableConcept	Vaccine preventable disease being targeted Binding: Xpandh Immunization Target Disease or Agent (preferred): The particular disease or diseases against which the patient has been immunized.
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Immunization.vaccineCode	preferred	VaccinesUvIps http://hl7.org/fhir/uv/ips/ValueSet/vaccines-uv-ips
Immunization.site	preferred	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Immunization.route	preferred	MedicineRouteOfAdministrationUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration
Immunization.protocolApplied.targetDisease	preferred	ImmunicationTargetVS http://hl7.eu/fhir/ig/xpandh/hdr/ValueSet/immunization-target-vs from this IG

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Immunization		0..*	Immunization	Immunization Profile
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	Business identifier
status	?!Σ	1..1	code	completed | entered-in-error | not-done Binding: ImmunizationStatusCodes (required): A set of codes indicating the current status of an Immunization.
statusReason		0..1	CodeableConcept	Reason not done Binding: ImmunizationStatusReasonCodes (example): The reason why a vaccine was not administered.
vaccineCode	Σ	1..1	CodeableConceptIPS	Vaccine that was administered or was to be administered.Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent / unknown code. Other coded information can be provided as well as: the IDMP Pharmaceutical Product Identifiers (PhPID), Medicinal Product Identifier (MPID), Packaged Medicinal Product Identifier (PCID), when available, or equivalent coded concepts; the WHO ATC codes; or any other kind of code that that identifies, classifies or cluster the administered product. Binding: Vaccines - IPS (preferred): The type of vaccine for particular disease or diseases against which the patient has been immunised, or a code for absent/unknown immunization. Additional Bindings Purpose Documentation Vaccines WHO ATC - IPS candidate For when WHO ATC code system is preferred
patient	Σ	1..1	Reference(Patient: HDR)	Who was immunized
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
encounter		0..1	Reference(Encounter)	Encounter immunization was part of
occurrence[x]	Σ	1..1		Vaccine administration date
occurrence[x]All Types				Content/Rules for all Types
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
data-absent-reason		0..1	code	occurrence[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
occurrenceDateTime			dateTime
occurrenceString			string
recorded		0..1	dateTime	When the immunization was first captured in the subject's record
primarySource	Σ	0..1	boolean	Indicates context the data was recorded in
reportOrigin		0..1	CodeableConcept	Indicates the source of a secondarily reported record Binding: ImmunizationOriginCodes (example): The source of the data for a record which is not from a primary source.
location		0..1	Reference(Location)	Where immunization occurred
manufacturer		0..1	Reference(Organization)	Vaccine manufacturer
lotNumber		0..1	string	Vaccine lot number
expirationDate		0..1	date	Vaccine expiration date
site		0..1	CodeableConceptIPS	Body site vaccine was administered Binding: SNOMEDCTBodyStructures (preferred)
route		0..1	CodeableConceptIPS	How vaccine entered body Binding: Medicine Route of Administration - IPS (preferred)
doseQuantity		0..1	SimpleQuantity	Amount of vaccine administered
performer	Σ	0..*	BackboneElement	Who performed event
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	Σ	0..1	CodeableConcept	What type of performance was done Binding: ImmunizationFunctionCodes (extensible): The role a practitioner or organization plays in the immunization event.
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Xpandh Organization Profile)	Individual or organization who was performing
note	Σ	0..*	Annotation	Additional immunization notes
reasonCode		0..*	CodeableConcept	Why immunization occurred Binding: ImmunizationReasonCodes (example): The reason why a vaccine was administered.
reasonReference		0..*	Reference(Condition | Observation | DiagnosticReport)	Why immunization occurred
isSubpotent	?!Σ	0..1	boolean	Dose potency
subpotentReason		0..*	CodeableConcept	Reason for being subpotent Binding: ImmunizationSubpotentReason (example): The reason why a dose is considered to be subpotent.
education	C	0..*	BackboneElement	Educational material presented to patient imm-1: One of documentType or reference SHALL be present
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
documentType		0..1	string	Educational material document identifier
reference		0..1	uri	Educational material reference pointer
publicationDate		0..1	dateTime	Educational material publication date
presentationDate		0..1	dateTime	Educational material presentation date
programEligibility		0..*	CodeableConcept	Patient eligibility for a vaccination program Binding: ImmunizationProgramEligibility (example): The patient's eligibility for a vaccation program.
fundingSource		0..1	CodeableConcept	Funding source for the vaccine Binding: ImmunizationFundingSource (example): The source of funding used to purchase the vaccine administered.
reaction		0..*	BackboneElement	Details of a reaction that follows immunization
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
date		0..1	dateTime	When reaction started
detail		0..1	Reference(Observation)	Additional information on reaction
reported		0..1	boolean	Indicates self-reported reaction
protocolApplied		0..*	BackboneElement	Protocol followed by the provider
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
series		0..1	string	Name of vaccine series
authority		0..1	Reference(Organization)	Who is responsible for publishing the recommendations
targetDisease		0..*	CodeableConcept	Vaccine preventable disease being targeted Binding: Xpandh Immunization Target Disease or Agent (preferred): The particular disease or diseases against which the patient has been immunized.
doseNumber[x]		1..1		Dose number within series
doseNumberPositiveInt			positiveInt
doseNumberString			string
seriesDoses[x]		0..1		Recommended number of doses for immunity
seriesDosesPositiveInt			positiveInt
seriesDosesString			string
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Immunization.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Immunization.status	required	ImmunizationStatusCodes http://hl7.org/fhir/ValueSet/immunization-status|4.0.1 from the FHIR Standard
Immunization.statusReason	example	ImmunizationStatusReasonCodes http://hl7.org/fhir/ValueSet/immunization-status-reason from the FHIR Standard
Immunization.vaccineCode	preferred	VaccinesUvIps http://hl7.org/fhir/uv/ips/ValueSet/vaccines-uv-ips
Immunization.patient.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Immunization.reportOrigin	example	ImmunizationOriginCodes http://hl7.org/fhir/ValueSet/immunization-origin from the FHIR Standard
Immunization.site	preferred	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Immunization.route	preferred	MedicineRouteOfAdministrationUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration
Immunization.performer.function	extensible	ImmunizationFunctionCodes http://hl7.org/fhir/ValueSet/immunization-function from the FHIR Standard
Immunization.reasonCode	example	ImmunizationReasonCodes http://hl7.org/fhir/ValueSet/immunization-reason from the FHIR Standard
Immunization.subpotentReason	example	ImmunizationSubpotentReason http://hl7.org/fhir/ValueSet/immunization-subpotent-reason from the FHIR Standard
Immunization.programEligibility	example	ImmunizationProgramEligibility http://hl7.org/fhir/ValueSet/immunization-program-eligibility from the FHIR Standard
Immunization.fundingSource	example	ImmunizationFundingSource http://hl7.org/fhir/ValueSet/immunization-funding-source from the FHIR Standard
Immunization.protocolApplied.targetDisease	preferred	ImmunicationTargetVS http://hl7.eu/fhir/ig/xpandh/hdr/ValueSet/immunization-target-vs from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Immunization	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Immunization	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Immunization	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Immunization	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Immunization	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
imm-1	error	Immunization.education	One of documentType or reference SHALL be present : documentType.exists() or reference.exists()

This structure is derived from Immunization

Summary

Mandatory: 1 element

Structures

This structure refers to these other structures:

• Codeable Concept (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips)
• Patient: HDR (http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/Patient-eu-xpandh)
• Practitioner (http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/Practitioner-eu-xpandh)
• PractitionerRole (http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/PractitionerRole-eu-xpandh)
• Xpandh Organization Profile (http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/organization-expandh)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/data-absent-reason

Other representations of profile: CSV, Excel, Schematron